Hygiene Hypothesis: 10 years later. Christina Ciaccio MD, MSc Assistant Professor The University of Chicago

Transcription

1 Hygiene Hypothesis: 10 years later Christina Ciaccio MD, MSc Assistant Professor The University of Chicago

2 none Disclosures

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5 Definitions Microbe: Microscopic organism Microbiota: Microbial community

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8 Definition Antibiotic: An agent that destroys bacteria

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11 Definition Probiotic: Microbes that confer a health benefit to the host

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15 Definitions Microbiome: Collective genomes and gene products of resident microbes living in an environment

16 Lee YK and Mazmanian SK. Science 2010;330:

17 Microbiome Varies significantly between individuals Diet Environment Antibiotic use Age Varies significantly by body locations Dry skin Moist skin GI tract (mouth, colon)

18 Microbiome 100 trillion microbes in GI tract 3.3 million genes 1000s different species 4 phyla Actinobacteria (bifidobacteria, streptomyces) Bacteroidetes (bacteroides) Firmicutes (lactobacillus, clostridium, staph) Proteobacteria (escherichia, pseudomonas)

19 Microbiome Development Mode of birth delivery Hospitalization Diet Nature of Feeding Multiple other exposures

20 Dominguez-Bello MG et al. Proc Natl Acad Sci 2010;107:

21 Formula fed Harmsen HJ et al. J Pediatr Gastroenterol Nutr. 2000; 30:61-67

22 Breast-fed Harmsen HJ et al. J Pediatr Gastroenterol Nutr. 2000; 30:61-67

23 Wu GD. Science. 2011;334:

24 Definition Prebiotic: Substance that promotes growth of probiotics

25 Definition Symbiotic: prebiotic + probiotic

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28 Maslowski KM and Mackay CR. Nature 2011;12: 5-9

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31 Commensal bacteria protect against food allergen sensitization Andrew T. Stefka, Taylor Feehley, Prabhanshu Tripathi, Ju Qiu, Kathy McCoy, Sarkis K. Mazmanian, Melissa Y. Tjot, Goo-Young Seo, Severine Cao, Betty R. Theriault, Dionysios A. Antonopoulos, Liang Zhou, Eugene B. Chang, Yang-Xin Fu, and Cathryn R. Nagler

32 Andrew T. Stefka et al. PNAS 2014;111:

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34 A Clostridia-containing microbiota protects against sensitization to food allergens. Andrew T. Stefka et al. PNAS 2014;111:

35 Clostridia-induced IL-22 regulates allergen access to the bloodstream. Andrew T. Stefka et al. PNAS 2014;111:

36 Clostridia-induced IL-22 regulates allergen access to the bloodstream. Andrew T. Stefka et al. PNAS 2014;111:

37 Lactobacillus rhamnosus GG-supplemented formula expands butyrate-producing bacterial strains in food allergic infants 19 CMA 20 controls Extensively hydrolyzed cow s milk formula With or without Lactobacillus rhamnosus GG 6 months

38 Berni Canani, et al. ISME 2015; 151; epub

39 Berni Canani, et al. ISME 2015; 151; epub

40 Severity of atopic disease inversely correlates with intestinal microbiota diversity and butyrate producing bacteria Allergy Volume 70, Issue 2, pages , 13 JAN 2015 DOI: /all

41 Severity of atopic disease inversely correlates with intestinal microbiota diversity and butyrate producing bacteria Allergy Volume 70, Issue 2, pages , 13 JAN 2015 DOI: /all

42 Methods Kansas City Safe and Healthy Homes Program Approved by the local IRB Informed consent/permission/assent

43 Methods Inclusion criteria (KCHHP) Families with a child that has been diagnosed with asthma, chronic respiratory symptoms, chronic allergy symptoms, or other chronic symptoms affected by a home environment were living in the Kansas City area were staying at the same home at least four nights per week had lived in the same home for the past six months planned to live in the same home for the next 12 months and were from families with a total family income less than 80% of the Kansas City median family income

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45 ERMI Mold Specific Quantitiative PCR (MSQPCR)

46 Vesper et al. J Asthma. 2012: 50(2):155-61

47 Vesper et al. J Asthma. 2012: 50(2):155-61

48 ERMI Vesper et al. J Asthma. 2012: 50(2):155-61

49 ERMI Vesper et al. J Asthma. 2012: 50(2):155-61

50 Vesper et al. J Asthma. 2012: 50(2):155-61

51 Vesper et al. J Asthma. 2012: 50(2):155-61

52 Vesper et al. J Asthma. 2012: 50(2):155-61

53 Vesper et al. J Asthma. 2012: 50(2):155-61

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62 Questions? Eat food, mostly plants, not too much Exercise outside whenever possible