Distinct Upper Airway Microbiota Trajectories Relate with Early Life Exposures and Allergy and Asthma Outcomes in Childhood

Authors

• Kameron Sugino
• Faith Vundla
• Holly Steininger
• Din Lin
• Margot Bacino
• Jenny Lee
• Claire Schachtschneider
• Kevin Magnaye
• Mustafa Ozcam
• Rahim Khan
• Chris Reyes
• Edward Zoratti, Henry Ford HealthFollow
• Fernando Martinez
• Christian Rosas-Salazar
• Leonard Bacharier
• James Gern
• Susan Lynch

Recommended Citation

Sugino K, Vundla F, Steininger H, Lin D, Bacino M, Lee J, Schachtschneider C, Magnaye K, Ozcam M, Khan R, Reyes C, Zoratti E, Martinez F, Rosas-Salazar C, Bacharier L, Gern J, Lynch S. Distinct Upper Airway Microbiota Trajectories Relate with Early Life Exposures and Allergy and Asthma Outcomes in Childhood. J Allergy Clin Immunol 2026; 157(2):AB422.

Document Type

Conference Proceeding

Publication Date

2-10-2026

Publication Title

J Allergy Clin Immunol

Keywords

immunoglobulin E, RNA 16S, adolescent, adult, age, allergy, asthma, birth cohort, cesarean section, child, childhood, conference abstract, drug therapy, early onset asthma, female, gestational age, Haemophilus, human, infant, lowest income group, major clinical study, male, microflora, Moraxella, nasopharynx, newborn, nonhuman, prevalence, sensitization, special situation for pharmacovigilance, Streptococcus, upper respiratory tract, urban area

Abstract

Rationale: Airway microbiota dominated by Streptococcus, Moraxella or Haemophilus in early life are associated with developing allergic sensitization and asthma. We hypothesize distinct airway microbiota developmental trajectories in childhood relate to early life exposures and atopic outcomes. Methods: 16S rRNA V4 sequencing was performed on n=2,554 nasopharyngeal samples collected from 1-10 years of age (n=720 participants) from three birth cohorts [Childhood Origins of Asthma (COAST), Infant Immune Study (IIS), and Urban Environment and Childhood Asthma (URECA)]. Clinical, demographic, and 16S rRNA data were harmonized. Microbiome trajectories were defined based on Sorensen distance matrix and compared to both fixed and repeated atopic outcomes. Results: Four distinct upper airway microbiota developmental trajectories were identified (TI, n=125; TII, n=431; TIII, n=31 and TIV, n=133). TIII children had higher circulating total IgE (p=0.004) and were more likely to develop asthma (p<0.001) compared to the other trajectories. Specifically, TIII had higher circulating total IgE at 5 years compared to TII and TIV, as well as a higher allergy prevalence than TII and TIV at 9 years of age. TIII children were associated with male sex, C-section delivery, lower gestational age, and lower income (p<0.05). Additionally, TIII were more likely to be dominated by Streptococcus, Moraxella, or Haemophilus at 36 months compared to the other trajectories [HMS dominant: TI: n=38 (30.4%), TII: n=64 (14.8%), TIII: n=20 (64.5%), TIV: n=19 (14.3%)]. Conclusions: Distinct upper airway microbiota development trajectories exist and associate with sex, early life exposures, and the risk of allergic sensitization and asthma.

Volume

157

Issue

2

First Page

AB422