A new study demonstrates the evolution of the microbiome in childhood

It’s long been known that the gut and specifically the microbiome evolve over the course of our lives, starting in a fairly malleable state when we are very young, and becoming defined by the variety and type of food we eat, our genetic predispositions, our general health, and by our environments. Lack of fiber, obesity, imbalanced or picky diets, courses of antibiotics, stress levels, and exposure to toxins can all radically alter our guts over time. We’ve written extensively about how food sensitivities and food allergies can alter the microbiome, cause inflammation in the gut, and open the tight junctions between cells in the intestinal walls which can lead to systemic inflammation that affects other regions of the body. New research now takes a look at microbiome development in children, and how food allergies can affect it.

A recent study published in Annals of Allergy, Asthma and Immunology, and reported by Healio, details how food allergies in children can impact the microbiome for years to come. The study, begun in 2014, examined children allergic to the most common childhood allergies: peanuts, milk, and eggs. The study compared these groups to a control group over time, starting at less than three years and continuing until the children were eighteen. Through stool samples, the children were analyzed for bacterial composition in the gut throughout their development to assess the state of their microbiomes to answer not only the question of whether the children with allergies had microbiomes markedly different from those who did not but also as to whether there was any correlation between age of onset of the allergies and gut dysbiosis.

The results were interesting. There was indeed a difference between those children with food allergies and those without as far as biota populations in the microbiome went. The children without allergies had a range of natural flora, as expected. Those with allergies were missing categories of beneficial flora and had populations of flora linked with gut dysbiosis. These results were no surprise to us here at Precision Point- we’ve heard many such cases from practitioners over the years, and other data confirms this. What’s interesting is that this study was conducted over many years and tracked children throughout their childhood. What they found out about microbiome development could have implications when treating children with either allergies or various types of gut dysbiosis.

Toddlers, those younger than three, displayed remarkable plasticity in their gut microbiome. Allergies with onset at that age responded better over time to allergy therapy and were less likely to have severe allergies. They were also less likely to have damage to their microbiome at a young age. Toddlers, and above, were more likely to have severe allergies, less successful with immune therapy, and were more likely to be dysbiotic. The study author, Dr. Punita Ponda, MD, FACAAI, FAAAAI, associate division chief and associate professor of medicine and pediatrics at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell commented that “It is important to understand how age affects our tolerance to foods” and “Waiting after age 3 for introduction to foods may be incorrect since the microbiota would not be as pliable,” she noted. “There should be consideration of pro- and prebiotics in younger children who show atopic diseases or have a high-risk history of atopy.” and noted that more studies should be done on the latter point. 

So, this study informs us about allergens in children as driving dysbiosis in the microbiome, but it also gives context to the development of the microbiome through childhood. It would seem to demonstrate that early intervention in gut dysbiosis might benefit the child. As Danielle Crumble Smith, RDN noted in her analysis of the article, “From a professional standpoint, these findings align with the growing body of evidence suggesting that early intervention and modulation of the gut microbiome could prevent or mitigate the severity of food allergies. The study supports the notion of a “window of opportunity” in early childhood, during which the gut microbiome is particularly malleable and responsive to dietary changes and interventions.” and “Understanding that significant microbiome differences manifest with age, screening and early intervention for food allergies might become a more tailored approach based on individual microbiome assessments. Utilization of stool testing to assess microbial balance could help know which pathogens might be present and/or which beneficial microbes and short-chain fatty acids need to increase to support microbial health.” In addition, it appears that the longer that gut dysbiosis goes on, the more long-term damage to the gut is done. Early intervention coupled with continued screening is the approach to follow with children who may have gut dysbiosis or food allergies and sensitivities.

The commentary on “screening for food allergies” and the “utilization of stool testing to assess microbial balance” are both apropos. We’d add to that an assessment of the state of tight junctions in the intestinal walls by measuring zonulin as well as other assessments of gut permeability as a way to surveil microbiome and gut health in children. 

Precision Point Diagnostics offers a body of testing that meets these needs:

The P88 Dietary Antigen Test, which measures four different immune reactions across 88 different foods: IgE to assess food allergies, IgG to determine food sensitivities, IgG4 to assess food tolerances, and C3d (a Complement measure) to assess the possibility of an accelerated immune reaction through cytokines to each allergen. This test can help monitor the state of food allergies, sensitivities, and tolerances throughout development if repeated yearly or semi-yearly.

The GI-MAP™  stool test to assess the microbiome. This test utilizes cutting-edge, quantitative PCR technology to provide a true DNA/PCR-based stool test. This technology has high sensitivity, specificity, and a rapid turnaround. The GI Pathogens section includes Bacterial pathogens, parasitic pathogens, and viral pathogens to accurately assess gut dysbiosis. If administered over time, it paints a picture of the gut microbiome’s development.

The Advanced Intestinal Barrier Assessment measures the condition of intestinal permeability and assesses overall gut inflammation. This test includes histamine and diamine oxidase (DAO) to give information about histamine balance and gut mucosal health. Plasma zonulin is a well-documented marker of intestinal tight junctions and is the preferred specimen for assessment. Lipopolysaccharides (LPS) are endotoxins produced by gram-negative bacteria. LPS antibodies give information about inflammation and intestinal permeability. Especially for children who may have already demonstrated gut dysbiosis to determine the extent of the damage to the intestinal lining and to ascertain the degree of intestinal inflammation.