Antibiotic Use by Pregnant Women Is a Risk Factor for Crohn’s and Colitis, Study Says
The correct use of antibiotics for treating medical conditions can be a hot topic of discussion. While many antibiotics provide powerful relief for a variety of conditions, there is some discussion about the negative side effects that can occur with the use of certain antibiotics. According to a study completed by Professor Eugene Chang and his team at the University of Chicago, the use of antibiotics during the peripartum stage of pregnancy may contribute to the development of Crohn’s disease and other inflammatory bowel diseases in the children of parents who are genetically susceptible to these conditions.
About the study
Professor Chang’s study was performed on a group of pregnant mice. While the study hasn’t been replicated on human subjects at this point, the results may still provide some insight into how these antibiotics affect humans who take them. Additionally, concerns about the effect of antibiotics used on humans during pregnancy have been raised before, especially considering how they contribute to the development of inflammatory bowel diseases. The mice in the test group were already genetically susceptible to developing inflammatory bowel disease, so their offspring would be as well. The pregnant mice were given doses of cefoperazone, an antibiotic commonly used to treat bacterial infections, at a very late stage in their pregnancy and into the nursing of their young. This was done to replicate the duration that a clinical exposure to an antibiotic will typically have in a human subject.
Although there was no recorded increase of inflammatory bowel symptoms in the adult mice, and none of the adult mice developed bowel diseases such as colitis, researchers did find that the offspring were more likely to develop some form of inflammatory bowel disease, especially when compared to the offspring of mice that had not been treated with cefoperazone during the peripartum period.
The increased likelihood for the second generation of mice to develop an inflammatory bowel disease is due in part to the changes that the use of the antibiotics affected in the adult mice. The gut microbiome of the adult mice was greatly changed by the use of the antibiotics, and these changes were permanent. Notably, these same changes were passed down to the adult mice’s offspring, and the changes were permanent in the second generation of mice as well.
According to Professor Chang, because of the changes in the microbiomes of the mother mice, the baby mice inherited a different and altered set of microbes. It was this change in the microbes passed down to the baby mice that made them more susceptible to the development of bowel diseases such as Crohn’s.
The results of the study
While the results of the study clearly revealed a link between the use of cefoperazone in the peripartum period and the development of inflammatory bowel diseases in offspring, the researchers also hoped to gain better insight into the details of the biological changes that were affected during treatment. The team at the University of Chicago used cutting-edge sequencing technologies to examine and review the gut microbial populations in the adult mice and in the second generation of mice as well. The researchers discovered that in the adult mice treated with cefoperazone, there was a decrease in diversity of the microbial population. They also noted that some of the microbial population sizes in the mother mice had increased or decreased relative to what was found in mice who were not treated with the antibiotic. Even after the administration of cefoperazone had been ceased, the changes in the microbial populations in the guts of the mother mice remained for four to eight weeks.
When the populations of the microbes in the guts of the second generation mice were examined, researchers found that they matched the findings from the mother mice. In comparison to mice who were born from mothers that were not treated with cefoperazone, the diversity in the microbe population of the mice in question was drastically decreased. However, unlike the mother mice who resumed normal levels of microbial function within four to eight weeks, the changes in the second generation mice were permanent and lasted throughout adulthood.
The results of this study suggest several important lessons for researchers and physicians. First, the results indicate that the timing of the application of certain antibiotics can be critical when it comes to determining what affects an antibiotic may have on offspring. This study specifically examined the results of giving adult mice antibiotics at a very late stage in their pregnancies and into the early stages of nursing. The effects of cefoperazone may have been more drastic and permanent in the second generation mice because they occurred at a period that is key to growth and development. At this stage of application, the young mice were still in the very early stages of development and therefore more vulnerable.
Second, and perhaps most importantly, the results of this study further indicate that caution should be exercised when prescribing the use of antibiotics, especially when patients are in periods of health and development that may be more critical or vulnerable. Professor Chang stressed the importance of not discounting antibiotics altogether. Many antibiotics are incredibly helpful for patients suffering from a variety of conditions, and despite the negative affects recorded in this study, Professor Chang explained that antibiotics should continue to be administered for the health of patients who need them.
While antibiotics are a serious medical asset, they can also have side effects that physicians may not always anticipate. Professor Chang also suggested that this experiment should cause physicians to be cautious when prescribing the use of antibiotics. While many antibiotics, cefoperazone included, can be immensely helpful, they do have side effects, and because these side effects can have negative consequences these drugs should not be prescribed without care or “just to be safe”.
What does this study tell us?
Ultimately, the results of this study may help to further exploration into understanding the nature of a healthy microbiome. A better understanding of the microbiome and how a health microbiome functions may also reveal what can be done to change a patient’s microbiome in order to promote health. Based on this study alone, it’s evident that alterations to an organism’s microbiome can have a big impact on that individual and its offspring. A greater understanding of the microbiome would provide more insight into how health and especially how immune systems develop and function.
In addition to shedding light on the potentially harmful effects of antibiotics especially when it comes to susceptibility and development of inflammatory bowel disease or Crohn’s disease, the results of this study may have implications for revealing more information about cultivating long term health in patients. Professor Chang hopes to continue researching the nature of the microbiome and to eventually create a microbial cocktail that could be given to infants in order to ensure that they develop a healthy and well-functioning microbial population in order to promote long term health.
The results of this study may be fairly limited, as it was after all conducted on a population of mice and has not been replicated on humans. Prior to this study, there were questions about the possible link between antibiotics in the peripartum period and the development of bowel diseases in offspring, and this study may lend credence to those questions. More than anything, the results highlight the need for caution when using antibiotics, especially in periods of vulnerable health, and perhaps as well what has yet to be learned about the role of a well-functioning microbial population in health.
References:
https://www.sciencedaily.com/releases/2017/07/170711125702.htm
