Gut microbial IgA coating levels in infancy differ between urban and agrarian cohorts, linked to allergic outcomes.
This cohort study followed infants from an urbanized Rochester (ROC) cohort and a traditional, agrarian Old Order Mennonite (OOM) community for the first 2 years of life. The population included 9 OOM infants and 21 ROC infants. The study assessed gut microbial IgA coating levels as an exposure and compared infants between the two cohorts.
The primary outcome was allergic outcomes (atopic dermatitis and/or food allergy). Main results showed that IgA coating of P. melaninogenica and Pasteurellaceae was associated with allergic outcomes. IgA coating of R. gnavus was observed in non-allergic infants. IgA coating of Atopobium, Bifidobacterium, and Coprococcus was positively associated with infant age, while IgA coating of Corynebacterium was negatively associated with infant age. IgA coating of Clostridium decreased in non-allergic infants, and IgA coating of Corynebacterium decreased in allergic infants.
Breastfeeding was associated with higher levels of fecal IgA in infancy. Milk from OOM mothers exhibited a higher IgA response to B. infantis and several other commensals compared to the ROC cohort. The IgA-binding to B. infantis was partially mediated by Fab-independent interactions through binding to glycosylated regions of immunoglobulins.
Safety and tolerability were not reported. Key limitations include the very small sample size (9 OOM and 21 ROC infants) and the observational design, which precludes causal inference. The study did not report p-values, confidence intervals, or effect sizes for the associations. Practice relevance was not reported, and the findings should be interpreted as hypothesis-generating for future research.