Atopic dermatitis and skin disease
Low diversity of the gut microbiota in infants with atopic eczema

https://doi.org/10.1016/j.jaci.2011.10.025Get rights and content

Background

It is debated whether a low total diversity of the gut microbiota in early childhood is more important than an altered prevalence of particular bacterial species for the increasing incidence of allergic disease. The advent of powerful, cultivation-free molecular methods makes it possible to characterize the total microbiome down to the genus level in large cohorts.

Objective

We sought to assess microbial diversity and characterize the dominant bacteria in stool during the first year of life in relation to atopic eczema development.

Methods

Microbial diversity and composition were analyzed with barcoded 16S rDNA 454-pyrosequencing in stool samples at 1 week, 1 month, and 12 months of age in 20 infants with IgE-associated eczema and 20 infants without any allergic manifestation until 2 years of age (ClinicalTrials.gov ID NCT01285830).

Results

Infants with IgE-associated eczema had a lower diversity of the total microbiota at 1 month (P = .004) and a lower diversity of the bacterial phylum Bacteroidetes and the genus Bacteroides at 1 month (P = .02 and P = .01) and the phylum Proteobacteria at 12 months of age (P = .02). The microbiota was less uniform at 1 month than at 12 months of age, with a high interindividual variability. At 12 months, when the microbiota had stabilized, Proteobacteria, comprising gram-negative organisms, were more abundant in infants without allergic manifestation (Empirical Analysis of Digital Gene Expression in R [edgeR] test: P = .008, q = 0.02).

Conclusion

Low intestinal microbial diversity during the first month of life was associated with subsequent atopic eczema.

Section snippets

Study design

The infants included in this study were part of a larger study in southeastern Sweden between 2001 and 2005 evaluating allergy prevention with the probiotic Lactobacillus reuteri ATCC 55730.14 In this study the infants received probiotics or placebo daily from day 1 to 3 until 12 months of age. Clinical follow-ups were done at 1, 3, 6, 12, and 24 months of age, and telephone interviews were done at 2, 4, 5, 8, 10, and 18 months of age. A questionnaire was completed on each occasion. Stool

Results

Infants with atopic eczema (ie, IgE-associated eczema) had a lower diversity of the total microbiota and the bacterial phylum Bacteriodetes and its genus Bacteroides at 1 month of age than infants who did not have any allergic manifestation during the 2 first years of life (Table II). The diversity of the phylum Proteobacteria, comprising gram-negative bacteria, was also reduced in the atopic infants, significantly so at 12 months of age (Table II). Furthermore, these phyla and genera differed

Discussion

Using the new high-throughput 16S-based molecular microbiology, we could confirm and extend previous findings that low intestinal diversity during the first month of life is associated with an increased risk of subsequent atopic disease.6, 9, 10 In contrast to previous studies, we could also show that the differences in diversity and relative abundance were attributed to specific bacterial phyla and genera, possibly because the sensitivity of our analyses was higher than in previous diversity

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    Supported by grants from BioGaia AB, Stockholm, Sweden; the Ekhaga Foundation, the Heart and Lung foundation; the Research Council for the South-East Sweden (grant no. F2000-106); the Olle Engqvist Foundation; the Swedish Asthma and Allergy Association; the Swedish Research Council; the University Hospital of Linköping; the Söderberg Foundation; and the Vårdal Foundation for Health Care Science and Allergy Research, Sweden.

    Disclosure of potential conflict of interest: B. Björkstén has received research support from BioGaia AB. M. C. Jenmalm has received lecture honoraria from BioGaia AB. The rest of the authors declare that they have no relevant conflicts of interest.

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