icon fsr

文献詳細

雑誌文献

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

小児

食物アレルギーの発症予防―腸内細菌叢への影響を含めて

著者: 福家辰樹1

所属機関: 1国立成育医療研究センターアレルギーセンター総合アレルギー科

ページ範囲:P.733 - P.739

文献概要

●食物アレルギーにおける最大の発症リスクとして,乳児期のアトピー性皮膚炎や皮膚バリア機能障害が知られており,適切な診断と外用療法による早期の介入が重要と考えられている.

●乳児期早期の腸内細菌叢がアレルギー疾患発症に関わる免疫制御や耐性獲得に重要とされる報告が数多くなされている.

●プロバイオティクスによる食物アレルギーの発症予防効果は現在のところ限定的とされる一方で,食の多様性がアレルギー疾患の発症予防に寄与する可能性が示唆されている.

参考文献

1)東京都健康安全研究センター:アレルギー疾患に関する3歳児全都調査(令和元年度).2020年10月
2)厚生労働省「授乳・離乳の支援ガイド」改定に関する研究会:授乳・離乳の支援ガイド(2019年改定版).2019年3月
3)海老澤元宏,他(監),日本小児アレルギー学会食物アレルギー委員会:食物アレルギー診療ガイドライン2021.協和企画,2021
4)Kramer MS, et al : Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Evid Based Child Health 9 : 447-483, 2014
5)Muraro A, et al : Dietary prevention of allergic diseases in infants and small children. part III : critical review of published peer-reviewed observational and interventional studies and final recommendations. Pediatr Allergy Immunol 15 : 291-307, 2004
6)Sicherer SH, et al : Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants. J Allergy Clin Immunol 126 : 1191-1197, 2010
7)Brough HA, et al : Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy. J Allergy Clin Immunol 135 : 164-170, 2015
8)Burke H, et al : Prenatal and passive smoke exposure and incidence of asthma and wheeze : systematic review and meta-analysis. Pediatrics 129 : 735-744, 2012
9)Tischer C, et al : Association between domestic mould and mould components, and asthma and allergy in children : a systematic review. Eur Respir J 38 : 812-824, 2011
10)Brown SJ, et al : loss-of-function variants in the filaggrin gene are a significant risk factor for peanut allergy. J Allergy Clin Immunol 127 : 661-667, 2011
11)Miyaji Y, et al : Earlier aggressive treatment to shorten the duration of eczema in infants resulted in fewer food allergies at 2 years of age. J Allergy Clin Immunol Pract 8 : 1721-1724.e6, 2020
12)Du Toit G, et al : Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 372 : 803-813, 2015
13)Du Toit G, et al : Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med 374 : 1435-1443, 2016
14)Fleischer DM, et al : Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. J Allergy Clin Immunol 136 : 258-261, 2015
15)Ierodiakonou D, et al : Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease : a systematic review and meta-analysis. JAMA 316 : 1181-1192, 2016
16)Tham EH, et al : Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective-An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology(APAPARI)consensus statement. Pediatr Allergy Immunol 29 : 18-27, 2018
17)Kirjavainen PV, et al : Farm-like indoor microbiota in non-farm homes protects children from asthma development. Nat Med 25 : 1089-1095, 2019
18)Mishra A, et al : Microbial exposure during early human development primes fetal immune cells. Cell 184 : 3394-3409.e20, 2021
19)Wang M, et al : Reduced diversity in the early fecal microbiota of infants with atopic eczema. J Allergy Clin Immunol 121 : 129-134, 2008
20)Gore C, et al : Bifidobacterium pseudocatenulatum is associated with atopic eczema : a nested case-control study investigating the fecal microbiota of infants. J Allergy Clin Immunol 121 : 135-140, 2008
21)Song H, et al : Faecalibacterium prausnitzii subspecies-level dysbiosis in the human gut microbiome underlying atopic dermatitis. J Allergy Clin Immunol 137 : 852-860, 2016
22)Thompson-Chagoyan OC, et al : Changes in faecal microbiota of infants with cow's milk protein allergy―a Spanish prospective case-control 6-month follow-up study. Pediatr Allergy Immunol 21 : e394-e400, 2010
23)Berni Canani R, et al : Lactobacillus rhamnosus GG-supplemented formula expands butyrateproducing bacterial strains in food allergic infants. ISME J 10 : 742-750, 2016
24)Bunyavanich S, et al : Early-life gut microbiome composition and milk allergy resolution. J Allergy Clin Immunol 138 : 1122-1130, 2016
25)Feehley T, et al : Healthy infants harbor intestinal bacteria that protect against food allergy. Nat Med 25 : 448-453, 2019
26)Azad MB, et al : Infant gut microbiota and food sensitization : associations in the first year of life. Clin Exp Allergy 45 : 632-643, 2015
27)Kalliomäki M, et al : Probiotics in primary prevention of atopic disease : a randomised placebocontrolled trial. Lancet 357 : 1076-1079, 2001
28)Cuello-Garcia CA, et al : Probiotics for the prevention of allergy : a systematic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol 136 : 952-961, 2015
29)Zutavern A, et al : Timing of solid food introduction in relation to eczema, asthma, allergic rhinitis, and food and inhalant sensitization at the age of 6 years : results from the prospective birth cohort study LISA. Pediatrics 121 : e44-e52, 2008
30)Roduit C, et al : Increased food diversity in the first year of life is inversely associated with allergic diseases. J Allergy Clin Immunol 133 : 1056-1064, 2014
31)Hussain M, et al : High dietary fat intake induces a microbiota signature that promotes food allergy. J Allergy Clin Immunol 144 : 157-170.e158, 2019
32)Roduit C, et al : High levels of butyrate and propionate in early life are associated with protection against atopy. Allergy 74 : 799-809, 2019

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

雑誌購入ページに移動
icon up

本サービスは医療関係者に向けた情報提供を目的としております。
一般の方に対する情報提供を目的としたものではない事をご了承ください。
また,本サービスのご利用にあたっては,利用規約およびプライバシーポリシーへの同意が必要です。

※本サービスを使わずにご契約中の電子商品をご利用したい場合はこちら