Mode of delivery -: Effects on gut microbiota and humoral immunity
Mode of delivery -: Effects on gut microbiota and humoral immunity
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DOI：
10.1159/000111102
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发表时间：
2008-01-01
期刊：
影响因子：
2.5
通讯作者：
Isolauri, Erika
中科院分区：
文献类型：
--
作者：
Huurre, Anu;Kalliomaki, Marko;Isolauri, Erika
背景：在过去的几十年里，全世界的剖腹产率增加了10倍。目的：探讨阴道分娩与剖宫产新生儿肠道微生物区系的差异及其对黏膜免疫功能的影响。方法：在我们芬兰图尔库的诊所收集了165名连续出生的儿童，其中141名(85%)通过阴道分娩，24名(15%)通过剖腹产出生。就诊时采血，用ELISPOT法间接评价粘膜免疫功能。取粪便标本，用细菌细胞荧光原位杂交法测定肠道微生物区系。结果：剖腹产婴儿早期双歧杆菌较少，体液免疫反应较强。在1个月龄时，经阴道分娩的婴儿每克粪便的肠道细菌总数(9.9x10(9)，95%可信区间7.9x10(9)-1.2x10(10))高于剖宫产儿(3.1x10(9)，95%可信区间1.1x10(9)-8.6x10(9))(p=0.001)。这主要是由于阴道分娩婴儿的双歧杆菌数量较多(分别为1.9x10(9)，95%可信区间6.3x10(8)-5.6x10(9)对1.5x10(6)，95%可信区间4.1x10(2)-5.7x10(9))(p=0.001)。在出生一年内，阴道分娩的婴儿的IgA、IgG和IgM分泌细胞总数低于剖腹产婴儿(分别为p=0.03，p=0.02，p=0.11)，这可能反映了过多的抗原暴露穿过脆弱的肠道屏障。结论：我们的研究结果表明，分娩方式可能通过肠道微生物区系的发育，对婴儿(http://www.clinicaltrials.gov/ct/gui/show/NCT00167700).的免疫功能有显著影响。版权所有(C)2007 S.Karger AG，巴塞尔。
Background: The rate of caesarean deliveries has increased 10-fold worldwide during the past decades. Objective: To evaluate differences in the establishment of gut microbiota in infants born by vaginal or caesarean delivery and its impact on mucosal immunity. Methods: Altogether, 165 consecutive children, prospectively followed from birth at our clinic in Turku, Finland, were gathered; 141 (85%) were born by vaginal delivery and 24 (15%) by caesarean section. Blood was drawn at physician visits for indirect evaluation of mucosal immunity by ELISPOT assay. Faecal samples were obtained for determination of the gut microbiota by fluorescence in situ hybridization of bacterial cells. Results: Infants delivered by caesarean section harboured fewer bifidobacteria at an early age and were shown to mount a stronger humoral immune response. At 1 month of age, the total gut bacterial cell counts per 1 g faeces were higher in vaginally delivered infants (9.9 x 10(9), 95% CI 7.9 x 10(9)-1.2 x 10(10)) as compared to caesarean section delivered (3.1 x 10(9), 95% CI 1.1 x 10(9)-8.6 x 10(9)) (p = 0.001). This distinction was mainly due to the greater number of bifidobacteria in vaginally delivered infants (1.9 x 10(9), 95% CI 6.3 x 10(8)-5.6 x 10(9) vs. 1.5 x 10(6), 95% CI 4.1 x 10(2)-5.7 x 10(9), respectively) (p = 0.001). During the first year of life, the total number of IgA-, IgG- and IgM-secreting cells was lower (p = 0.03, p = 0.02, p = 0.11, respectively) in infants born by vaginal delivery than in those born by caesarean section, possibly reflecting excessive antigen exposure across the vulnerable gut barrier. Conclusions: Our findings demonstrate that the mode of delivery may have, possibly via gut microbiota development, significant effects on immunological functions in the infant (http://www.clinicaltrials.gov/ct/gui/show/NCT00167700). Copyright (C) 2007 S. Karger AG, Basel.