Twitter: @MeghanAzad

LinkedIn: https://www.linkedin.com/in/meghanazad

Developmental origins of asthma: role of breastfeeding, milk composition, and maternal factors

My lab is studying the effect of breastfeeding on asthma development, and exploring how these effects are influenced by breast milk composition and maternal characteristics.  In this project, we are specifically asking:

1. Does breastfeeding reduce the risk of childhood asthma? (If so, are the amount and duration of breastfeeding important? Do breastfeeding effects differ between mothers with and without asthma?)

2. Do bacteria (microbiota) in breast milk influence asthma development?

3. What maternal characteristics influence breast milk microbiota and asthma development?

To address these questions, we will use data and breast milk samples from the Canadian Healthy Infant Longitudinal Development (CHILD) study of 3624 mothers and their infants.  We will also examine medical records from all mothers and children in Manitoba, using the Manitoba Population Health Data Repository.

Why is the research project/program important?

Over the last 50 years, asthma rates have been rising around the world, especially among children.  Asthma is now the most common chronic disease of childhood, affecting 1 in 6 Canadian children.  It is a major cause of hospitalization, and the most common reason for children to miss school.  It is also expensive: the total cost of asthma to society has been estimated at $56 billion per year in the US. Treatments are available to help manage asthma symptoms, but there is no cure. Prevention is the key to reducing the health and economic burden associated with asthma.

To prevent asthma, we need to understand how the disease originates and develops during early life. The respiratory and immune systems begin to develop in utero, and continue to mature after birth.  During these critical time periods, environmental factors can support or disrupt development and have long-term effects on health.  Some research shows that breastfeeding may reduce the risk of childhood asthma, but not all studies have confirmed this association.  These inconsistent results might be related to differences in breast milk composition or maternal characteristics, but this has not been widely studied until now.  

What was the result of the project and what impact will it have?

This research is still ongoing (through June 2018).  It will provide important new information about the early-life origins of asthma.  The results will ultimately contribute to asthma prevention efforts, and help to reduce the large health and economic burden associated with this disease. Specifically, this research will:

1. Clarify the role of breastfeeding in asthma prevention.

2. Identify specific breast milk components that influence asthma development.

3. Identify maternal factors that influence milk composition and asthma development.

These results will help inform new strategies for asthma prevention. For example:

• Breastfeeding recommendations (What is the optimal duration, and does this differ for mothers with asthma or allergies?)
• Nutritional counselling (Specific dietary modifications to 'optimize' breast milk composition; for example, supplementation with specific probiotic bacteria.).
• Policies on medication use for women who are pregnant or breastfeeding (Should certain   antibiotics be avoided during specific time periods?)
• Development of improved infant formula for those who cannot breastfeed

Publications

Association Between Artificially Sweetened Beverage Consumption During Pregnancy and Infant Body Mass Index.
Azad MB, Sharma AK, de Souza RJ, Dolinsky VW, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Lefebvre DL, Sears MR. JAMA pediatrics. 2016; 170(7):662-70. PMID: 27159792

Bcl-2 family member Mcl-1 expression is reduced under hypoxia by the E3 ligase FBW7 contributing to BNIP3 induced cell death in glioma cells.
Chen Y, Henson ES, Xiao W, Shome E, Azad MB, Burton TR, Queau M, Sathya A, Eisenstat DD, Gibson SB.Cancer biology & therapy. 2016; 17(6):604-13. PMID: 26467103

High fecal IgA is associated with reduced Clostridium difficile colonization in infants.
Bridgman SL, Konya T, Azad MB, Guttman DS, Sears MR, Becker AB, Turvey SE, Mandhane PJ, Subbarao P, Scott JA, Field CJ, Kozyrskyj AL. Microbes and infection / Institut Pasteur. 2016; PMID: 27235197

Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study.
Azad MB, Konya T, Persaud RR, Guttman DS, Chari RS, Field CJ, Sears MR, Mandhane PJ, Turvey SE, Subbarao P, Becker AB, Scott JA, Kozyrskyj AL. BJOG : an international journal of obstetrics and gynaecology. 2016; 123(6):983-993. PMID: 26412384

Wheezing Patterns in Early Childhood and the Risk of Respiratory and Allergic Disease in Adolescence.
Azad MB, Chan-Yeung M, Chan ES, Dytnerski AM, Kozyrskyj AL, Ramsey C, Becker AB. JAMA pediatrics. 2016; 170(4):393-5. PMID: 26857593

Early Exposure to Nonnutritive Sweeteners and Long-term Metabolic Health: A Systematic Review.
Reid AE, Chauhan BF, Rabbani R, Lys J, Copstein L, Mann A, Abou-Setta AM, Fiander M, MacKay DS, McGavock J, Wicklow B, Zarychanski R, Azad MB. Pediatrics. 2016; 137(3):e20153603. PMID: 26917671

Gut microbiota and allergic disease in children.
Bridgman SL, Kozyrskyj AL, Scott JA, Becker AB, Azad MB.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2016; 116(2):99-105. PMID: 26815703

Infant gut immunity: a preliminary study of IgA associations with breastfeeding.
Bridgman SL, Konya T, Azad MB, Sears MR, Becker AB, Turvey SE, Mandhane PJ, Subbarao P, Scott JA, Field CJ, Kozyrskyj AL. Journal of developmental origins of health and disease. 2016; 7(1):68-72. PMID: 26690933

Perinatal antibiotic exposure of neonates in Canada and associated risk factors: a population-based study.
Persaud RR, Azad MB, Chari RS, Sears MR, Becker AB, Kozyrskyj AL. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2015; 28(10):1190-5. PMID: 25053193

Infant gut microbiota and food sensitization: associations in the first year of life.
Azad MB, Konya T, Guttman DS, Field CJ, Sears MR, HayGlass KT, Mandhane PJ, Turvey SE, Subbarao P, Becker AB, Scott JA, Kozyrskyj AL. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2015; 45(3):632-43. PMID: 25599982