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West, Christina E.
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Publications (10 of 72) Show all publications
Fox, A. T., Wopereis, H., Van Ampting, M. T. J., Nijhuis, M. M. O., Butt, A. M., Peroni, D. G., . . . Muraro, A. (2019). A specific synbiotic-containing amino acid-based formula in dietary management of cow's milk allergy: a randomized controlled trial. Clinical and Translational Allergy, 9, Article ID 5.
Open this publication in new window or tab >>A specific synbiotic-containing amino acid-based formula in dietary management of cow's milk allergy: a randomized controlled trial
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2019 (English)In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 9, article id 5Article in journal (Refereed) Published
Abstract [en]

Background: Here we report follow-up data from a double-blind, randomized, controlled multicenter trial, which investigated fecal microbiota changes with a new amino acid-based formula (AAF) including synbiotics in infants with non-immunoglobulin E (IgE)-mediated cow’s milk allergy (CMA).

Methods: Subjects were randomized to receive test product (AAF including fructo-oligosaccharides and Bifidobacterium breve M-16V) or control product (AAF) for 8 weeks, after which infants could continue study product until 26 weeks. Fecal percentages of bifidobacteria and Eubacterium rectale/Clostridium coccoidesgroup (ER/CC) were assessed at 0, 8, 12, and 26 weeks. Additional endpoints included stool markers of gut immune status, clinical symptoms, and safety assessments including adverse events and medication use.

Results: The trial included 35 test subjects, 36 controls, and 51 in the healthy reference group. Study product was continued by 86% and 92% of test and control subjects between week 8–12, and by 71% and 80%, respectively until week 26. At week 26 median percentages of bifidobacteria were significantly higher in test than control [47.0% vs. 11.8% (p < 0.001)], whereas percentages of ER/CC were significantly lower [(13.7% vs. 23.6% (p = 0.003)]. Safety parameters were similar between groups. Interestingly use of dermatological medication and reported ear infections were lower in test versus control, p = 0.019 and 0.011, respectively. Baseline clinical symptoms and stool markers were mild (but persistent) and low, respectively. Symptoms reduced towards lowest score in both groups.

Conclusion: Beneficial effects of this AAF including specific synbiotics on microbiota composition were observed over 26 weeks, and shown suitable for dietary management of infants with non-IgE-mediated CMA.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Bifidobacterium breve M-16V, Gut microbiota, Prebiotic, Probiotic, Cow's milk allergy, Symptoms
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-155758 (URN)10.1186/s13601-019-0241-3 (DOI)000455597600001 ()30651972 (PubMedID)
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-09-05Bibliographically approved
Wopereis, H., van Ampting, M. T. J., Cetinyurek-Yavuz, A., Slump, R., Candy, D. C. A., Butt, A. M., . . . West, C. E. (2019). A specific synbiotic-containing amino acid-based formula restores gut microbiota in non-IgE mediated cow's milk allergic infants: a randomized controlled trial. Clinical and Translational Allergy, 9, Article ID 27.
Open this publication in new window or tab >>A specific synbiotic-containing amino acid-based formula restores gut microbiota in non-IgE mediated cow's milk allergic infants: a randomized controlled trial
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2019 (English)In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 9, article id 27Article in journal (Refereed) Published
Abstract [en]

Background: Altered gut microbiota is implicated in cow’s milk allergy (CMA) and differs markedly from healthy, breastfed infants. Infants who suffer from severe CMA often rely on cow’s milk protein avoidance and, when breastfeeding is not possible, on specialised infant formulas such as amino-acid based formulas (AAF). Herein, we report the effects of an AAF including specific synbiotics on oral and gastrointestinal microbiota of infants with non-IgE mediated CMA with reference to healthy, breastfed infants.

Methods: In this prospective, randomized, double-blind controlled study, infants with suspected non-IgE mediated CMA received test or control formula. Test formula was AAF with synbiotics (prebiotic fructo-oligosaccharides and probiotic Bifidobacterium breve M-16V). Control formula was AAF without synbiotics. Healthy, breastfed infants were used as a separate reference group (HBR). Bacterial compositions of faecal and salivary samples were analysed by 16S rRNA-gene sequencing. Faecal analysis was complemented with the analysis of pH, short-chain fatty acids (SCFAs) and lactic acids.

Results: The trial included 35 test subjects, 36 controls, and 51 HBR. The 16S rRNA-gene sequencing revealed moderate effects of test formula on oral microbiota. In contrast, the gut microbiota was substantially affected across time comparing test with control. In both groups bacterial diversity increased over time but was characterised by a more gradual increment in test compared to control. Compositionally this reflected an enhancement of Bifidobacterium spp. and Veillonella sp. in the test group. In contrast, the control-fed infants showed increased abundance of adult-like species, mainly within the Lachnospiraceaefamily, as well as within the Ruminococcus and Alistipes genus. The effects on Bifidobacterium spp. and Lachnospiraceae spp. were previously confirmed through enumeration by fluorescent in situ hybridization and were shown for test to approximate the proportions observed in the HBR. Additionally, microbial activity was affected as evidenced by an increase of l-lactate, a decrease of valerate, and reduced concentrations of branched-chain SCFAs in test versus control.

Conclusions: The AAF including specific synbiotics effectively modulates the gut microbiota and its metabolic activity in non-IgE mediated CMA infants bringing it close to a healthy breastfed profile.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Cow's milk allergy, Pediatrics, Gut microbiota, Prebiotics, Probiotics
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-160608 (URN)10.1186/s13601-019-0267-6 (DOI)000469809400001 ()31164972 (PubMedID)
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-09-05Bibliographically approved
Simonyté Sjödin, K., Hammarström, M.-L., Rydén, P., Sjödin, A., Hernell, O., Engstrand, L. & West, C. E. (2019). Temporal and long-term gut microbiota variation in allergic disease: a prospective study from infancy to school age. Allergy. European Journal of Allergy and Clinical Immunology, 74(1), 176-185
Open this publication in new window or tab >>Temporal and long-term gut microbiota variation in allergic disease: a prospective study from infancy to school age
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2019 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 74, no 1, p. 176-185Article in journal (Refereed) Published
Abstract [en]

Background: Compositional changes in the early‐life gut microbiota have been implicated in IgE‐associated allergic diseases, but there is lack of longitudinal studies. We examined gut microbiota development from infancy to school age in relation to onset of IgE‐associated allergic diseases. At 8 years of age, we also examined the relationship between gut microbiota and T‐cell regulation, estimated as responses to polyclonal T‐cell activation.

Methods: Stool samples were collected from 93 children at 4, 6, 13 months, and 8 years of age. The gut microbiota was profiled using 16S rRNA gene sequencing. Peripheral blood was drawn from all children, and mononuclear cells were polyclonally activated. Levels of IL‐10 and FOXP3 mRNA copies were determined using real‐time quantitative reverse transcriptase‐PCR.

Results: At 8 years of age, 21 children were diagnosed with IgE‐associated allergic disease and 90% displayed allergic comorbidity. Seventy‐two children were nonallergic and nonsensitized. Statistical tests with multiple testing corrections demonstrated temporal underrepresentation of Ruminococcus and consistent underrepresentation of Bacteroides, Prevotella, and Coprococcus in allergic compared to nonallergic children from infancy to school age. The gut microbiota of the allergic 8‐year‐olds was enriched in Bifidobacteriumand depleted of Lactobacillus, Enterococcus, and Lachnospira. In allergic 8‐year-olds, Faecalibacterium correlated with IL‐10 mRNA levels (rs = 0.49, Padj = 0.02) with the same trend for FOXP3 (rs = 0.39, Padj = 0.08).

Conclusions: We identified both temporal and long‐term variation in the differential abundance of specific bacterial genera in children developing IgE‐associated allergic disease. Improved dietary interventions aiming at expanding immune‐modulatory taxa could be studied for prevention of allergic disease.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
allergy, diversity, intestinal colonization, microbiome, T-cell response
National Category
Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-157612 (URN)10.1111/all.13485 (DOI)000459664100017 ()29786876 (PubMedID)
Available from: 2019-03-27 Created: 2019-03-27 Last updated: 2019-03-27Bibliographically approved
Candy, D. C. A., Van Ampting, M. T. J., Nijhuis, M. M. O., Wopereis, H., Butt, A. M., Peroni, D. G., . . . Michaelis, L. J. (2018). A synbiotic-containing amino-acid-based formula improves gut microbiota in non-IgE-mediated allergic infants. Pediatric Research, 83(3), 677-686
Open this publication in new window or tab >>A synbiotic-containing amino-acid-based formula improves gut microbiota in non-IgE-mediated allergic infants
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2018 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 83, no 3, p. 677-686Article in journal (Refereed) Published
Abstract [en]

Background: Prebiotics and probiotics (synbiotics) can modify gut microbiota and have potential in allergy management when combined with amino-acid-based formula (AAF) for infants with cow’s milk allergy (CMA).

Methods: This multicenter, double-blind, randomized controlled trial investigated the effects of an AAF-including synbiotic blend on percentages of bifidobacteria and Eubacterium rectale/Clostridium coccoides group (ER/CC) in feces from infants with suspected non-IgE-mediated CMA. Feces from age-matched healthy breastfed infants were used as reference (healthy breastfed reference (HBR)) for primary outcomes. The CMA subjects were randomized and received test or control formula for 8 weeks. Test formula was a hypoallergenic, nutritionally complete AAF including a prebiotic blend of fructo-oligosaccharides and the probiotic strain Bifidobacterium breve M-16V. Control formula was AAF without synbiotics.

Results: A total of 35 (test) and 36 (control) subjects were randomized; HBR included 51 infants. At week 8, the median percentage of bifidobacteria was higher in the test group than in the control group (35.4% vs. 9.7%, respectively; P<0.001), whereas ER/CC was lower (9.5% vs. 24.2%, respectively; P<0.001). HBR levels of bifidobacteria and ER/CC were 55% and 6.5%, respectively.

Conclusion: AAF including specific synbiotics, which results in levels of bifidobacteria and ER/CC approximating levels in the HBR group, improves the fecal microbiota of infants with suspected non-IgE-mediated CMA.

National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-147477 (URN)10.1038/pr.2017.270 (DOI)000430304300018 ()29155807 (PubMedID)
Available from: 2018-05-21 Created: 2018-05-21 Last updated: 2018-06-09Bibliographically approved
Gustafsson, A., Granström, E., Stecksén-Blicks, C., West, C. E. & Silfverdal, S.-A. (2018). The antisecretory factor in plasma and breast milk in breastfeeding mothers: a prospective cohort study in Sweden. Nutrients, 10(9), Article ID 1227.
Open this publication in new window or tab >>The antisecretory factor in plasma and breast milk in breastfeeding mothers: a prospective cohort study in Sweden
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2018 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 9, article id 1227Article in journal (Refereed) Published
Abstract [en]

Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and inflammation. The objective of the study was to describe AF-levels in plasma and breast milk, and in relation to breast complications. Breastfeeding mothers (n = 95) were consecutively recruited at a Well Baby Clinic in Umeå, Sweden. At inclusion four weeks postpartum, samples of venous blood (10 mL) and breast milk (10 mL) were collected. Active AF was analyzed with ELISA using a monoclonal antibody mAb43, and was detected in all samples of plasma and breast milk with a positive correlation (Spearman coefficient = 0.40, p < 0.001; Pearson correlation = 0.34, p < 0.01). High AF-levels in plasma correlated with high AF-levels in breast milk. The results suggest a co-regulation between active AF in plasma and breastmilk, and/or a local regulation of AF in the breast. Further studies are needed to determine the pathways for the activation of AF-levels in breast milk and plasma.

Place, publisher, year, edition, pages
MDPI, 2018
Keywords
antisecretory factor, breast milk, breastfeeding, candida, human milk, inflammation, lactoferrin
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-151722 (URN)10.3390/nu10091227 (DOI)000448659900100 ()30181494 (PubMedID)2-s2.0-85053077078 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2018-09-11 Created: 2018-09-11 Last updated: 2018-11-26Bibliographically approved
Fox, A., van Ampting, M., Nijhuis, M. O., Wopereis, H., Butt, A., Peroni, D., . . . Michaelis, L. (2017). Acid-based formula with synbiotics modifies gut microbiota in non-ige mediated cow's milk allergic infants. Internal medicine journal (Print), 47, 15-15
Open this publication in new window or tab >>Acid-based formula with synbiotics modifies gut microbiota in non-ige mediated cow's milk allergic infants
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2017 (English)In: Internal medicine journal (Print), ISSN 1444-0903, E-ISSN 1445-5994, Vol. 47, p. 15-15Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-139798 (URN)10.1111/imj.35_13578 (DOI)000409520300035 ()
Note

Supplement: 5, Special Issue: SI, Meeting Abstract: P35

Available from: 2017-09-27 Created: 2017-09-27 Last updated: 2018-06-09Bibliographically approved
Fox, A. T., Wopereis, H., Van Ampting, M. T., Oude, N. M. M., Butt, A. M., Peroni, D. G., . . . Michaelis, L. J. (2017). Amino acid-based formula including specific synbiotics modifies the gut microbiota and reduces clinical symptoms in non-IgE mediated cow's milk allergic infants. Paper presented at Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, JUN 17-21, 2017, Helsinki, FINLAND. Allergy. European Journal of Allergy and Clinical Immunology, 72, 102-103
Open this publication in new window or tab >>Amino acid-based formula including specific synbiotics modifies the gut microbiota and reduces clinical symptoms in non-IgE mediated cow's milk allergic infants
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2017 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 72, p. 102-103Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-139814 (URN)000408773100162 ()
Conference
Congress of the European-Academy-of-Allergy-and-Clinical-Immunology, JUN 17-21, 2017, Helsinki, FINLAND
Note

Supplement: 103, Special Issue: SI, Meeting Abstract: 0122

Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09Bibliographically approved
West, C. E., Dzidic, M., Prescott, S. L. & Jenmalm, M. C. (2017). Bugging allergy; role of pre-, pro- and synbiotics in allergy prevention. Allergology International, 66(4), 529-538
Open this publication in new window or tab >>Bugging allergy; role of pre-, pro- and synbiotics in allergy prevention
2017 (English)In: Allergology International, ISSN 1323-8930, E-ISSN 1440-1592, Vol. 66, no 4, p. 529-538Article, review/survey (Refereed) Published
Abstract [en]

Large-scale biodiversity loss and complex changes in social behaviors are altering human microbial ecology. This is increasingly implicated in the global rise in inflammatory diseases, most notably the "allergy epidemic" in very early life. Colonization of human ecological niches, particularly the gastrointestinal tract, is critical for normal local and systemic immune development and regulation. Disturbances in composition, diversity and timing of microbial colonization have been associated with increased allergy risk, indicating the importance of strategies to restore a dysbiotic gut microbiota in the primary prevention of allergic diseases, including the administration of probiotics, prebiotics and synbiotics. Here, we summarize and discuss findings of randomized clinical trials that have examined the effects of these microbiome-related strategies on short and long-term allergy preventative effects - including new guidelines from the World Allergy Organization which now recommend probiotics and prebiotics for allergy prevention under certain conditions. The relatively low quality evidence, limited comparative studies and large heterogeneity between studies, have collectively hampered recommendations on specific probiotic strains, specific timing and specific conditions for the most effective preventive management. At the same time the risk of using available products is low. While further research is needed before specific practice guidelines on supplement probiotics and prebiotics, it is equally important that the underlying dietary and lifestyle factors of dysbiosis are addressed at both the individual and societal levels.

Place, publisher, year, edition, pages
JAPANESE SOCIETY ALLERGOLOGY, 2017
Keywords
Asthma, Biodiversity, Eczema, Microbiome, Probiotic
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-142276 (URN)10.1016/j.alit.2017.08.001 (DOI)000414537600004 ()28865967 (PubMedID)
Available from: 2017-12-01 Created: 2017-12-01 Last updated: 2018-06-09Bibliographically approved
Szajewska, H., Ruszczynski, M., Szymanski, H., Sadowska-Krawczenko, I., Piwowarczyk, A., Rasmussen, P. B., . . . Hernell, O. (2017). Effects of infant formula supplemented with prebiotics compared with synbiotics on growth up to the age of 12 mo: a randomized controlled trial. Pediatric Research, 81(5), 752-758
Open this publication in new window or tab >>Effects of infant formula supplemented with prebiotics compared with synbiotics on growth up to the age of 12 mo: a randomized controlled trial
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2017 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 81, no 5, p. 752-758Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Growth is an essential outcome measure for evaluating the safety of infant formulas (IF). We investigated the effects of consumption of IF supplemented with prebiotics (fructooligosaccharides, FOS, and galactooligosaccharides, GOS) compared with synbiotics (FOS/GOS and Lactobacillus paracasei ssp. paracasei strain F19) on the growth of healthy infants. METHODS: 182 full-term infants who were weaned completely from breast milk to IF at 28 d of age were randomly assigned to receive prebiotic- or synbiotic-supplemented, otherwise identical, IF until 6 mo of age (intervention period). RESULTS: A total of 146 (80%) infants were included in the intention-to-treat analysis at 6 mo. Anthropometric parameters were similar in the two groups during the intervention and follow-up period until 12 mo of age. Compared with the prebiotic group, a significant reduction in the cumulative incidence of lower respiratory tract infections was found in the synbiotic group; however, the confidence interval of the estimate was wide, resulting in uncertainty. CONCLUSION: The lack of a significant difference between the formula-fed groups in growth, or the occurrence of serious adverse events, supports the safety of using IF supplemented with synbiotics. Further studies are needed to evaluate the effects of such formula on lower-respiratory tract infections.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2017
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-136195 (URN)10.1038/pr.2017.5 (DOI)000400800600007 ()28060791 (PubMedID)
Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2018-06-09Bibliographically approved
West, C. E., Kvistgaard, A. S., Peerson, J. M., Donovan, S. M., Peng, Y.-m. & Lönnerdal, B. (2017). Effects of osteopontin-enriched formula on lymphocyte subsets in the first 6 months of life: a randomized controlled trial. Pediatric Research, 82(1), 63-71
Open this publication in new window or tab >>Effects of osteopontin-enriched formula on lymphocyte subsets in the first 6 months of life: a randomized controlled trial
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2017 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 82, no 1, p. 63-71Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Human milk is rich in osteopontin (OPN), which has immunomodulatory functions. METHODS: In a randomized controlled trial, standard formula (SF) and the same formula with 65 mg of OPN/L (F65) or 130 mg of OPN/L (F130), representing similar to 50 and 100% of the OPN concentration in human milk, were compared. We examined frequencies and composition of peripheral blood immune cells by four-color immunoflow cytometry of formula-fed infants at ages 1, 4, and 6 months, and compared them with a breastfed (BF) reference group. RESULTS: The F130 group had increased T-cell proportions compared with the SF (P = 0.036, average effect size 0.51) and F65 groups (P = 0.008, average effect size 0.65). Compared with the BF group, the monocyte proportions were increased in the F65 (P=0.001, average effect size 0.59) and F130 (P=0.006, average effect size 0.50) groups, but were comparable among the formula groups. CONCLUSION: OPN in an infant formula at a concentration close to that of human milk increased the proportion of circulating T cells compared with both SF and formula with added OPN at similar to 50% of the concentration in human milk. This suggests that OPN may favorably influence immune ontogeny in infancy and that the effects appear to be dose-dependent.

Place, publisher, year, edition, pages
Nature Publishing Group, 2017
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-138423 (URN)10.1038/pr.2017.77 (DOI)000406256000012 ()
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2018-06-09Bibliographically approved
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