臨床婦人科産科77巻7号

2023年07月発行

今月の臨床 細菌叢から読み解く女性と子どものヘルスケア 周産期

胎生期から新生児にかけての腸内細菌叢形成―分娩様式，母乳，腸管免疫を中心に

著者： 最上晴太¹ 久保のぞみ¹ 近藤英治²

所属機関： ¹京都大学医学部婦人科学産科学教室 ²熊本大学大学院生命科学研究部産科婦人科学講座

ページ範囲：P.711 - P.717

●胎児期から腸内細菌叢は形成されはじめる．

●母乳は新生児期〜乳児期の正常な腸内細菌叢の形成に欠かせない．

●児の腸内細菌叢構成の形成異常は，その後の喘息，アトピー性皮膚炎などのアレルギー疾患，炎症性腸疾患，自己免疫性疾患などの発症リスクを増加させる．

参考文献

1）Rackaityte E, et al : Viable bacterial colonization is highly limited in the human intestine in utero. Nat Med 26 : 599-607, 2020

2）Li N, et al : Memory CD4（+）T cells are generated in the human fetal intestine. Nat Immunol 20 : 301-312, 2019

3）Arboleya S, et al : Intestinal microbiota development in preterm neonates and effect of perinatal antibiotics. J Pediatr 166 : 538-544, 2015

4）Bokulich NA, et al : Antibiotics, birth mode, and diet shape microbiome maturation during early life. Sci Transl Med 8 : 343ra82, 2016

5）Yassour M, et al : Natural history of the infant gut microbiome and impact of antibiotic treatment on bacterial strain diversity and stability. Sci Transl Med 8 : 343ra81, 2016

6）Atyeo C, et al : The multifaceted roles of breast milk antibodies. Cell 184 : 1486-1499, 2021

7）Stewart CJ, et al : Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature 562 : 583-588, 2018

8）van den Elsen LWJ, et al : Shaping the gut microbiota by breastfeeding : the gateway to allergy prevention? Front Pediatr 7 : 47, 2019

9）Fernández L, et al : The human milk microbiota : origin and potential roles in health and disease. Pharmacol Res 69 : 1-10, 2013

10）Charbonneau MR, et al : A microbial perspective of human developmental biology. Nature 535 : 48-55, 2016

11）Relman DA : Maternal IgA : matchmaking in early childhood. Immunity 51 : 211-213, 2019

12）Brower-Sinning R, et al : Mucosa-associated bacterial diversity in necrotizing enterocolitis. PLoS One 9 : e105046, 2014

13）Gopalakrishna KP, et al : Maternal IgA protects against the development of necrotizing enterocolitis in preterm infants. Nat Med 25 : 1110-1115, 2019

14）Tamburini S, et al : The microbiome in early life : implications for health outcomes. Nat Med 22 : 713-722, 2016

15）Savino F, et al : Lactobacillus reuteri DSM 17938 in infantile colic : a randomized, double-blind, placebo-controlled trial. Pediatrics 126 : e526-e533, 2010

16）Arrieta MC, et al : The intestinal microbiome in early life : health and disease. Front Immunol 5 : 427, 2014

17）Unger SA, et al : The respiratory microbiome and respiratory infections. J Infect 74（Suppl 1） : S84-S88, 2017

18）Zheng W, et al : Microbiota-targeted maternal antibodies protect neonates from enteric infection. Nature 577 : 543-548, 2020

19）Liang G, et al : The stepwise assembly of the neonatal virome is modulated by breastfeeding. Nature 581 : 470-474, 2020

20）Schlaudecker EP, et al : IgA and neutralizing antibodies to influenza a virus in human milk : a randomized trial of antenatal influenza immunization. PLoS One 8 : e70867, 2013

21）Perl SH, et al : SARS-CoV-2-specific antibodies in breast milk after COVID-19 vaccination of breastfeeding women. JAMA 325 : 2013-2014, 2021

22）Henrick BM, et al : Bifidobacteria-mediated immune system imprinting early in life. Cell 184 : 3884-3898.e11, 2021

23）Dzidic M, et al : Aberrant IgA responses to the gut microbiota during infancy precede asthma and allergy development. J Allergy Clin Immunol 139 : 1017-1025.e14, 2017

24）Arrieta MC, et al : Early infancy microbial and metabolic alterations affect risk of childhood asthma. Sci Transl Med 7 : 307ra152, 2015

25）Vuong HE, et al : The Microbiome and Host Behavior. Annu Rev Neurosci 40 : 21-49, 2017

26）Romero R, et al : The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women. Microbiome 2 : 4, 2014

27）Azad MB, et al : Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life : a prospective cohort study. BJOG 123 : 983-993, 2016

28）Shao Y, et al : Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth. Nature 574 : 117-121, 2019

29）Chu DM, et al : Maturation of the infant microbiome community structure and function across multiple body sites and in relation to mode of delivery. Nat Med 23 : 314-326, 2017

30）Cabrera-Rubio R, et al : The human milk microbiome changes over lactation and is shaped by maternal weight and mode of delivery. Am J Clin Nutr 96 : 544-551, 2012

31）Martino C, et al : Microbiota succession throughout life from the cradle to the grave. Nat Rev Microbiol 20 : 707-720, 2022

32）Reyman M, et al : Impact of delivery mode-associated gut microbiota dynamics on health in the first year of life. Nat Commun 10 : 4997, 2019

33）Ahlqvist VH, et al : Elective and nonelective cesarean section and obesity among young adult male offspring : a Swedish population-based cohort study. PLoS Med 16 : e1002996, 2019

34）Bruce A, et al : Mode of delivery and risk of inflammatory bowel disease in the offspring : systematic review and meta-analysis of observational studies. Inflamm Bowel Dis 20 : 1217-1226, 2014

35）Koletzko S, et al : Cesarean section on the risk of celiac disease in the offspring : the Teddy study. J Pediatr Gastroenterol Nutr 66 : 417-424, 2018

36）Masukume G, et al : Caesarean section delivery and childhood obesity in a British longitudinal cohort study. PLoS One 14 : e0223856, 2019

37）Dominguez-Bello MG, et al : Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nat Med 22 : 250-253, 2016

38）Liu Y, et al : Effects of vaginal seeding on gut microbiota, body mass index, and allergy risks in infants born through cesarean delivery : a randomized clinical trial. Am J Obstet Gynecol MFM 5 : 100793, 2023

39）Korpela K, et al : Maternal fecal microbiota transplantation in cesarean-born infants rapidly restores normal gut microbial development : a proof-of-concept study. Cell 183 : 324-334.e5, 2020