The Editor takes a closer look at some of this month's articles

Abstract

Clinical & Experimental AllergyVolume 45, Issue 9 p. 1373-1373 Editor's ChoiceFree Access The Editor takes a closer look at some of this month's articles First published: 24 August 2015 https://doi.org/10.1111/cea.12602AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat The gut microbiome: a key to the development of allergic disease? A fascinating story is emerging that a general lack of diversity of the gut microbiome and a reduced presence of those gut commensals which induce a tolerant immune environment is associated with the development of allergic disease in early childhood 1. Moreover, a tolerance inducing gut microbiome is a feature of infants brought up in a farming environment which has been clearly shown to be associated with a greatly reduced risk of developing allergic disease 2. This story is given further support by West and colleagues who have found a relationship between eczema and an infant gut microbiome which contains low levels of tolerance associated gut bacteria such as Ruminococcaceae and Proteobacteria. Reduced amounts of these bacterial types in the gut are in turn associated with enhanced innate immune responses with increased production of inflammatory mediators such as TNF-alpha. This increasingly persuasive explanation for the allergy epidemic is in tune with the idea that probiotics are the solution to childhood allergies, a topic which has long been popular with our authors 3. Christina West Microbiota composition at the phylum level and α-diversity at 1 week, 1 month and 1 year in vaginally delivered infants (n = 7, n = 5, n = 11) and their mothers (n = 11), and Caesarean-delivered infants (n = 7, n = 6, n = 9) and their mothers (n = 8) in pregnancy. [See figure 1a in C. E. West et al. (pp. 1419–1429)]. Harbingers of asthma: infant cough as well as wheeze Both wheeze and cough are characteristic symptoms of asthma. However, while infant wheeze has been exhaustively explored as a marker for the subsequent development of asthma, cough as a sentinel symptom has been relatively ignored. In a novel and deceptively simple paper, Oren et al. have taken advantage of a non-selected birth cohort to determine whether a persistent cough in infancy predicts the later onset of asthma between the ages of 2 and 9. They found a greater than threefold increase in the likelihood of a later diagnosis of asthma in infants who had a persistent cough in the first year of life which was independent of wheeze. The association was particularly strong in those children whose mothers had asthma. It will be interesting to know whether the same heterogeneity is seen in infant coughers as has been demonstrated for infant wheezers. Eyal Oren The prevalence of asthma by cough duration, stratified by the presence of maternal asthma. [See figure 3 in E. Oren et al. (pp. 1439–1446)]. References 1Abrahamsson TR, Jakobsson HE, Andersson AF, Bjorksten B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy 2014; 44: 842– 50. 2Braun-Fahrlander C, von Mutius E. Can farm milk consumption prevent allergic diseases? Clin Exp Allergy 2011; 41: 29– 35. 3Campbell DE. Probiotics and primary prevention of atopic disease: are we closer to a firm evidence base for clinical use? Clin Exp Allergy 2013; 43: 978– 80. Caption to cover illustration: An example of vocal cord dysfunction (Image courtesy of S. J. Fowler). This logo highlights the Editor's choice articles on the cover and the first page of each of the articles. Volume45, Issue9September 2015Pages 1373-1373 ReferencesRelatedInformation