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Min-Hye Kim1, Dong In Suh2
, Soo-Young Lee3, Yoon-Keun Kim4, Young-Joo Cho1, Sang-Heon Cho5
, Soo-Young Lee3, Yoon-Keun Kim4, Young-Joo Cho1, Sang-Heon Cho5
Abstract
Food allergy (FA) and atopic dermatitis (AD) are representative allergic diseases that begin early in life and result in considerable socioeconomic burden. While the pathophysiology and the optimal treatment modalities of these diseases are largely unknown, the role of microbes in health and disease are being highlighted. Recent advances in analyzing microbiome have enabled us to expand our research on impacts of the microbiome on the onset and course of FA and AD. Risk factors that are presumed to affect intestinal microbiome also modulate the onset of allergic diseases, which is more evident in AD than in FA. Considering animal studies, intestinal microbiota interacts with FA and the influence is bi-directional. The activation of regulatory T cell and the innate immune system is supposed to mediate the interaction. Regarding human studies, there exists the difference in the composition of microbiome between subjects with FA or AD and matched normal controls, which can further play as a predictive marker for later development of FA or AD. Probiotics are now investigated as a primary therapeutic agent or as an adjuvant tool for conventional therapies in preventing or modulating FA or AD. Currently, several reports on favorable outcomes become available, which should be replicated and backed up by large-scale studies with more detailed protocols.
Figures and Tables
Table 1
List of human microbiome studies on food allergy
| Researcher | Disease | Subjects | Design | Sample | Method | Key findings | Comments |
|---|---|---|---|---|---|---|---|
| Apostolou et al. (2001)32 | Atopic dermatitis | Adults 8 (sensitive) 9 (control) | Case-control | Feces | FISH probing | LGG-consumption resulted in Bifidobacteria (▲) in healthy but not in milk-sensitive subjects, as well as general (▲) in bacterial numbers. | Profile, therapeutic effects |
| Thompson-Chagoyan et al. (2010)27 | Cows milk allergy | Infants 46 (allergic) 46 (control) | Clinical trial | Feces | FISH probing | Comparison of faecal samples from cows milk protein allergic infants (baseline/ 6 months) showed count and proportion of Lactobacilli (▲), counts and proportions of Enterobacteria (▼) and Bifidobacteria (▼). | Profile longitudinal |
| Thompson-Chagoyan et al. (2011)73 | Cows milk allergy | Infants 46 (allergic) 46 (control) | Case-control | Feces | FISH probing | Milk-allergic infant faeces had Clostridium cocoides group (▲), Atopobium cluster (▲), and sum of proportions of the different bacterial groups (▲). | Profile mechanisms |
| Ling et al. (2014)31 | Food allergy | Infants 17 (IgE-mediated) 17 (non-IgE-mediated) 45 (control) | Case-control | Feces | 16S rRNA pyrosequencing | Infants with IgE-mediated food allergy had Clotridium sensu stricto (▲), Anaerobacter (▲), and Bacteroides (▼), Clostridium XVIII (▼). | Profile |
| Azad et al. (2015)29 | Child cohort participants | Infants 12 (sensitized) 154 (control) | Case-control | Feces | 16S rRNA next generation sequencing | Low gut microbiota richness and an elevated Enterobacteriaceae to Bacteroidanceae ratio in early infancy are linked with subsequent food sensitization. | Profile longitudinal |
| Tang et al. (2015)33 | Peanut allergy | Children 31 (case) 31 (placebo) | Observative | N/A | N/A | Probiotics and peanut oral immunotherapy has good efficacy. | Therapeutic effects |
| Chen et al. (2016)74 | Food sensitization | Children 23 (sensitized), 22 (control) | Cohort | Feces | 16S rRNA pyrosequencing | In sensitized groups, the number of Bacteroidetes (▼) and that of Firmicutes (▲). | Profile |
| Hua et al. (2016)30 | American gut project participants | Adults 1,879 | Case-control | Feces | 16S rRNA sequencing | American adults with allergies have diversity (▼), Clostridiales (▼), and Bacteroidales (▲) in their gut microbiota. | Profile |
| Berni Canani et al. (2016)28 | Cows milk allergy | Infants 19 (allergic) 20 (control) | Clinical trial | Feces | 16S rRNA sequencing | EHCF+LGG promote tolerance in milk allergic infants, in part, by influencing the strain-level bacterial community structure. | Profile, therapeutic effects |
Table 2
List of human microbiome studies on atopic dermatitis
| Source | Disease | Subejcts | Design | Sample | Method | Key findings | Comments |
|---|---|---|---|---|---|---|---|
| Dekio et al. (2007)49 | AD | Adults 13 (case) 10 (control) | Case-control | Skin swab | Terminal restriction fragment length polymorphism (T-RFLP) analysis of 16S rRNA genes | Stenotrophomonas maltophilia (▲) was detected significantly more commonly in AD patients, whilst Dietzia maris was detected significantly more commonly in normal controls | Profile |
| Penders et al. (2007)55 | AD | Infants 957 (koala birth cohort) | Cohort | Feces | Real time-PCR for bacterial DNA | The presence of Escherichia coli (▲) was associated with a higher risk of developing eczema (OR, 1.87; 95% CI, 1.15–3.04). Infants colonised with Clostridium difficile (▲) were at higher risk of developing eczema (OR, 1.40; 95% CI, 1.02–1.91) and diagnosis of atopic dermatitis during the home visit (OR, 1.73; 95% CI, 1.08–2.78). | Profile longitudinal |
| Wang et al. (2008)75 | AD | Infants 15 (case) 20 (control) | Case-control | Feces | T-RFLP, Temporal temperature gradient gel electrophoresis (TTGE) analysis of 16S rRNA genes | There is a reduced diversity (▼) in the early fecal microbiota of infants with atopic eczema during the first 18 months of life. | Profile longitudinal |
| Fierer et al. (2008)40 | Normal skin flora | Adults 51 (healthy control) | Observative | Skin swab (hand) | 16S rRNA gene pyrosequencing | Propionibacteria (32%), Streptococcus (17%), Staphylococcus (8%), Corynebacterium (4%), Lactobacillus (3%) were the most abundant genera on palm surfaces. | Profile |
| Grice et al. (2009)39 | Normal skin flora | Adults 10 (healthy control) | Observative | Skin swab and scraping | 16S rRNA gene sequencing | Propionibacteria species and staphylococci species predominated in sebaceous sites. | Profile |
| Corynebacteria species predominated in moist sites, although staphylococci species were also represented. A mixed population of bacteria resided in dry sites, with a greater prevalence of β-Proteobacteria and Flavobacteriales. | |||||||
| Dominguez-Bello et al. (2010)76 | Normal skin flora | Mother & neonates 4 (vaginal delivery) 6 (cesarian section) | Observative | Mothers' skin, oral mucosa, vagina, neonates' skin, oral mucosa, nasopharyngeal aspirate | 16S rRNA gene sequencing | Vaginally delivered infants acquired bacterial communities resembling their own mother's vaginal microbiota, dominated by Lactobacillus, Prevotella, Sneathia spp., and C-section infants harbored bacterial communities similar to those found on the skin surface, dominated by Staphylococcus, Corynebacterium, Propionibacterium spp. | Profile |
| De Filippo et al. (2010)51 | Normal gut flora | Children 15 (from burkina faso, africa) 15 (from florence, italy) | Observative | Feces | 16S rRNA gene sequencing | Burkina Faso children showed a significant enrichment in Bacteroidetes (▲) and depletion in Firmicutes (▼). Also, Enterobacteriaceae (Shigella and Escherichia) (▼) were significantly underrepresented in BF than in EU children. | Profile |
| Capone et al. (2011)38 | Normal skin flora | Infants 31 (healthy infants) 5 (healthy mothers) | Observative | Skin swab | 16S rRNA gene sequencing | Composition of cutaneous microbial communities evolves over the first year of life, showing increasing diversity with age. Although early colonization is dominated by staphylococci, their significant decline contributes to increased population evenness by the end of the first year. | Profile longitudinal |
| Human Microbiome Project Consortium (2012)16 | Normal skin flora | Aldults 242 (human microbiome project cohort) | Cohort | Oral cavity, skin, stool, vagina | 16S rRNA gene sequencing | Skin communities were dominated by one of Staphylococcus (Firmicutes), Propionibacterium, or Corynebacterium (Actinobacteria) with a continuum of oral organisms (Streptococcus) appearing in nares communities. | Profile |
| Kong et al. (2012)46 | AD | Children 12 (case) 11 (placebo) | Case-control | Skin swab and scraping | 16S rRNA gene sequencing | In AD, the proportion of Staphylococcus sequences, particularly S. aureus (▲) was greater during disease flares than at baseline or post-treatment, and correlated with worsened disease severity. S. epidermidis (▲) also significantly increased during flares. | |
| Increases in Streptococcus, Propionibacterium, and Corynebacterium species were observed following therapy. | |||||||
| Gosalbes et al. (2013)37 | AD | Infants 20 (term newborns) 2 (infants) 7 (pregnant women) | Observative | Feces, meconium | 16S rRNA gene sequencing | One of the types was less diverse, dominated by enteric bacteria (▲) and associated with a history of atopic eczema in the mother, whereas the second type was dominated by lactic acid bacteria (▲) and associated with respiratory problems in the infant. | Profile |
| Seite et al. (2014)44 | AD | Children & adults 49 (case) | Observative | Skin swab | 16S rRNA gene sequencing | Overabundance of Staphylococcus species (▲) and a decrease in bacterial diversity were observed on affected skin. After 84-days of emollient treatment, increased overall diversity and a decrease in the Staphylococcus and Stenotrophomonas species were observed in treatment responders. | Profile longitudinal |
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