Abstract
Asthma, allergic rhinitis, food allergy, and atopic dermatitis are common childhood diseases with several different underlying mechanisms, i.e., endotypes of disease. Metabolomics has the potential to identify disease endotypes, which could beneficially promote personalized prevention and treatment. Here, we summarize the findings from metabolomics studies of children with atopic diseases focusing on tyrosine and tryptophan metabolism, lipids (particularly, sphingolipids), polyunsaturated fatty acids, microbially derived metabolites (particularly, short-chain fatty acids), and bile acids. We included 25 studies: 23 examined asthma or wheezing, five examined allergy endpoints, and two focused on atopic dermatitis. Of the 25 studies, 20 reported findings in the pathways of interest with findings for asthma in all pathways and for allergy and atopic dermatitis in most pathways except tyrosine metabolism and short-chain fatty acids, respectively. Particularly, tyrosine, 3-hydroxyphenylacetic acid, N-acetyltyrosine, tryptophan, indolelactic acid, 5-hydroxyindoleacetic acid, p-Cresol sulfate, taurocholic acid, taurochenodeoxycholic acid, glycohyocholic acid, glycocholic acid, and docosapentaenoate n-6 were identified in at least two studies. This pathway-specific review provides a comprehensive overview of the existing evidence from metabolomics studies of childhood atopic diseases. The altered metabolic pathways uncover some of the underlying biochemical mechanisms leading to these common childhood disorders, which may become of potential value in clinical practice.
Highlights
Asthma, allergic rhinitis, food allergy, and atopic dermatitis (AD)—the atopic diseases—are common childhood diseases with prevalences that vary across geographical regions, age groups, and disease severity
A total of 20 of the 25 studies reported significant metabolites or enriched pathways associated with either asthma, allergy, or AD in the prespecified pathways
Tryptophan metabolites were significantly associated with atopic diseases in children
Summary
Allergic rhinitis, food allergy, and atopic dermatitis (AD)—the atopic diseases—are common childhood diseases with prevalences that vary across geographical regions, age groups, and disease severity. The prevalence of asthma is approximately 14% in children [1], allergic rhinitis is diagnosed in up to 15% of children [2,3], food allergy in up to 8% of children [4], and AD in up to 20% of children [5]. These diseases, asthma, are very heterogeneous with several underlying pathophysiological mechanisms, i.e., endotypes of disease [6,7], all of which may require different terms of prevention and treatment. Fluctuations in metabolites represent an integrated pathophysiologic profile involving environmental exposures and genetics [10] and the interplay between those mediated by an epigenetic mechanism [11]
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