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文章:Can we predict future allergies from our infant gut microbiota?
Sensitization to food allergens is common during early life, affecting up to 28% of preschool children(学龄前的儿童多会发生食物过敏的情况). While 66–90% of infants outgrow their sensitization to egg and milk, respectively, and prevalence rates drop to around 2% by age 5(随着年龄的增长,这种情况有所减轻)。 文章“The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: areview”总结了小孩和青少年的食物过敏对于家庭的影响。为了提前进行预测以更早进行干预,文章“Skin prick test responses and allergen-specific IgE levels as predictors of peanut, egg,and sesame allergy in infants. ”总结了利用皮试检测IgE的水平以判断infants对于penaut、egg和sesame的过敏情况。随着新一代测序技术的发展,目前的趋势呈现为:more complete assessment of gut microbial communities during infancy enhances our ability to identify gut microbiome biomarkers which can predict future allergic disease.
有研究发现:
1)在European cohort的研究中,1个月大的infants,肠道菌群多样性的减少、Bacteroides含量的减少是atopic dermatitis的标志现象。如果母亲患有哮喘,infants的菌群多样性较少,在6岁时,具有较高风险的allergic sensitization。
2)在KOALA birth cohort study of 1000 infants中,1个月时肠道内繁殖有Clostridium difficile,则在2岁时会出现 atopic sensitization.
3)在18个月大时,诊断有atopic dermatitis的小孩体内会聚集Clostridium,而Bacteroides spp. 的含量则会下降。
4)在肠道生态出现紊乱的infants中,确定有food allergy.
5)在5个月大具有food allergy的infants中, Firmicutes含量较高、Bacteroidetes含量较低,菌群多样性未见到呈现变化。
6)在具有cow’s milk allergy的infants中,多发现有Clostridium coccoides、lactobacilli和其他的厌氧菌,同时具有较少量的bifidobacteria和enterobacteria.
7)food-sensitized infants are twice as likely to experience the “atopic march” to conditions such as atopic dermatitis, allergicrhinitis and asthma. 3个月时体内Bacteroidaceae含量的减少会在9个月时出现food sensitization.
在这些研究中有几个需要关注的情况:
1)不同的生育方式、不同的母乳喂养方式对infants中的菌群影响存在差异。
2)结果是不能通用的,每个国家的情况可能还不一致。A taxonomic marker that works well in Canada and Finland may not work well in Germanyor the USA. 为此有必要中国人群自己的数据集。
3)预测模型无论基于IgE或者是microbiota,效果都有待提高,或许很多症状的出现不是一个层面,一个维度的数据可以简单判断的,是一个综合的效应。
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