NEONATAL gut microbiota composition is significantly associated with the risk of developing food sensitisation (FS) and food allergy (FA), with Bifidobacterium-dominant enterotypes showing the lowest risk.
FS, a precursor to FA, often develops in early infancy and is influenced by various factors, including gut microbiota. This study aimed to identify distinct gut microbiota enterotypes and their relationship to FS and FA risk. Researchers combined data from two longitudinal birth-cohort studies in Japan, analysing gut microbiomes and short-chain fatty acid concentrations from 1-week-old to 7-year-old children and their mothers. The goal was to explore enterotype patterns and assess their association with FS and FA through multivariable regression models.
The analysis included 2563 microbiome samples and identified six distinct enterotypes. In 1-month-old children, gut microbiota, particularly Bifidobacterium, were more strongly associated with FS and FA risk than in 1-week-old infants. Enterotypes at 1 month were classified as Bacteroides-dominant, Klebsiella-dominant, or Bifidobacterium-dominant. The Bifidobacterium-dominant enterotype, characterised by the highest faecal propionate concentrations, was linked to the lowest risk of FS and FA, especially hen egg white sensitization. In one cohort, Bifidobacterium-dominant enterotypes at 2 years old reduced the risk of FS compared to Bacteroides-dominant (adjusted odds ratio [adjOR]: 0.10, 95% CI: 0.01-0.78) and Klebsiella-dominant enterotypes (adjOR: 0.10, 95% CI: 0.01-0.77). Similarly, in the second cohort, Bifidobacterium-dominant enterotypes at 9 months old showed a lower risk (vs Bacteroides-dominant, adjOR: 0.33, 95% CI: 0.11-0.91).
These findings highlight the potential of early gut microbiota modulation in reducing FS and FA risk. Bifidobacterium-dominant enterotypes appear protective, likely through their association with increased faecal propionate, a short-chain fatty acid with immunomodulatory properties. Future clinical strategies could focus on promoting beneficial microbiota, such as Bifidobacterium, in early infancy through dietary or probiotic interventions. Further research is needed to refine these interventions and integrate microbiome-based approaches into routine paediatric care.
Abigail Craig, EMJ
Reference
Shibata R et al. Neonatal gut microbiota and risk of developing food sensitization and allergy. J Allergy Clin Immunol. 2024; DOI: 10.1016/j.jaci.2024.10.029.
