A new multidisciplinary study by researchers at the University of Rochester Medical Center found that the development of three systems, the intestinal microbiome, the respiratory system and the immune system, is related to the baby’s respiratory health and that a child may have negative breathing. results if the development of one of these systems is interrupted.
The study, published in “Developmental pathways of T cells and microbiota predict respiratory risk in childhood.” iScience (Cell Press) and Kristin Scheible, MD, associate professor in the Department of Pediatrics and Microbiology and Immunology, and Andrew McDavid, Ph.D., Department of Biostatistics and Computational Biology.
The project looked at more than 148 children and 119 children from birth to one year of age to study how microbiome, immunity and the respiratory system develop and how this development affects a child’s health. These systems are usually developed in sync with the child in the first year of life.
The study found that any breach in all three systems caused children to become more respiratory. In addition, the child’s post-menstrual age (or weeks from birth) was a more accurate reference for predicting any interruption in the system than the time from birth.
“When a baby is born, that’s usually a zero day for that baby. Instead, we model it with the child’s age starting on the day of conception,” Scheible said. “The immune development and microbial development of a 2-month-old baby is not the same as that of a 32-week-old child compared to 42-year-olds.”
The implications of using postpartum age as a reference may change how clinicians see the risk and benefit of changing immunological or microbial therapies, such as antibiotics or probiotics. This study found that prenatal antibiotics or infections disrupt the developmental pathway. If babies are exposed to antibiotics, especially premature babies, this increases their risk of developing respiratory illness in the first year of life.
In addition, caregivers should consider the use of pro and prebiotics, according to Scheible. These interventions may not work when they fall into an inappropriate timeline for development, and clinicians should consider using postmenstrual age to be willing to see the benefits of therapies targeted to the microbiome and immune system.
“When you take an unborn baby and take away all the mother’s protection, such as the placenta, it’s important to know what happens to underdeveloped systems like the microbiome and the immune system. Intubation, central lines, oxygen-like interventions, and antibiotics are implemented and developed they affect, and the impact of disturbing these systems may be greater for the child during those first two critical weeks, ”Scheible said.
Up to this point, the study found that when the fetus is exposed to antibiotics or infections before birth, it disrupts the normal developmental pathway of the T cell population, which predicts subsequent respiratory colonization and respiratory disease. In addition, the researchers found that when the microbiome, immune system, or respiratory system is disrupted, all three systems are not in a parallel path of development, and it can take several years to catch the affected systems.
We were able to model and measure immune development and microbiome development and compare it to the patient’s clinical history, and the asynchrony of these systems directly leads to worse respiratory outcomes. “
Andrew McDavid, PhD, Department of Biostatistics and Computational Biology, University of Rochester Medical Center
Further research is needed to validate these findings and to determine the mechanisms that link the development between microbes and immunities. If confirmed, these results may have significant implications for determining the risk / benefits of perinatal antibiotic administration, the most appropriate time for immune and microbiota targeting interventions, and predicting potential for respiratory mortality in premature and full-term infants.
“We still can’t find a magic bullet to determine who will develop the disease. Its usefulness is to suggest other models or interventions that can be tested to try to see how the immune system or microbiome can change with age,” McDavid said.
University of Rochester Medical Center
McDavid, A., et al. (2022) The developmental pathways of newborn T cells and the microbiota predict respiratory engagement in childhood. Science. doi.org/10.1016/j.isci.2022.104007.