The gut microbiome may be involved in Kawasaki Syndrome

Clinical manifestations and time course of Kawasaki disease

Kawasaki disease occurs in young children, and is characterized by long-lasting fever, coughing, diarrhea, along with other symptoms. What specifically causes this disease is unknown, but scientists guess it may be influenced genetically or by intestinal microbiota. Japan seems to have an unusually high rate of occurrence of KD. Researchers in Tokyo performed a longitudinal study of the intestinal microbiomes of KD patients, in order to look for any patterns that could suggest a relationship between intestinal microbiota and Kawasaki disease. The results have been published by Frontiers in Microbiology.

Fecal samples were collected from 28 Japanese children, ages ranging from 3 months to 9 years 6 months. Patients were both male (15) and female (13).  Fecal samples were collected twice from each child, for a total of 56 samples. The first (acute phase) sample was taken at the time of hospital admission, while the second (non-acute phase) was collected 4-6 months after the onset of Kawasaki disease. DNA was extracted from the fecal samples and sequenced to determine the bacterial composition of the intestines.

Roseburia species were found to be relatively abundant during the non-acute phase (4-6 months after disease onset). Species of Streptococcus were found mainly during the acute phase, such as S. pneumonia, orlais, pseudopneumoniae, mitis, gordonii, and sanguinis. This means there is a potential that these species of Streptococcus could be related to KD. To further determine if the Streptococcus species were related to KD, the researchers compared the species’ genomes to recent research in which they are involved, and found that Streptococcus could be a biomarker or pathogen for diseases with unknown causes, such as Kawasaki disease. While this is still a hypothesis and nothing is proven to be 100% true yet, it is definitely a topic that will be researched extensively in the nearby future. It may hold the key for understanding many other diseases whose causes are a mystery.   

The nasal microbiome of infants may impact risk of developing asthma

Many lower respiratory illnesses have been shown to associate with specific lung, throat and nasal bacteria, but the role of the microbiome is still unclear, and mechanisms for the connection have yet to be proven.  Of particular interest is asthma, which affects around 7% of people in the US, and increases a person’s risk for many other conditions.  While it is normally diagnosed in toddlers, scientists believe that the groundwork for the disease is actually laid during infancy.  With that in mind, researchers in Australia performed the first longitudinal study of infants’ nasopharyngeal (nose and throat) during the first year of their lives, and tracked episodes of respiratory illness during that time.  They discovered a strong connection between the microbiome and respiratory illness, including asthma, and last month published their results in Cell Host and Microbe.

The researchers collected nasopharyngeal microbiome samples from 234 infants at different time points during their first year of life.  Most infants’ microbiomes were dominated by the following species: Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Alloiococcus otitidis.  Interestingly, this was true for infants regardless of birth delivery mode (i.e. cesarean or vaginal) as well as length of breast feeding.  In contrast, having a furry animal in the house tended to increase the abundance of Streptococcus, but having older siblings tended to decrease it.  In addition, there were strong seasonal effects on the microbiome, with Haemophilus being associated with the summer, and Moraxella the winter.  In children with respiratory illness, Haemophilus, Moraxella, and Streptococcus were most frequently measured, and Staphylococcus, Alloiococcus, and Corynebacterium least frequently measured.

When the scientists compared their results with the asthma outcomes of the children at 5 years old they noticed one significant trend.  Colonization by Streptococcus at around 2 months old, which was asymptomatic at the time and occurred in 14% of infants tested, was strongly connected to chronic wheezing (itself an indication of asthma) at 5 years old.  They suggest that the developing airways in infants may be especially vulnerable to Streptococcus.

This long term study does a really nice job of defining how the microbiome grows and develops in the airways of infants – something which previously hadn’t been performed at such a large scale.  While this study alone does not figure out exactly what the microbiome’s role is in childhood respiratory illnesses, it does provide a baseline for future studies to work off of.