Tuesday, December 6, 2016

How Does the Infant #Microbiome Affect Allergy?

It seems everyone is trying to repopulate their intestines with "good bacteria" and to eat natural sources of probiotics like kambucha and kimchi.  Catch phrases with the term "microbiome" are in the news and magazines.  More and more of my patients are asking me about the influence of microbiomes (bacteria that naturally populate our body and live with us without harming us) on their health and more importantly on their allergies.  More of the conferences I attend have entire lectures focused on the microbiome.  I recently attended Advances in Autoimmunity at NYU Langone this was an exciting half day lecture series  with speakers from across the country entirely dedicated to talking about the role of bacteria and our immune system.  

Recent studies by researchers at the Henry Ford Health system point to variations in bacteria levels and varieties of bacteria as one of the factors influencing why some children get asthma and allergies and other's don't. They recently reported their findings in Nature Medicine in September.  They showed that variations and low leves of just four kinds of bacteria—Bifidobacteria, Lactobacillus, Faecalibacterium, and Akkermansi led to increased risk of asthma and allergies in children followed by the study to age 4. 

Studying gut bacteria since 2003, researchers at Henry Ford Health System, have been attempting to figure out why some children get asthma and allergies while others don't.   "We have been working for over a decade, trying to figure out why some children get asthma and allergies and some don't," said co-senior author Christine Cole Johnson, PhD, MPH.   There findings are provide more evidence of the role of the microbiome and the development of allergies.  

But were does the microbiome initially come from and does it really affect the development of allergies and other diseases?  

Birth and the MicrobiomeThe microbiome is initially formed at birth and infants are immediately populated with bacteria within a few minutes.  Infants are naturally populated with bacteria at birth from bacteria from their mother through a vaginal delivery.  But what if you have a C-section?  In a small study of 18 babies in Puerto Rico conducted by Maria Dmoniguez - Bello she showed that swabbing  babies delivered via c-section with the mom's vaginal fluids can offer the same benefit as being delivered vaginally.  The first three years of life are key in influencing bacteria that will be with us for the rest of our lives.

Breast Feeding and the Microbiome.  Breast feeding is another important way of transfering mom's bacteria to a new born.  Breast milk contains bacteria Weisella, Leuconostoc, Staphylococcus, Streptococcus, and Lactococcus; these bacteria are important in populating the infant gut. But it's not just the type of bacteria that breast milk supports, but the variety of bacteria. Our immune system loves diversity and this diversity appears to help teach our immune systems to function normally.   Breast milk is highly complex that contains compounds that help nourish these important bacteria. 

 Dog exposure and Infants: Gramercy Allergy loves dogs and here's another reason why- they are important for populating our immune system.  Living with a dog is another important way that infants are populated with bacteria.  These bacteria help "teach" infants what are safe and dangerous signals.  Multiple studies show us that the variations, types and numbers of bacteria living in infant guts affect the development of disease and allergies.  Other ways to influence the microbiome are living with a dog,  "Humans have co-evolved with microbes and as a result we rely on their genomes for certain critical functions. We believe this is particularly true during the earliest stages of human development," Lynch, one of the authors working with Dr. Cole at the  Henry Ford Health System, said. "But lifestyles have changed dramatically over the past several decades: We've significantly reduced our exposure to these environmental microbes our bodies rely on. Having a dog tracks the external environment into the home may be just one way to improve the breadth of microbes babies are exposed to in very early life."  says Lynch. 

Pacifiers and the Microbiome:  Other ways an infant's gut is populated is by  sucking on a pacifier to clean it rather than washing it off (Hesselmar, et al. "Pacifier Cleaning Practices and Risk of Allergy Development. Pediatrics, 2013), and avoidance of antibiotics in the first 2 years of life.  Researchers think that sucking the pacifier rather then cleaning it may transfer of harmless bacteria from their mouth to the child.  These Swedish children had less eczema.  

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