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CIMMAP is an ancillary study based on the PREGRALL clinical study funded by the Ministry of Health, which will be launched in November 2017 and aims to evaluate for the first time a maternal antenatal prebiotic (GOS / Inulin) supplementation on atopic dermatite occurrence in children of high allergic risk.

Background:

Allergies affect 30-40% of the world's population. Among them, Atopic Dermatite (AD) is most often associated with food allergies (FA), followed by allergic rhinitis and/or asthma. The "atopic march"  describes the tendency for allergic diseases to develop sequential throughout childhood. The pathophysiology of AD is not fully elucidated and there is currently no effective strategy for prevention of the disease. AD is a multifactorial disease influenced by genetic (including early functional alteration of the skin barrier) and environmental factors. AD is associated with a dysregulated Immune System and a decrease of gut microbiota diversity. This observation raises the interesting possibility that an early intervention that acts to induce an optimal gut microbiota, such as prebiotic supplementation, may function to prevent AD development, and therefore prevent the initial phase of the atopic march.

Objectives:

CIMMAP will use biological samples from at least 60 mother-child dyads (n≥30 per arm) recruited in PREGRALL (blood and stools from mothers and infants, cord blood, colostrum and breast milk) in order to characterize:

1) IS activity and maturation in mother and newborn, respectively, by exploring the innate cell responsiveness/functionality and the adaptive immunity
2) the modulation of the infant IS by maternal gut microbiota and its derived products
3) the composition and function (production of metabolites such as SCFA) of the maternal and newborn microbiota
4) the composition of  breast milk (immune and growth factors, nutrients and miRNA) and its impact on immune and microbial factors of the newborn;

Additionally, a preclinical model of cutaneous sensitization, to mimic the clinical symptoms of AD associated with FA, will be used to study the mechanisms of AM and the effects of prebiotics. These results should allow to identify the immunological, physiological and microbial biomarkers of allergy and the potential effect of prebiotics.

CIMMAP should improve our understanding of the occurrence of allergic pathologies and, from an industrial perspective, yield new opportunities to develop foods enriched in prebiotics to prevent allergies.

Consortium:

The CIMMAP  ANR is a collaborative research project coordinated by Marie Bodinier (Allergy to food proteins team). This project involves a consortium of 7 partners:

• UR1268 BIA, INRA center of Angers-Nantes (Marie Bodinier, coordinator)
• CHU of Nantes (Sebastien Barbarot)
• UMR MICALIS, INRA center of Jouy-en-Josas (Philippe Langella)    
• UMR PHAN, INRA center of Angers-Nantes (Bertrand Kaeffer)
• UMR INRA-CEA SPI, IBITECH-S, CEA of Saclay (Karine Adel-Patient)
• USC StatSC, ONIRIS and INRA center of Angers-Nantes (Veronique Cariou)
• The Center for Research in Human Nutrition of Western France, CRHN-W  (David Riochet)

Overall, members of the consortium involved in the CIMMAP project all have the expertise and a clinical tools, techniques, and technologies required to achieve our objectives, both in terms of medical and scientific aspects, as well as feasibility (project and Intellectual Property (IP) management, business development). CIMMAP brings together science-based academics (immunologists, microbiologists, physiologists, omics specialists, molecular biologists and statisticians) as well as clinical dermatologists, paediatric dermatologists and obstetricians. These partners, by sharing their different expertise and technical approaches, have afforded a unique opportunity to test, for the first time, the effect of prebiotics in antenatal period for allergy prevention.