Gallant Rachel, Reza Samiha, Wiemels Joseph L, Greaves Mel
Center for Genetic Epidemiology, Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, United States of America.
Pediatric Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
PLoS One. 2025 May 20;20(5):e0324167. doi: 10.1371/journal.pone.0324167. eCollection 2025.
Despite the different pathologies and genetic susceptibilities of childhood ALL, T1DM and allergies, these conditions share epidemiological risk factors related to timing of infectious exposures and acquisition of the gut microbiome in infancy. We have assessed whether lower microbiome diversity (Shannon Index) and shared genus/species profiles are associated with pediatric ALL, allergies, and T1DM.
Literature search was performed using PubMed, Embase, Cochrane, and Web of Science databases. Case-control, meta-analyses, and cohort studies were considered for inclusion. Inclusion criteria: (i) subjects age 1-18 years at diagnosis, (ii) reports effect of microbiome measured prior to/at time of diagnosis/first intervention (iii) outcome of ALL, allergies, asthma, or T1DM, (iv) English text. Exclusion criteria: (i) age < 1 or >18 years at diagnosis, (ii) Down Syndrome-associated ALL, (iii) non-English text, (iv) reviews, pre-print, or abstracts, (v) heavily biased studies. Abstract and full text screening were performed by two independent reviewers. Data extraction was performed by one reviewer following PRISMA guidelines. Data were pooled using a random-effects model. Eighty-eight studies were included in the analysis, with seventy-seven in the qualitative analysis and 54 in the meta-analysis. Cases were found to have lower alpha-diversity than controls in ALL (SMD:-0.78, 95%CI:-1.21, -0.34), T1DM (SMD:-1.26, 95%CI:-3.49, 0.96), eczema (SMD:-0.34, 95%CI:-0.56, -0.12), atopy (SMD:-0.06, 95%CI:-0.34, 0.22), asthma (SMD:-0.37, 95%CI:-1.16, 0.42), and food allergy (SMD:-0.11, 95%CI:-0.63, 0.41).
These results highlight similarities in the microbiome diversity and composition of children with ALL, T1DM, and allergies. This is compatible with a common risk factor related to immune priming in infancy and highlights the gut microbiome as a potentially modifiable risk factor and preventative strategy for these childhood diseases.
尽管儿童急性淋巴细胞白血病（ALL）、1型糖尿病（T1DM）和过敏症有着不同的病理和遗传易感性，但这些病症具有一些共同的流行病学风险因素，这些因素与婴儿期感染暴露的时间以及肠道微生物群的获得有关。我们评估了较低的微生物群多样性（香农指数）和共享的属/种谱是否与儿童ALL、过敏症和T1DM相关。
使用PubMed、Embase、Cochrane和Web of Science数据库进行文献检索。纳入病例对照研究、荟萃分析和队列研究。纳入标准：（i）诊断时年龄为1 - 18岁的受试者；（ii）报告在诊断前/诊断时/首次干预时测量的微生物群的影响；（iii）ALL、过敏症、哮喘或T1DM的结局；（iv）英文文本。排除标准：（i）诊断时年龄<1岁或>18岁；（ii）唐氏综合征相关的ALL；（iii）非英文文本；（iv）综述、预印本或摘要；（v）严重偏倚的研究。由两名独立评审员进行摘要和全文筛选。一名评审员按照PRISMA指南进行数据提取。使用随机效应模型汇总数据。88项研究纳入分析，77项纳入定性分析，54项纳入荟萃分析。发现ALL（标准化均值差：-0.78，95%置信区间：-1.21，-0.34）、T1DM（标准化均值差：-1.26，95%置信区间：-3.49，0.96）、湿疹（标准化均值差：-0.34，95%置信区间：-0.56，-0.12）、特应性（标准化均值差：-0.06，95%置信区间：-0.34，0.22）、哮喘（标准化均值差：-0.37，95%置信区间：-1.16，0.42）和食物过敏（标准化均值差：-0.11，95%置信区间：-0.63，0.41）病例的α多样性低于对照。
这些结果突出了ALL、T1DM和过敏症患儿在微生物群多样性和组成方面的相似性。这与婴儿期免疫启动的一个共同风险因素相符，并突出了肠道微生物群作为这些儿童疾病潜在可改变的风险因素和预防策略。
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