ABSTRACT
Objective:
To investigate the effect of different delivery and
feeding modes on
intestinal microflora in
infants with
atopic dermatitis (AD) .
Methods:
A total of 33
infants with AD were enrolled from Department of
Dermatology, Wuhan NO.1
Hospital from July 2019 to December 2020, and 30 healthy
infants were selected as
control group. Then, all
infants were grouped according to different delivery and
feeding modes cesarean-delivery AD group (22 cases) , cesarean-delivery
control group (19 cases) , spontaneous-delivery AD group (11 cases) , and spontaneous-delivery
control group (11 cases) ; mixed-
feeding AD group (13 cases) , mixed-
feeding control group (11 cases) , formula
milk powder-
feeding AD group (12 cases) , formula
milk powder-
feeding control group (11 cases) ,
breastfeeding AD group (8 cases) , and
breastfeeding control group (12 cases) . The total
DNA was extracted from the
infant feces,
PCR was performed to amplify the V1 - V9 regions of bacterial
16S rRNA gene, and PacBio Sequel sequencer was used for
high-throughput sequencing. Wilcoxon rank sum test was used to compare the bacterial
community composition at genus and species levels, and correlations of relative abundance of differentially abundant bacterial taxa with
eosinophil counts and SCORing
Atopic Dermatitis (SCORAD) scores were analyzed.
Results:
In the spontaneous-delivery
control group, cesarean-delivery
control group, spontaneous-delivery AD group, and cesarean-delivery AD group, the top 5 bacterial genera with high relative abundance were
Bifidobacterium,
Bacteroides,
Veillonella,
Streptococcus, and
Escherichia. In the formula
milk powder-
feeding control group,
breastfeeding control group, mixed-
feeding control group, formula
milk powder-
feeding AD group,
breastfeeding AD group, and mixed-
feeding AD group, the top 5 abundant bacterial genera were
Bifidobacterium,
Bacteroides,
Clostridium,
Veillonella, and
Escherichia. Linear
discriminant analysis of effect size (LEfSe) showed no significant difference in the relative abundance of bacterial taxa among different delivery mode groups; among different
feeding mode groups,
Akkermansia and Akkermansiamuciniphila were the most differentially abundant microbes in the formula
milk powder-
feeding AD group at genus (LDA = 4.78) and species (LDA = 4.91) levels, respectively. The relative abundance of
Akkermansia and Akkermansiamuciniphila (both 9.6% ± 0.72%) was significantly higher in the formula
milk powder-
feeding AD group than in the formula
milk powder-
feeding control group (both 2.50% ± 0.83%, Z = 1.66, P = 0.048) , the mixed-
feeding AD group (both 0, Z = 2.26, P = 0.012) and the
breastfeeding AD group (both 0, Z = 1.85, P = 0.032) . Additionally, the relative abundance of
Akkermansia and
Akkermansia- muciniphila was positively correlated with SCORAD scores in AD
patients ( ρ = 0.384, 0.387, respectively, both P < 0.05) .
Conclusion:
Different delivery modes did not significantly
affect the
intestinal flora of AD or healthy
infants, and the relative abundance of
Akkermansia and Akkermansiamuciniphila increased in the formula
milk powder-
feeding infants with AD, which may be involved in the occurrence of AD.