The Role of the Microbiome in Allergic Diseases

The mass of cells is 10% and the remaining 90% is the mass of the microbiome in the human body [1]. The microbiome is the aggregation of microbes and their genomes in a certain part of the body such as the gastrointestinal tract [2]. 90% of the gut microbiome consists of the colonization of the following phyla: Firmicutes, Bacteroides, Actinobacteria, Fusobacteria, Proteobacteria, and Verrucomicrobia [3,4].

The gastrointestinal tract does not contain any microorganisms at birth and the first colonization of the gut microbiome occurs during delivery [5]. The intestinal microbiota primarily consists of Bifidobacteria as well as Lactobacilli, Bacteroides, Proteobacteria and Actinobacteria in infants by vaginal delivery [6]. However, the intestinal microbiome of infants has more Escherichia coli as well as Clostridia, especially C. difficile, and less Bacteroides and Bifidobacteria when delivered by cesarean section [6]. Likewise, infants who are breastfeeding have a higher abundance of Bifidobacteria, whereas, in infants which are formula feeding, Bifidobacteria and Bacteroides as well as Clostridia and Staphylococci were determined in equal numbers [7]. In contrast, another experiment has shown that the intestinal flora of breastfed infants contain Bifidobacteria, Actinomyces, and Haemophilus while formula-fed infants contain Firmicutes and Bacteroidetes [8]. When the babies are started to feed solid foods, the intestinal flora will be getting dominant by the bacterial species which interact with carbohydrates, protein and fat utilization and synthesis of vitamins [9].

The first colonization of the intestinal tract will affect the gut microbiome in the coming years, because of the long-lasting effect on the population of microbes in the intestinal tract and the organism’s physiology [9]. The bacterial context of the intestinal flora of 3-year-old child is similar to an adult’s and stays stable until old age when the variety increases in the population of the microorganisms [10]. Many different factors affect the composition of the gut microbiome in the coming years after birth: diet, gender, geographic location, and ethnicity [8,9]. The gut microbiota is also affected by the use of antibiotics [11]. Antibiotics target pathogens and so, the related microbes in the gut microbiome [12]. Long-term use of antibiotics has a negative effect on intestinal flora [12]. The variety of microbiomes is effected and decreased by the use of antibiotics [11].

Allergic diseases have become a big problem in welfare societies [13]. Losing protective factors and the increase in risk factors in the environment promote the increasing generality of these diseases because alteration in the genotype cannot clarify the fast increase of generality of allergic diseases [14]. The first microbiome on the gastrointestinal tract has a significant role in the improvement of the natural and acquired immune systems [15]. Cesarean section delivery is a risk factor for the improvement of Ig-E-mediated diseases and other immune-mediated diseases [16][17]. Cesarean section delivery is related to the reduced variability and presence of Bacteroidetes phylum in the first year of life [18].

The changes in gut microbes influence immunity and could cause allergic diseases [19]. The gut microbiota has an important role as a functional barrier [20][21]. The breakdown of this barrier may cause sensitivity to allergens [22,23]. Alters in the use of antibiotics and in the diet can cause the derangement of the intestinal microbiome so, might cause the dysfunction of the immune system [24]. The intestinal microflora and the organism that has the intestinal flora (host) have a symbiotic relationship, while the intestinal microflora has been related to disease that is mediated by the immune system, such as allergic diseases and asthma [25].

Children living in urban areas have an important increased risk of having hay fever, asthma and eczema compared to children living in farming areas [26,27]. Some studies investigate that prenatal exposure has an effect on Ig-E-mediated diseases and estimate that exposure to a farming environment in the prenatal term has an important effect to decrease the frequency of allergic rhinitis, asthma and eczema  [28,29]. The hygiene hypothesis explains that the opposite proportion is between the frequency of hay fever and the older siblings [30]. Unhygienic touch by an infected older sibling or the mother who has infected older child transmits the infection to infants and this will cause the prevention of allergic diseases [31].

The World Health Organization and Food and Agriculture Organization of the United Nations describe probiotics as living microorganisms that have a good health effect when taken in an adequate amount [32]. There is a potential goodness of probiotics for the prevention of allergic diseases such as eczema in infants as stated by the World Allergy Organization [33]. For example, one strain, Lactobacillus rhamnosus (Lactobacillus GG, American Type Culture Collection 53103), has provided safe and effective allergy inflammation treatment at an early age [34]. In an experiment, Lactobacillus GG was given to mothers before birth for 2-4 weeks and infants who have a high risk of allergic diseases for 6 months [35]. Specific strains in local intestinal flora have an efficient effect on the physiology and immunology of the organism [35]. The time of interference and the condition of the gastrointestinal flora is important for the efficiency of probiotics [36].

Prebiotics are defined as a fermented product which could lead to a change in the composition of the intestinal microbiota and so, provides profit to organisms [37]. The fermentation product of some groups of bacteria could be substrates for another group of bacteria and this is included in the fermentation of prebiotics [38]. This cross-feeding and the complex communication in microbiota is essential for a healthy organism [38]. Prebiotic additions interacted with an important increase of fecal Bifidobacteria, however, not with any important changes in Lactobacilli [39]. In the first 6 months, the addition of prebiotics to milk decreased the infectious frequency in a group of infants [40]. The same group of infants taking prebiotic addition had decreased frequency of allergic symptoms in the coming 2 years [41]. After 5 years of study, the infant group which received prebiotic addition had an important decrease in allergic symptoms and atopic dermatitis compared to the placebo group [42].

To sum up, intestinal flora composition is affected by many different factors and the flora affects the mechanisms of different processes. Asthma, allergic diseases, and other diseases which are caused by the flora can be treated by enhancing the gastrointestinal microbiome.

References:

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Inspector: İrem ÖĞÜTÜCÜ

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