The role of the microbiome in childhood disease

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From these observational studies we have made several scientific advances related to the involvement of the childhood microbiome over different disease states: 1) We identified that certain features of the skin microbiome in the first week of life can predict which children will go on to develop eczema in early childhood. 2) We identified for the first time that in very young children who carry SARS-CoV-2 that there is a depletion of anti-inflammatory bacterial taxa; we are now examining the long-term impacts on health of this finding. In addition we are examining how persistent changes in the microbiome after a SARS-CoV-2 infection can lead to persistent symptoms in older children. 3) We showed that in children delivered by caesarean section, compared to vaginal delivery, there were differences in gut bacteriophages over the first two years of life. We are now investigating the potential physiological impacts of this. 4) We showed that children delivered by caesarean section were more likely to be colonized by environmental bacteria compared to children delivered by vaginal delivery in the first week of like, likely due to impaired colonization resistance. 5) We identified profound microbiome changes after pediatric bariatric surgery in children with obesity. We are now investigating in animal models whether these microbiome changes are causal to any of the beneficial phenotypic outcomes seen after bariatric surgery.