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September 25, 2023

Literature Review

1) This is an important paper for all of us to understand as it relates to disease prevention. From Nature Communications: "Here we show, using deeply phenotyped participants in the CHILD birth cohort (n = 1115), that there are early-life influences

and microbiome features which are uniformly associated with four distinct allergic diagnoses at 5 years: atopic dermatitis (AD, n = 367), asthma (As, n = 165), food allergy (FA, n = 136), and allergic rhinitis (AR, n = 187). In a subset with shotgun metagenomic and metabolomic profiling (n = 589), we discover that impaired 1-year microbiota maturation may be universal to pediatric allergies (AD p = 0.000014; As p = 0.0073; FA p = 0.00083; and AR p = 0.0021). Extending this, we find a core set of functional and metabolic imbalances characterized by compromised mucous integrity, elevated oxidative activity, decreased secondary fermentation, and elevated trace amines, to be a significant mediator between microbiota maturation at age 1 year and allergic diagnoses at age 5 years (βindirect = −2.28; p = 0.0020). Microbiota maturation thus provides a focal point to identify deviations from normative development to predict and prevent allergic disease." (Hoskinson et. al. 2023)

Over the past 15 years we have noted a connection between the intestinal microbiome and allergic/autoimmune disease activity in humans. This study continues to pull on this thread of knowledge. We see a direct correlation between a dysbiotic microbiome and human disease risk as young as 5 years of age. The upstream targets remain the same. Healthy food, avoidance of chemicals, consistent daily movement, exposure to normal macrobes and microbes, chronic stress mitigation, vaginal deliveries, breast feeding, avoidance of antibiotics/antacids and more.

2) Covid vaccine associated myocarditis has been noted for years now. The risk is higher in post pubertal males post vaccine than natural infection. The study by Yu in Circulation looked at teenage boys with a presentation of vaccine induced myocarditis noting left ventricular function and EKG changes and then at 1 year follow up. Most of the patients completely resolved all symptoms including echocardiographic findings as well EKG abnormalities. However, a subset of them were noted at a year to have signs of fibrosis and ventricular deformations in their hearts. This remains an unknown as to how this will affect these individuals long term. However, fibrosis is never good and portends loss of function in those tissues potentially over time as age causes more cellular senescence. (Yu et. al. 2023)

3) People with blood type A remain at higher risk for contracting SARS2. The science is showing that the Sars2 virus uses the blood group A antigen to gain access to our respiratory epithelial cells. The Sars2 receptor binding domain preferentially binds to the ACE2 receptor and the blood group A antigen. If it binds to the A antigen that makes the cell surface stickier for the binding of the ACE2 receptor which is the viral portal of entry. Sort of an affinity frequency increase effect. (Gaskill S. 2023)

4) Current allergic disease incidence was looked at in a large research study from the Children's Hospital of Philadelphia. They found that 10% of children (average age 4 months) developed atopic dermatitis, 4% (avg 13 months) for IgE mediated food allergy, 20% (13 months) for asthma, 20% (26 months) for allergic rhinitis, and 0.1% (35 months) for eosinophilic esophagitis. Food allergy incidence was: peanut (2%), egg (0.8%), and shellfish (0.6%).(Gabryszewski et. al. 2023) This data set is lower for food allergy than many other studies begging the question of criteria used for diagnosis in disparate study results. Overall, the study points to a continuing trend towards more disease.


Dr. M

Hoskinson Nature Communications

Yu Circulation

Gaskill Immunology

Gabryszewski Pediatrics