The maternal gut microbiome during pregnancy and offspring allergy and asthma

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  • Yuan Gao
  • Ralph Nanan
  • Laurence Macia
  • Jian Tan
  • Luba Sominsky
  • Thomas P. Quinn
  • Martin O'Hely
  • Anne-Louise Ponsonby
  • Mimi L. K. Tang
  • Fiona Collier
  • Deborah H. Strickland
  • Poshmaal Dhar
  • Susanne Brix
  • Simon Phipps
  • Peter D. Sly
  • Sarath Ranganathan
  • Stokholm, Jakob
  • Kristiansen, Karsten
  • Lawrence E.K. Gray
  • Peter Vuillermin

Environmental exposures during pregnancy that alter both the maternal gut microbiome and the infant's risk of allergic disease and asthma include a traditional farm environment and consumption of unpasteurized cow's milk, antibiotic use, dietary fiber, and psychosocial stress. Multiple mechanisms acting in concert may underpin these associations and prime the infant to acquire immune competence and homeostasis following exposure to the extrauterine environment. Cellular and metabolic products of the maternal gut microbiome can promote the expression of microbial pattern recognition receptors, as well as thymic and bone marrow hematopoiesis relevant to regulatory immunity. At birth, transmission of maternally derived bacteria likely leverages this in utero programming to accelerate postnatal transition from a TH2- to TH1- and TH17-dominant immune phenotype and maturation of regulatory immune mechanisms, which in turn reduce the child's risk of allergic disease and asthma. Although our understanding of these phenomena is rapidly evolving, the field is relatively nascent, and we are yet to translate existing knowledge into interventions that substantially reduce disease risk in humans. Here, we review evidence that the maternal gut microbiome impacts the offspring's risk of allergic disease and asthma, discuss challenges and future directions for the field, and propose the hypothesis that maternal carriage of Prevotella copri during pregnancy decreases the offspring's risk of allergic disease via production of succinate, which in turn promotes bone marrow myelopoiesis of dendritic cell precursors in the fetus.

OriginalsprogEngelsk
TidsskriftJournal of Allergy and Clinical Immunology
Vol/bind148
Udgave nummer3
Sider (fra-til)669-678
ISSN0091-6749
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
Supported by National Health and Medical Research Council of Australia grants 1082307; 1147980; 1134812; 1166319. Disclosure of potential conflict of interest: M. O'Hely, A.-L. Ponsonby, M. L. K. Tang, F. Collier, S. Ranganathan, and P. Vuillermin have a financial interest in the biotech company Prevatex Pty Ltd, which seeks to develop technology regarding maternal and infant carriage of Prevotella copri (PCT2016905378; PCT/AU2019/050878). M. L. K. Tang is an inventor on the patent ?Methods and compositions for determining and for minimizing the likelihood of development of allergy in infants? (pending and licensed to Prevatex Limited).

Funding Information:
Supported by National Health and Medical Research Council of Australia grants 1082307 ; 1147980 ; 1134812 ; 1166319 .

Publisher Copyright:
© 2021 American Academy of Allergy, Asthma & Immunology

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