Featured Research

from universities, journals, and other organizations

Birth by C-section, early antibiotic use put kids at risk for allergic esophagitis

Date:
May 12, 2014
Source:
Johns Hopkins Medicine
Summary:
Children delivered by cesarean section and those given antibiotics during early infancy appear more prone to developing allergic inflammation of the esophagus -- the muscular tube that connects the mouth to the stomach, according to results of a study. Eosinophilic esophagitis, or EoE, is an emerging allergic disease, the causes of which remain unclear. While still relatively rare, EoE appears to be on the rise in both children and adults, research shows.

Children delivered by cesarean section and those given antibiotics during early infancy appear more prone to developing allergic inflammation of the esophagus -- the muscular tube that connects the mouth to the stomach, according to results of a study by investigators from the Johns Hopkins Children's Center and Harvard Medical School.

The findings, published online May 2 in the Journal of Allergy and Clinical Immunology: In Practice, reveal that early antibiotic treatment and C-section delivery may somehow precipitate disease development by altering a child's microbiota -- the trillions of bacteria and other organisms residing in human intestines that regulate digestive health and immunity.

Eosinophilic esophagitis, or EoE, is an emerging allergic disease, the causes of which remain unclear. While still relatively rare, EoE appears to be on the rise in both children and adults, research shows. The condition is marked by irritation, inflammation and constriction of the esophagus and by proliferation of eosinophils, or immune cells that multiply during allergic reactions. Because EoE's cardinal symptoms -- heartburn, swallowing difficulties and persistent burping -- mimic garden-variety gastritis, biopsy of the esophagus remains the only definitive way to distinguish between the two disorders.

"It is becoming increasingly clear that the early development and composition of our gut bacteria can influence immunity for life," says study lead investigator Corinne Keet, M.D., Ph.D., a pediatric allergist at the Johns Hopkins Children's Center. "Now, our findings suggest that delivery via C-section and early treatment with antibiotics also play an important role in this serious allergic disease."

Although more research is needed to understand the precise mechanism by which C-section birth and antibiotics lead to EoE, the researchers suspect these two factors precipitate serious shifts in the composition of a baby's developing gut. Babies born via vaginal delivery are exposed to certain maternal bacteria as they pass through the birth canal. Those bacteria colonize the newborn's gut and help build immunity. Children born via C-section, however, miss out on this vital initial exposure to bacteria, the researchers say, which may render their immune systems more sensitive to food and other generally harmless substances.

Also, during the first year of life, the gut microbiome undergoes dramatic changes as the infant encounters various microorganisms in the environment. Antibiotics during this critical period may alter gut immunity because the drugs tend to cause collateral damage by wiping out "healthy" bacteria along with disease-causing ones, the team notes, which can lead to an imbalance between good and bad bacteria in the gut.

The researchers analyzed the medical records and upper endoscopy test results of 99 children, ages 1 through 5, one fourth of whom had been diagnosed with EoE. In addition, the investigators collected information from parents about the children's symptoms and behavior.

The rate of EoE was three times higher among children born via C-section, compared with those delivered vaginally. EoE rates were 3.5 times higher among those treated with antibiotics in the first year of life. Breastfeeding did not make a difference in EoE risk, the study found, nor did the age at which a baby started eating solid foods.

"Our findings are yet another reminder to be vigilant against unnecessary antibiotic use, but particularly so in the first year of life because infants are extra sensitive to the effects of these drugs and can suffer lifelong consequences to immunity and digestive health," Keet says.

In addition, Keet says, the link between C-sections and EoE raises important questions about finding alternative ways to introduce these good maternal bacteria into a newborn's system if vaginal delivery is not possible.

The work was funded by the National Institute of Allergy and Infectious Diseases under grant 1K23AI103187-01. Additional support was provided by the Demarest Lloyd Jr. Foundation. FAST FACTS: • Babies born via C-section, and those treated with antibiotics early in life appear more prone to allergic inflammation of the esophagus, a condition known as eosinophilic esophagitis (EoE).

  • Further studies are needed to establish the precise mechanism by which C-section birth and antibiotics precipitate the disease, but investigators believe that:
  • Antibiotic use in infancy appears to impede the growth of certain beneficial gut bacteria responsible for digestive health and normal immunity.
  • C-section delivery prevents a baby's exposure to important maternal bacteria in the vaginal canal that go on to colonize a baby's gut and help build immunity.
  • The findings underscore the importance of judicious use of antibiotics, especially during infancy, as well as the importance of finding alternative ways to expose C-section delivered babies to beneficial maternal bacteria.

Story Source:

The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Marcella C. Radano, Qian Yuan, Aubrey Katz, Jude T. Fleming, Stephanie Kubala, Wayne Shreffler, Corinne A. Keet. Cesarean section and antibiotic use found to be associated with eosinophilic esophagitis. The Journal of Allergy and Clinical Immunology: In Practice, 2014; DOI: 10.1016/j.jaip.2014.02.018

Cite This Page:

Johns Hopkins Medicine. "Birth by C-section, early antibiotic use put kids at risk for allergic esophagitis." ScienceDaily. ScienceDaily, 12 May 2014. <www.sciencedaily.com/releases/2014/05/140512124108.htm>.
Johns Hopkins Medicine. (2014, May 12). Birth by C-section, early antibiotic use put kids at risk for allergic esophagitis. ScienceDaily. Retrieved July 28, 2014 from www.sciencedaily.com/releases/2014/05/140512124108.htm
Johns Hopkins Medicine. "Birth by C-section, early antibiotic use put kids at risk for allergic esophagitis." ScienceDaily. www.sciencedaily.com/releases/2014/05/140512124108.htm (accessed July 28, 2014).

Share This




More Health & Medicine News

Monday, July 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com
West Africa Gripped by Deadly Ebola Outbreak

West Africa Gripped by Deadly Ebola Outbreak

AFP (July 28, 2014) The worst-ever outbreak of the deadly Ebola epidemic grips west Africa, killing hundreds. Duration: 00:48 Video provided by AFP
Powered by NewsLook.com
Trees Could Save More Than 850 Lives Each Year

Trees Could Save More Than 850 Lives Each Year

Newsy (July 27, 2014) A national study conducted by the USDA Forest Service found that trees collectively save more than 850 lives on an annual basis. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins