Reviews and feature articleAssociation between the intestinal microbiota and allergic sensitization, eczema, and asthma: A systematic review
Section snippets
Systematic review methods
A systematic search of MEDLINE was done in April 2018 using the OVID interface from 1946 to present the following search terms: (eczema OR dermatitis, atopic OR asthma OR hypersensitivity OR immunoglobulin) AND (microbio* OR biodiversity OR DNA, bacterial OR 16S rRNA OR metagenom* OR Lactobacillus OR Bacteroid* OR Bifidobacter* OR feces OR faeces OR meconium OR intestin* OR stool OR gut). These terms were used without language limitations. This identified 1747 studies, of which 42 were original
Systematic review results
Our review resulted in a total of 47 studies reporting results from 11,954 stool samples from 3,071 children with allergic sensitization, eczema, or asthma and from 3,606 control subjects (Table I).7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53 Forty-two (89%) of the 47 studies were done in industrialized countries. The number of children in each study ranged
Results
Associations found between the intestinal microbiota and allergic sensitization, eczema, and asthma are summarized in Table III.† A total of 162 findings were reported (excluding diversity) on different bacterial taxonomic levels: phyla (16S rRNA gene sequencing, 3 findings), family (53 findings; 16S rRNA gene sequencing, 51
Discussion
The intestinal microbiota plays a crucial role in maturation of the immune system in early life. During the preweaning period, the immune system learns to recognize commensal microbiota as a critical step in immunotolerance. Predisposition to allergic disease and asthma starts very early in life. One of the most plausible theories for the increase in allergic sensitization, eczema, and asthma in industrialized countries is that early exposure to microbial immune stimulation and a greater
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P.Z. is supported by a Fellowship from the European Society of Paediatric Infectious Diseases and an International Research Scholarship from the University of Melbourne.
Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.