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Early-life cytomegalovirus infection is associated with gut microbiota perturbations and increased risk of atopy
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  • Hind Sbihi,
  • Karen Simmons,
  • Malcolm Sears,
  • Theo Moraes,
  • Allan Becker,
  • PJ Mandhane,
  • Padmaja Subbarao,
  • Darlene Dai,
  • B. Brett Finlay,
  • Stuart Turvey,
  • Soren Gantt
Hind Sbihi
The University of British Columbia
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Karen Simmons
The University of British Columbia
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Malcolm Sears
McMaster University
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Theo Moraes
University of Toronto
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Allan Becker
University of Manitoba
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PJ Mandhane
University of Alberta
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Padmaja Subbarao
University of Toronto
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Darlene Dai
The University of British Columbia
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B. Brett Finlay
The University of British Columbia
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Stuart Turvey
University of British Columbia
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Soren Gantt
University of Montreal
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Abstract

Background: The ‘old friends’ hypothesis posits that reduced exposure to previously ubiquitous microorganisms is one factor involved in the increased rates of allergic diseases. Cytomegalovirus (CMV) may be one of the “old friends” hypothesized to help prevent allergic diseases. We sought to elucidate whether early-life CMV infection is associated with childhood atopy via perturbations of the gut microbiota. Methods: Participants were recruited from a population-based birth cohort (CHILD study) and followed prospectively until age five years in four Canadian cities. A total of 928 participants provided stool microbiome data, urine for CMV testing, skin-prick tests, and questionnaires-based detailed environmental exposures. CMV infection was assessed in the first year of life while the main outcome was defined by persistent sensitization to any allergen at ages 1, 3, and 5 years. Results: Early CMV infection was associated with increased beta and decreased alpha diversity of the gut microbiota. Both changes in diversity measures and early CMV infection were associated with persistent allergic sensitization at age 5 years (aOR= 2.08; 95%CI: 1, 4.33). Mediation analysis demonstrated that perturbation of gut microbial composition explains 30% of the association. Conclusions: Early-life CMV infection is associated with an alteration in the intestinal microbiota, which mediates the effect of the infection on childhood atopy. This work indicates that preventing CMV infection would not put children at increased risk of developing atopy. Rather, a CMV vaccine, in addition to preventing CMV-associated morbidity and mortality, might reduce the risk of childhood allergic diseases.

Peer review status:ACCEPTED

05 Apr 2021Submitted to Pediatric Allergy and Immunology
07 Apr 2021Reviewer(s) Assigned
14 May 2021Review(s) Completed, Editorial Evaluation Pending
17 May 2021Editorial Decision: Revise Major
11 Aug 20211st Revision Received
14 Aug 2021Review(s) Completed, Editorial Evaluation Pending
16 Aug 2021Reviewer(s) Assigned
25 Aug 2021Editorial Decision: Accept