Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study
Open accessAbstract
BACKGROUND AND AIMS: Perturbations in intestinal microbiota composition due to lifestyle changes may be involved in the development of atopic diseases. We examined gut microbiota composition in early infancy and the subsequent development of atopic manifestations and sensitisation. METHODS: The faeces of 957 infants aged 1 month and participating in the KOALA Birth Cohort Study were analysed using quantitative real-time PCR. Information on atopic symptoms (eczema, wheeze) and potential confounders was acquired through repeated questionnaires. Total and specific IgE were measured in venous blood samples collected during home visits when the infant was 2 years old. During these home visits a clinical diagnosis of atopic dermatitis was made according to the UK-Working Party criteria. RESULTS: The presence of Escherichia coli was associated with a higher risk of developing eczema (OR(adj) = 1.87; 95% CI 1.15 to 3.04), this risk being increased with increasing numbers of E coli (p(for trend) = 0.016). Infants colonised with Clostridium difficile were at higher risk of developing eczema (OR(adj) = 1.40; 95% CI 1.02 to 1.91), recurrent wheeze (OR(adj) = 1.75; 95% CI 1.09 to 2.80) and allergic sensitisation (OR(adj) = 1.54; 95% CI 1.02 to 2.31). Furthermore, the presence of C difficile was also associated with a higher risk of a diagnosis of atopic dermatitis during the home visit (OR(adj) = 1.73; 95% CI 1.08 to 2.78). CONCLUSION: This study demonstrates that differences in gut microbiota composition precede the development of atopy. Since E coli was only associated with eczema and C difficile was associated with all atopic outcomes, the underlying mechanisms explaining these association may be different.
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Presence of Clostridium difficile at 1 month of age is associated with increased risk for allergic sensitization (OR 1.54; 95% CI 1.09-2.31) until age 2.
“Penders et al.447 found that the presence of Clostridium difficile at 1 month of age was associated with an increased risk for allergic sensitization (odds ratio [OR] 1.54; 95% confidence interval [CI], 1.09 to 2.31) until the age of 2 years.”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [447]
The Results report that C. difficile colonisation at 1 month was associated with atopic sensitisation within the first 2 years of life, with an adjusted OR of 1.54. The cited confidence interval is incorrect: the Results give 95% CI 1.02–2.31, not 1.09–2.31. No page number is provided in our copy. (LLM, conf=0.93)
Experimental — accuracy not yet measuredThe evidence supports a link between early-life microbiota composition or antibiotic use and later metabolic and immune function, specifically overweight/obesity and asthma/allergy.
“The evidence supports a link between early-life microbiota composition, or antibiotic use, and later metabolic and immune function (specifically overweight/obesity and asthma/allergy; Abrahamsson et al., 2014;Azad et al., 2014;Penders et al., 2007;Sjogren et al., 2009;Stanislawski et al., 2018a;Sugino et al., 2019).”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Penders et al., 2007
The Abstract (page unavailable in our copy) reports that gut microbiota composition at one month was associated with eczema, recurrent wheeze and allergic sensitisation during the first two years. The discussion (page unavailable) says antibiotic therapy can perturb infant gut microbiota, but this study does not establish an antibiotic-use link to those later outcomes. It does not report overweight or obesity outcomes, and describes asthma as a possible outcome requiring longer follow-up. (LLM, conf=0.87)
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- Authors
- Penders, J., Thijs, C., van den Brandt, P. A., Kummeling, I., Snijders, B., Stelma, F., Adams, H., van Ree, R., & Stobberingh, E. E.
- Affiliations
- Maastricht University (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Penders, J.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2007-05-01
- Volume
- 56
- Issue
- 5
- Pages
- 661-667
- ISSN
- 0017-5749 (ISSN-L)
- PMC
- PMC1942165
- OpenAlex
- W2167142729
- Cited by
- 844
- References
- 62
- Citations by year
- 2026: 19 · 2025: 38 · 2024: 28 · 2023: 43 · 2022: 42 · 2021: 42 · 2020: 46 · 2019: 55 · 2018: 50 · 2017: 47 · 2016: 64 · 2015: 42 · 2014: 56 · 2013: 48 · 2012: 48
- FWCI
- 12.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- gut microbiota, atopic dermatitis, wheezing, atopic sensitization, Escherichia coli, Clostridium difficile, fecal microbiota, early infancy
- MeSH terms
- Bacteria, Dermatitis, Atopic, DNA, Bacterial, Escherichia coli, Feces, Female, Follow-Up Studies, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Infant, Male, Prospective Studies, Respiratory Hypersensitivity, Respiratory Sounds, Polymerase Chain Reaction, Clostridioides difficile
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