High risk of asthma in children with orofacial defects, finds study

Patients with congenital orofacial defects, cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) have continuous exposure of the respiratory system to the microbiome from the oral environment, offering opportunities for mucosal immunity development in the airway.

The study was conducted in two parts by Hsin-Chun Huang, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan, and colleagues, They aimed to analyze data on asthma occurrence in infants with cleft lip, cleft palate, and CLP and the composition of the salivary microbiome. Also, they evaluated the oral microbiota and its association with the risk of childhood asthma development.

For this purpose, the researchers retrospectively analyzed patient data from the research database of Chang Gung Memorial Hospital from 2004 to 2015 by multivariable regression. Disease diagnoses were defined by ICD codes. Asthma must also fulfil the criteria for receiving treatment with selective β2 agonistic or/and inhaled corticosteroid within 1 year. A prospective analysis was performed of the saliva microbiome from 2016 to 2020 among 10 healthy term infants and 10 CLP infants on postnatal 7th day, 1 month, and 6 months by next-generation sequencing.

The study led to the following findings:

• Asthma and nonasthma groups included 988 and 3952 patients, respectively.
• The incidence of asthma development was higher in patients with CP than in CL and CLP groups (aOR: 5.644).
• The species composition of the microbiome at 1 and 6 months was significantly different between infants with CLP and healthy infants.

"Children with orofacial defects have a higher risk of developing asthma with a possible contribution from oral microbiota in the early months of life," the researchers concluded.

Reference:

Chen, L., Huang, F., Li, C., & Huang, C. Salivary microbiome and asthma risk in children with orofacial defects. Pediatric Pulmonology. https://doi.org/10.1002/ppul.26582