Doctors have long understood that antibiotics that protect infants from infection also can disrupt the normal growth of their gut bacteria. However, a new study reveals that the consequences of routine antibiotic use may be deeper and longer lasting than expected.
The study, published in Science Translational Medicine, shows that short-term disruption of gut bacteria makes infant mice more likely to develop pneumonia. It also makes them more likely to die from it. Longer term, continued disruptions to gut bacteria appears to cause permanent immune system damage.
The study may spark a wider conversation about antibiotics use, including the near-automatic practice of prescribing them to women before Cesarean section deliveries, according to the authors.
"It is time to begin pushing back on practices that were established decades ago, when our level of understanding was different," says lead author of the study. "To prevent infection in one infant, we are exposing 200 infants to the unwanted effects of antibiotics. A more balanced, more nuanced approach is possible."
Nearly every C-section in the U.S. involves prescribing antibiotics to mothers shortly before delivery. Up to 30 percent of newborns in neonatal intensive care units (NICUs) also receive antibiotics.
The treatments help prevent Group B streptococcal infections -- the leading cause of deadly infections in newborns. However, in most cases the drugs are given as a precaution, not because infections have been confirmed, lead author says.
Once taken, the antibiotics act against a wide range of bacteria, be they good or bad. It turns out that commensal -- or "good" -- bacteria play a vital role in building a healthy immune system.
Even after birth, an infant's lungs are still forming and their immune defenses remain under construction.
Authors found that strong defenses depend on a flow of molecular signals occurring as the body reacts to waves of normal bacteria colonizing the gut. These signals tell the lungs when to build immune cells, how many, and where they should be deployed.
Specifically, the presence of commensal bacteria triggers the production of group 3 innate lymphoid cells (ILC3). These sentinel cells migrate to mucosal linings in the lungs, where they produce Interleukin-22 (IL-22). This vital signaling protein helps activate the immune response to infection.
The problem is when antibiotics wipe out good bacteria, they cut off that important flow of signals. As a result, the lungs build weaker castle walls with fewer guards on duty.
If antibiotic use is limited and early, a human infant would have some time to replenish commensal bacteria. But the process can take months, senior author says, and the result may not be a normal mix of bacteria.
After about a year, human infants have completed building their immune systems. That means any construction weaknesses are likely to be permanent.
This outcome of excess antibiotic use may help explain why some people with no obvious genetic risk factors develop asthma or other lung diseases later in life, senior author says.
Rapidly restoring good bacteria may help.
The need to use antibiotics to save lives when dangerous infections strike has not changed. However, these findings do suggest re-thinking routine preventive use in newborns, the researchers say. The good news: methods exist for restoring normal bacteria levels. In fact, when the researchers used such methods in mice, it restored their resistance to pneumonia.
Do mice experiments in the current paper apply to humans? A clinical study to evaluate the safety and benefits of limiting antibiotic use among expectant mothers and newborns is among the next steps researchers are pursuing, senior author says.
https://www.cincinnatichildrens.org/news/release/2017/antibiotics-in-newborns
http://stm.sciencemag.org/content/9/376/eaaf9412
Latest News
How protein synthesis in de…
By newseditor
Posted 22 Apr
Atlas of mRNA variants in d…
By newseditor
Posted 22 Apr
Mapping microbiome in metas…
By newseditor
Posted 22 Apr
Full-length mRNA packaged i…
By newseditor
Posted 22 Apr
Glucose-sensing mechanism t…
By newseditor
Posted 21 Apr
Other Top Stories
Inherited pancreatic cancer risk mutation identified!
Read more
Anti-cancer effect of keto diet
Read more
Connection between nutrients and follicular lymphoma
Read more
Treating deadly children's brain cancer by targeting a unique pathway!
Read more
Unblocking the inhibition of body's natural killer cells to stop ca…
Read more
Protocols
A programmable targeted pro…
By newseditor
Posted 23 Apr
MemPrep, a new technology f…
By newseditor
Posted 08 Apr
A tangible method to assess…
By newseditor
Posted 08 Apr
Stem cell-derived vessels-o…
By newseditor
Posted 06 Apr
Single-cell biclustering fo…
By newseditor
Posted 01 Apr
Publications
Neuronal activity rapidly r…
By newseditor
Posted 22 Apr
A perspective on muscle phe…
By newseditor
Posted 22 Apr
Foxp1 suppresses cortical a…
By newseditor
Posted 22 Apr
Single-cell long-read seque…
By newseditor
Posted 22 Apr
Unlocking potential: the ro…
By newseditor
Posted 22 Apr
Presentations
Hydrogels in Drug Delivery
By newseditor
Posted 12 Apr
Lipids
By newseditor
Posted 31 Dec
Cell biology of carbohydrat…
By newseditor
Posted 29 Nov
RNA interference (RNAi)
By newseditor
Posted 23 Oct
RNA structure and functions
By newseditor
Posted 19 Oct
Posters
A chemical biology/modular…
By newseditor
Posted 22 Aug
Single-molecule covalent ma…
By newseditor
Posted 04 Jul
ASCO-2020-HEALTH SERVICES R…
By newseditor
Posted 23 Mar
ASCO-2020-HEAD AND NECK CANCER
By newseditor
Posted 23 Mar
ASCO-2020-GENITOURINARY CAN…
By newseditor
Posted 23 Mar