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In short:
The development of asthma has been linked to antibiotics exposure in toddlers, with research finding this increases the risk of allergy later in life.
Scientists have found this can be mitigated by a dietary supplement of gut microbiome IPA, which directly counters impairments to the lung, and in turn the risk of asthma.
What's next?
The findings from Monash University's research are likely to now be assessed in the pharmaceutical context.
Groundbreaking research has discovered a potential preventative treatment for asthma, shedding new light on how antibiotics may be driving the disease's onset.
The development of asthma is typically hereditary, triggered by pre-existing respiratory illnesses and allergies, or through exposure to pollutants, smoke, and certain types of dust.
But immunology research by Monash University has now uncovered the use of antibiotics amongst children as another factor, finding kids who consume the drug type were far more susceptible to developing asthma later in life, compared to those who don't in their first years of life.
It found early-life antibiotics unintentionally increased the risk of an individual having an allergy in adulthood through airway inflammation, which consequently increased vulnerability to asthma.
This occurs through a short-term depletion of microbiomes in the gut, through a molecule called indole-3-propionic acid (IPA), which in turn induces chronic changes to functions of the lungs.
Individuals who were exposed to antibiotics and already predisposed to developing asthma would continue to remain susceptible even after the gut microbiome and IPA levels returned to normal, the research found.
Lead researcher Professor Ben Marsland concluded it was this IPA molecule that could make at-risk children immune to asthma in the long term, recommending it be administered to infants and toddlers in the form of dietary supplements to improve gut health.
Through years of lab testing on mice, his work determined IPA was a key agent in countering the detrimental effects of early-life antibiotics, effectively eliminating the likelihood of allergic airway inflammation or asthma later in life.
It found mice who susceptible to airway allergies induced by house dust mites — a common asthma trigger — were cured when their diet was supplemented by IPA.
"We have discovered that a consequence of antibiotic treatment is the depletion of bacteria that produce IPA, thus reducing a key molecule that has the potential to prevent asthma," Professor Marsland said.
"The use of antibiotics in the first year of life can have the unintentional effect of reducing bacteria which promote health, and we now know from this research that antibiotics lead to reduced IPA, which we have found is critical early in life as our lung cells mature, making it a candidate for early life prevention of allergic airway inflammation."
He explained infants at high risk of allergies and asthma were proven to have an abnormal maturation of the gut, which could sought to be stabilised through nutritious food intake, diet supplementation, and limited environmental exposure.
GPs say asthma cure now more achievable
The Royal Australian College of General Practitioners (RACGP) hailed the research findings as a welcome development in what has long been an inert area of medicine.
"Some people think looking for a cure for asthma is still aspirational, but I think it's within reach, and in the meantime, we need to emphasise that asthma can be managed," Dr Kerry Hancock, a respiratory medicine expert from the body said.
Dr Hancock said it was "exciting" to finally have insight into the relationship between early-life antibiotic use and the development of asthma, pointing out the research highlighted a need for better education from GPs on their administration in kids.
"Some of the early exposure to antibiotics is in children who end up in neonatal intensive care or neonatal units who do get given antibiotics out of necessity, and then you've got the infants and young children who may be given antibiotics," she said.
"While sometimes you do need them, we need to have good stewardship around use of antibiotics."
Asthma affects about 11 per cent of the Australian population — 2.8 million people — according to the Australian Institute of Health and Welfare (AIHW)'s statistics for 2022.
The disease was the underlying cause of death for 467 people that year, with the hospitalisation rate being significantly higher among children aged 0-14 than in people older.
Asthma constituted 35 per cent of all respiratory conditions in the country in 2023.
There's currently no cure for the disease, but a range of tailored treatments ranging in severity are undertaken to prevent attacks.
Inhalers are the most common form of treatment, which can help both ease symptoms and stop them from developing.
Asthma specialists also provide short-term relief for reducing inflammation in airways, and daily use long-term control medications.