Association between gut microbiota development and allergy in infants born during pandemic‐related social distancing restrictions

• Published in: Allergy (Copenhagen) Vol. 79; no. 7; pp. 1938 - 1951
• Main Authors: Korpela, Katri, Hurley, Sadhbh, Ford, Sinead Ahearn, Franklin, Ruth, Byrne, Susan, Lunjani, Nonhlanhla, Forde, Brian, Neogi, Ujjwal, Venter, Carina, Walter, Jens, Hourihane, Jonathan, O'Mahony, Liam, MCCallion, Naomi, Byrne, Aideen, White, Martin, Fitzsimons, John
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-07-2024
• Subjects: Age; Allergic diseases; allergy; Atopic dermatitis; Child, Preschool; Clostridia; Cohort Studies; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; environment; Environmental Exposure - adverse effects; Epidemiology; Feces; Feces - microbiology; Female; Food allergies; Food plants; Gastrointestinal Microbiome; Humans; Hypersensitivity - epidemiology; Hypersensitivity - etiology; Infant; Infants; Information processing; Intestinal microflora; Male; Medicin och hälsovetenskap; Microbiota; Pandemics; Physical Distancing; Relative abundance; SARS-CoV-2; Skin diseases; Skin tests; Social distancing; Weaning; microbiota; allergy; environment; infants; COVID‐19
• ISSN: 0105-4538; 1398-9995; 1398-9995
• DOI: 10.1111/all.16069

Background
Several hypotheses link reduced microbial exposure to increased prevalence of allergies. Here we capitalize on the opportunity to study a cohort of infants (CORAL), raised during COVID‐19 associated social distancing measures, to identify the environmental exposures and dietary factors that contribute to early life microbiota development and to examine their associations with allergic outcomes.
Methods
Fecal samples were sequenced from infants at 6 (n = 351) and repeated at 12 (n = 343) months, using 16S sequencing. Published 16S data from pre‐pandemic cohorts were included for microbiota comparisons. Online questionnaires collected epidemiological information on home environment, healthcare utilization, infant health, allergic diseases, and diet. Skin prick testing (SPT) was performed at 12 (n = 343) and 24 (n = 320) months of age, accompanied by atopic dermatitis and food allergy assessments.
Results
The relative abundance of bifidobacteria was higher, while environmentally transmitted bacteria such as Clostridia was lower in CORAL infants compared to previous cohorts. The abundance of multiple Clostridia taxa correlated with a microbial exposure index. Plant based foods during weaning positively impacted microbiota development. Bifidobacteria levels at 6 months of age, and relative abundance of butyrate producers at 12 months of age, were negatively associated with AD and SPT positivity. The prevalence of allergen sensitization, food allergy, and AD did not increase over pre‐pandemic levels.
Conclusions
Environmental exposures and dietary components significantly impact microbiota community assembly. Our results also suggest that vertically transmitted bacteria and appropriate dietary supports may be more important than exposure to environmental microbes alone for protection against allergic diseases in infancy.
This study examines the environmental exposures and dietary factors that contribute to early life microbiota development, and their associations with allergic outcomes, in infants raised during COVID‐19 associated social distancing measures (CORAL cohort). Bifidobacteria are higher and clostridia are lower compared to pre‐pandemic cohorts. Breastfeeding, plant based weaning foods, siblings, rural environment, pets, and smoking in the home associated with different microbiota patterns. Bifidobacteria and SCFA‐producing microbes may be important to prevent allergies. Abbreviations: AD, atopic dermatitis; CORAL, Impact of CORona Virus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdow; COVID‐19, coronavirus disease 2019; SCFA, short chain fatty acid; seq, sequencing; SPT, skin prick test.