Northwell, New Hyde Park, New York; Division of Allergy and Immunology, Cohen Children's Medical Center, New Hyde Park, New York.
Biostatistics Unit, Office of Academic Affairs, Northwell Health, New Hyde Park, New York.
Ann Allergy Asthma Immunol. 2024 Aug;133(2):203-210.e6. doi: 10.1016/j.anai.2024.04.028. Epub 2024 Apr 30.
Immune regulation by gut microbiota is affected by dysbiosis and may precede food allergy onset. Prior studies lacked comparisons stratified by age and clinical phenotype.
To assess the microbiome of children with food allergy (<3 years, 3-18 years) compared with similar aged children without food allergy.
A real-world prospective cross-sectional study performed from 2014 to 2019 recruited children highly likely to have milk, egg, or peanut allergy defined by history and serum IgE or confirmed by food challenge. 16S ribosomal RNA sequencing identified stool microbial DNA. Alpha and beta diversity was compared between groups with food allergy and healthy controls stratified by age. Differential abundance for non a priori taxa was accepted at absolute fold-change greater than 2 and q value less than 0.05.
A total of 70 patients were included (56 with food allergy and 14 healthy controls). Groups were not significantly different in age, gender at birth, race, mode of delivery, breastfeeding duration, or antibiotic exposure. Younger children with food allergy had similar alpha diversity compared with controls. Beta diversity was significantly different by age (P = .001). There was differential abundance of several a priori (P < .05) taxa (including Clostridia) only in younger children. Both a priori (including Coprococcus and Clostridia) and non a priori (q < 0.05) Acidobacteria_Gp15, Aestuariispira, Tindallia, and Desulfitispora were significant in older children with food allergy, especially with peanut allergy.
Dysbiosis associates with food allergy, most prominent in older children with peanut allergy. Younger children with and without food allergy have fewer differences in gut microbiota. This correlates with clinical observations of persistence of peanut allergy and improved efficacy and safety of oral immunotherapy in younger children. Age younger than 3 years should be considered when initiating therapeutic interventions.
肠道微生物群的免疫调节受菌群失调的影响，并且可能先于食物过敏的发生。先前的研究缺乏按年龄和临床表型分层的比较。
评估食物过敏儿童（<3 岁、3-18 岁）与同龄无食物过敏儿童的微生物组。
这是一项 2014 年至 2019 年进行的真实世界前瞻性横断面研究，招募了由病史和血清 IgE 定义的或经食物激发试验确认的有极高可能患有牛奶、鸡蛋或花生过敏的儿童。16S 核糖体 RNA 测序鉴定粪便微生物 DNA。按年龄将有食物过敏和健康对照的组进行分层，比较两组之间的 alpha 和 beta 多样性。非先验分类群的差异丰度接受绝对倍数变化大于 2 和 q 值小于 0.05 的标准。
共纳入 70 例患者（56 例食物过敏，14 例健康对照）。两组在年龄、出生时的性别、种族、分娩方式、母乳喂养时间或抗生素暴露方面无显著差异。有食物过敏的年幼儿童与对照组相比具有相似的 alpha 多样性。按年龄分层，beta 多样性有显著差异（P=0.001）。仅在年幼儿童中存在几种先验（P<0.05）分类群的差异丰度（包括梭菌）。在有食物过敏的年长儿童中，包括普雷沃氏菌科和梭菌科）和非先验（q<0.05）的酸杆菌科_Gp15、Aestuariispira、Tindallia 和 Desulfitispora 均有显著差异，尤其是花生过敏的儿童。
菌群失调与食物过敏有关，在有花生过敏的年长儿童中最为明显。有和无食物过敏的年幼儿童的肠道微生物群差异较小。这与临床观察到的花生过敏持续存在以及在年幼儿童中口服免疫治疗的疗效和安全性提高相一致。在开始治疗干预时应考虑 3 岁以下年龄。
