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Disturbed Pediatric Gut Microbiome Maturation in the Developmental Origins of Subsequent Chronic Disease

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPG.0000000000003664

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antibiotics; appendectomy; chronic disease; developmental origins of disease; inflammatory bowel disease; microbiome; obesity

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The microbiome plays a crucial role in human health, particularly during early childhood. Exposure to environmental factors during this developmental period can lead to dysbiosis, which can increase the risk of developing common chronic diseases worldwide. This article focuses on the impact of childhood antibiotic use and appendectomy as inducers of dysbiosis on the pathogenesis of diseases such as celiac disease, inflammatory bowel disease, and obesity. Understanding the microbial developmental origins of these disorders is essential for preventing and managing them in the future.
The microbiome is known to play an important role in the development and maintenance of human health. During early childhood the gut microbiome undergoes a rapid evolution, making this developmental window most susceptible to microbial manipulation and, therefore, most vulnerable to environmental stimuli. Such stimuli may induce persistent alterations (or dysbiosis) in microbiome and/or host physiology, thereby resulting in susceptibility to subsequent disease development. This phenomenon is frequently described as the microbial developmental origins of disease. In this topic of the month, we call attention to the microbial developmental origins of disease by examining the potential for childhood antibiotic exposures and appendectomy (ie, inducers of dysbiosis) to influence the pathogenesis of certain multifactorial, common diseases (eg, celiac disease, inflammatory bowel disease, obesity), especially those with increasing incidence worldwide. We conclude that fully appreciating the critical components in the microbial developmental origins of common chronic disorders is a major task ahead of pediatric gastroenterologists in the 21(st) century. Such information will be key in working to prevent numerous common and emerging disorders.

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