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Review
. 2024 Feb 23;73(3):541-549.
doi: 10.1136/gutjnl-2023-330002.

Early-life exposures and the microbiome: implications for IBD prevention

Lin Zhang #  1   2   3 , Manasi Agrawal #  4   5 , Siew C Ng  1   2   3 , Tine Jess  6   7
Affiliations
Review

Early-life exposures and the microbiome: implications for IBD prevention

Lin Zhang et al. Gut. .

Abstract

The early-life period is one of microbiome establishment and immune maturation. Early-life exposures are increasingly being recognised to play an important role in IBD risk. The composition of functions of the gut microbiome in the prenatal, perinatal, and postnatal period may be crucial towards development of health or disease, including IBD, later in life. We herein present a comprehensive summary of the interplay between early-life factors and microbiome perturbations, and their association with risk of IBD. In addition, we provide an overview of host and external factors in early life that are known to impact gut microbiome maturation and exposures implicated in IBD risk. Considering the emerging concept of IBD prevention, we propose strategies to minimise maternal and offspring exposure to potentially harmful variables and recommend protective measures during pregnancy and the postpartum period. This holistic view of early-life factors and microbiome signatures among mothers and their offspring will help frame our current understanding of their importance towards IBD pathogenesis and frame the roadmap for preventive strategies.

Keywords: CROHN'S DISEASE; INFLAMMATORY BOWEL DISEASE; INTESTINAL MICROBIOLOGY; MOLECULAR EPIDEMIOLOGY; ULCERATIVE COLITIS.

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Conflict of interest statement

Competing interests: MA has served as a consultant for Douglas Pharmacoceuticals. LZ and SCN are named inventors of patent applications held by the CUHK and MagIC that cover the therapeutic and diagnostic use of microbiome. SCN has served as an advisory board member for Pfizer, Ferring, Janssen, and Abbvie and received honoraria as a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie, and Takeda. SCN has received research grants through her affiliated institutions from Olympus, Ferring, and Abbvie. SCN is a founder member, non-executive director, non-executive scientific advisor, and shareholder of GenieBiome Ltd. SCN receives patent royalties through her affiliated institutions. TJ has served as a consultant for Ferring.

Figures

Figure 1.
Figure 1.
Impact of geography on early life gut microbiome type: Among infants from 15 countries (China,[14] Japan,[20] Korea,[19] Mexico,[153] The US,[154] Denmark,[17] Spain,[18] Indonesia,[24], Singapore,[24] Australia,[23] Ireland,[21] Slovenia,[22] Gambia,[155] Nigeria,[156] Tanzania,[78]), the bacterial phyla in infant fecal samples showed significant differences in gut bacterial type by region of residence.
Figure 2.
Figure 2.
An overview of relevant early life host and external factors on early life microbiome perturbations. The major influencing factors are summarized in this figure. These factors include those that operate during the prenatal, perinatal, and postnatal periods.
Figure 3.
Figure 3.
Proposed “multiple hits” hypothesis in IBD pathogenesis, with early life variables leading to altered gut microbiome and immune function, leading to susceptibility to subsequent exposures and IBD risk.
Figure 4.
Figure 4.
Proposed interventions during pregnancy and in early childhood towards potential reduction in IBD risk later in life.
See this image and copyright information in PMC

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