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Showing posts with label Microbiome and Allergies. Show all posts
Showing posts with label Microbiome and Allergies. Show all posts

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 Microbiome: The 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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Tuesday, October 13, 2015

Can You Prevent Allergy Prenatally?





Can You Prevent Allergies During Pregnancy?

Allergies are strongly influenced by genetics.  Did you know that a child has a 50% chance of having allergies their mom or dad have allergies; this increases up to 75% if both parents have allergies? Because of the strong influence of genes, many women with allergies ask me, “what can I do to prevent allergies in my baby?” 

Some believe that the diversity of bacteria living in our guts (our microbiome) influence the development of allergic disease (asthma, eczema and allergic rhinitis).  They hypothesis that these bacteria “teach” our immune systems how to differentiate safe from non-safe.  Changes to these bacteria may lead to dysfunctioning inmmune systems and thereby the development of allergies.  Using probiotics, the most popular being Lactobacillus, during and after pregnancy potentially can alter the development of allergies and asthma.
 
Probiotics in the Prevention of Allergy among Children in Trondheim, a group of researchers in Norway, wanted to look more into these question.  

Can Probiotics in Pregnancy Prevent the Development of Allergic Disease?
The Probiotics in the Prevention of Allergy among Children in Trondheim (ProPACT) study just released the follow up to their original study started in 2003.  They followed 415 pregnant women’s children from age 3 months to 6 years.  Moms were randomized to get milk with and without probiotics from 36 weeks gestation to 3 months after delivery.  

Can Probiotics Prevent Allergic Disease?
  • Researchers found that at 2 years of age, children who’s mom’s had received the milk fortified with probiotics had less eczema (OR 0.51, 95 % CI 0.30 – 0.87, p = 0.013).
  • At 2, there was no impact on asthma, allergic sensitization or allergic rhinitis/conjunctivitis
  • Follow up by questionnaire and exam at 6 years, 81 and 82 children (in the milk and milk with probiotic groups respectively) were re-assessed for the development of eczema, allergic sensitization asthma and allergic rhinoconjunctivitis.


What did They Find Out?
  • At age 6 there was a trend towards a reduction in eczema in school age children, but it was not statistically significant.

What’s the Bottom Line?
  • Perinatal supplementation with probiotics may prevent the onset of eczema, but has no effect on the development of asthma, allergic sensitization and allergic rhinitis/conjunctivitis.
  • The microbiome may have a role in the development and prevention of eczema.
  • We still have a lot to learn about prevention of allergic disease. Stay tuned to learn more about the microbiome and allergies.



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