Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses.

Autor:	Agrawal M; The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States., Sabino J; Gastroenterology Division, University Hospital of Leuven, Leuven, Belgium., Frias-Gomes C; Division of Gastroenterology, Hospital Beatriz Ângelo, Loures 2674-514, Portugal., Hillenbrand CM; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States., Soudant C; Levy Library, The Mount Sinai Medical Center, New York, NY, United States.; Medical Library, Memorial Sloan Kettering Cancer Center, New York, NY, United States., Axelrad JE; Division of Gastroenterology, New York University Grossman School of Medicine, New York, NY, United States., Shah SC; Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, United States.; Section of Gastroenterology, Veterans Affairs Tennessee Valley Healthcare System, Nashville campus, Nashville, TN, United States., Ribeiro-Mourão F; Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal.; Pediatrics Department, Centro Materno Infantil do Norte - Centro Hospitalar e Universitário do Porto, Porto, Portugal.; Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal., Lambin T; Department of Gastroenterology, Claude Huriez Hospital, University of Lille, Lille, France., Peter I; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States., Colombel JF; The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States., Narula N; Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive, Health Research Institute, McMaster University, Hamilton, ON, Canada., Torres J; The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.; Division of Gastroenterology, Hospital Beatriz Ângelo, Loures 2674-514, Portugal.; Faculdade de Medicina, Universidade de Lisboa, Portugal.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2021 May 15; Vol. 36, pp. 100884. Date of Electronic Publication: 2021 May 15 (Print Publication: 2021).
DOI:	10.1016/j.eclinm.2021.100884
Abstrakt:	Background: Early life exposures impact immune system development and therefore the risk of immune-mediated diseases, including inflammatory bowel disease (IBD). We systematically reviewed the impact of pre-, peri‑, and postnatal exposures up to the age of five years on subsequent IBD diagnosis. Methods: We identified case-control and cohort studies reporting on the association between early life environmental factors and Crohn's disease (CD), ulcerative colitis (UC), or IBD overall. Databases were search from their inception until May 24th, 2019 until July 14th, 2020. We conducted meta-analyses for quantitative review of relevant risk factors that were comparable across studies and qualitative synthesis of the literature for a wide range of early life exposures, including maternal health and exposures during pregnancy, perinatal factors, birth month and related-factors, breastfeeding, hygiene-related factors and social factors, immigration, antibiotics, offspring health, including infections, and passive smoking. PROSPERO registration: CRD42019134980. Findings: Prenatal exposure to antibiotics (OR 1.8; 95% CI 1.2-2.5) and tobacco smoke (OR 1.5; 95% CI 1.2-1.9), and early life otitis media (OR 2.1; 95% CI 1.2-3.6) were associated with IBD. There was a trend towards an association between exposure to antibiotics in infancy and IBD (OR: 1.7, 95% CI 0.97, 2.9), supported by positive data on population-based data. Breastfeeding was protective against IBD. Other early life risk factors had no association with IBD, but data were limited and heterogenous. Interpretation: Early life is an important period of susceptibility for IBD development later in life. Tobacco smoke, infections and antibiotics were associated positively, and breastfeeding was associated negatively with IBD. Our findings offer an opportunity to develop primary prevention strategies. Funding: This study did not receive any funding. Competing Interests: The corresponding author confirms on behalf of all authors that there have been no involvements that might raise the question of bias in the work reported or in the conclusions, implications, or opinions stated. JS reports personal fees from Takeda, Abbvie, and Janssen, and grants from Helmsley Charity Trust Fund and Fonds voor Wetenschappelijk Onderzoek – Vlaanderen, outside the submitted work. TL reports grants from DigestScience foundation and received travel accommodation from Adacyte Therapeutics. JFC reports grants and consultancy and lectures from Abbvie; consultancy and lectures from Ferring Pharmaceutical; consultancy from Amgen, Arena Pharmaceuticals, Boehringer Ingelheim, Celgene Corporation, Eli Lilly, Enterome, Geneva, and Genentech; grants and consultancy from Janssen Pharmaceuticals; consultancy from Landos, LimmaTech Biologics AG, Ipsen, Imedex, Merck, Novartis, O Mass, Ostuka, and Pfizer; consultancy and lectures from Shire; grants, consultancy and lectures from Takeda; consultancy from Tigenix; and is a stock holder with Intestinal Biotech Development and Genfit, outside the submitted work. NN has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring for advisory boards. JT has received research grants from Janssen and Abbvie, speaker fees from Janssen, and Advisory Board fees from Janssen, Pfizer, Arena Pharmaceuticals, Pfizer, Gilead and Galapagos. MA reports grants from Dickler Family Fund, New York Community Trust, grants from Leona M. and Harry B. Helmsley Charitable Trust for SECURE-IBD database, outside the submitted work. All other authors have nothing to disclose. (© 2021 The Authors.)
Databáze:	MEDLINE
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