The Neonatal Microbiome and Its Partial Role in Mediating the Association between Birth by Cesarean Section and Adverse Pediatric Outcomes.
Neonatology. 2018 May 22;114(2):103-111
Authors: Montoya-Williams D, Lemas DJ, Spiryda L, Patel K, Carney OO, Neu J, Carson TL
BACKGROUND: Cesarean sections (CS) are among the most commonly performed surgical procedures in the world. Epidemiologic data has associated delivery by CS with an increased risk of certain adverse health outcomes in children, such as asthma and obesity.
OBJECTIVE: To explore what is known about the effect of mode of delivery on the development of the infant microbiome and discuss the potentially mediating role of CS-related microbial dysbiosis in the development of adverse pediatric health outcomes. Recommendations for future inquiry are also provided.
METHODS: This study provides a narrative overview of the literature synthesizing the findings of literature retrieved from searches of PubMed and other computerized databases and authoritative texts.
RESULTS: Emerging evidence suggests that mode of delivery is involved in the development of the neonatal microbiome and may partially explain pediatric health outcomes associated with birth by CS. Specifically, the gut microbiome of vaginally delivered infants more closely resembles their mothers' vaginal microbiome and thus more commonly consists of potentially beneficial microbiota such as Lactobacillus, Bifidobacterium, and Bacteroides. Conversely, the microbiome of infants born via CS shows an increased prevalence of either skin flora or potentially pathogenic microbial communities such as Klebsiella, Enterococcus, and Clostridium.
CONCLUSIONS: Mode of delivery plays an important role in the development of the postnatal microbiome but likely tells only part of the story. More comprehensive investigations into all the pre- and perinatal factors that have the potential to contribute to the neonatal microbiome are warranted.
PMID: 29788027 [PubMed - as supplied by publisher]
The exhaled nitric oxide and mannitol test to predict exercise-induced bronchoconstriction.
Pediatr Int. 2018 May 22;:
Authors: Kim K, Cho HJ, Yoon JW, Choi SH, Sheen YH, Han M, Baek H
BACKGROUND: Exercise-induced bronchoconstriction (EIB) is diagnosed via exercise challenge on a treadmill. However, such testing requires complex equipment and sufficient healthcare resources. The fraction of exhaled nitric oxide (FeNO) test and mannitol bronchial provocation test (BPT) may serve as a surrogate of exercise testing.
METHODS: We compared the diagnostic utilities of the FeNO test and mannitol BPT in predicting EIB in asthmatic children. We retrospectively analysed data from 60 asthmatic children aged 6-16 years. We compared the exercise BPT results, FeNO levels, and mannitol BPT data.
RESULTS: All cases were divided into exercise-positive or -negative BPT groups (n=41, 19, respectively). Of the 41 exercise-positive patients, 32 and 9, respectively, were mannitol BPT-positive and -negative. Of the 19 exercise-negative patients, 9 and 10, respectively, were mannitol BPT-positive and -negative. The maximum %forced expiratory volume in 1 s (FEV1 ) decreases after exercise were positively correlated with the FeNO level (r=0.556, P<0.001), the mannitol response-dose ratio (RDR; r=0.416, P=0.001). The receiver operating characteristic (ROC) curve for the FeNO level discriminating between asthmatics with and without EIB had an area under the curve (AUC) of 0.771 (95% CI=0.643-0.870). The discriminatory ROC curve for the mannitol RDR had an AUC of 0.763 (95% CI=0.633-0.864). The AUCs of the FeNO level and mannitol RDR did not differ significantly.
CONCLUSIONS: EIB significantly correlated with both FeNO levels and mannitol BPT data. Since both methods similarly predicted EIB in asthmatic children, the simpler and safer FeNO test alone may be a clinically useful diagnostic tool. This article is protected by copyright. All rights reserved.
PMID: 29786927 [PubMed - as supplied by publisher]
Serum lipid levels are associated with allergic rhinitis, nasal symptoms, peripheral olfactory function, and nasal airway patency in children.
Allergy. 2018 May 22;:
Authors: Yon DK, Lee SW, Ha EK, Lee KS, Jung YH, Jee HM, Kim MA, Ahn JC, Sheen YH, Han MY
Extensive studies support the presence of links between dyslipidemia and allergic diseases, and there has been with particular emphasis on allergen sensitization1-3 , asthma2,4 , and atopic dermatitis (AD). Although evidence supporting a link of allergic rhinitis (AR) with dyslipidemia is limited and controversial2,3 , many researchers have focused on the relationship of obesity and rhinitis, rather than blood lipids.5 This study determined the association of different blood lipids with current rhinitis and rhinitis-related parameters, including nasal symptoms, peripheral olfactory function, and nasal volume. This article is protected by copyright. All rights reserved.
PMID: 29786875 [PubMed - as supplied by publisher]
Variants in genes coding for glutathione S-transferases and asthma outcomes in children.
Pharmacogenomics. 2018 May 22;:
Authors: Turner S, Francis B, Wani N, Vijverberg S, Pino-Yanes M, Mukhopadhyay S, Tavendale R, Palmer C, Burchard EG, Merid SK, Melén E, Maitland-van der Zee AH, The Pharmacogenomics In Childhood Asthma Consortium OBO
Our hypothesis was that children with mutations in genes coding for glutathione S-transferases (GST) have worse asthma outcomes compared with children with active type genotype. Data were collected in five populations. The rs1695 single nucleotide polymorphism (GSTP1) was determined in all cohorts (3692 children) and GSTM1 and GSTT1 null genotype were determined in three cohorts (2362 children). GSTT1 null (but not other genotypes) was associated with a minor increased risk for asthma attack and there were no significant associations between GST genotypes and asthma severity. Interactions between GST genotypes and SHS exposure or asthma severity with the study outcomes were nonsignificant. We find no convincing evidence that the GST genotypes studied are related to asthma outcomes.
PMID: 29785881 [PubMed - as supplied by publisher]
Cost effectiveness of vitamin c supplementation for pregnant smokers to improve offspring lung function at birth and reduce childhood wheeze/asthma.
J Perinatol. 2018 May 22;:
Authors: Yieh L, McEvoy CT, Hoffman SW, Caughey AB, MacDonald KD, Dukhovny D
OBJECTIVE: To determine the implications of supplemental vitamin C for pregnant tobacco smokers and its effects on the prevalence of pediatric asthma, asthma-related mortality, and associated costs.
STUDY DESIGN: A decision-analytic model built via TreeAge compared the outcome of asthma in a theoretical annual cohort of 480,000 children born to pregnant smokers through 18 years of life. Vitamin C supplementation (500 mg/day) with a standard prenatal vitamin was compared to a prenatal vitamin (60 mg/day). Model inputs were derived from the literature. Deterministic and probabilistic sensitivity analyses assessed the impact of assumptions.
RESULT: Additional vitamin C during pregnancy would prevent 1637 cases of asthma at the age of 18 per birth cohort of pregnant smokers. Vitamin C would reduce asthma-related childhood deaths and save $31,420,800 in societal costs over 18 years per birth cohort.
CONCLUSION: Vitamin C supplementation in pregnant smokers is a safe and inexpensive intervention that may reduce the economic burden of pediatric asthma.
PMID: 29785060 [PubMed - as supplied by publisher]