Welcome to the ArRiEta lab

The early-life microbiome
in health & disease 


Microbial colonization begins at birth, rapidly populating every surface in contact with the environment, giving rise to stable communities, or microbiomes. Microbes have been studied for decades due to their roles in infectious diseases, but we are now starting to comprehend the significant impact of the microbiome on our health. In the Arrieta lab, our primary focus is the communication between the early-life microbiome and developmental programming events necessary for a healthy start in life.

"The world is covered in a fine patina of feces" 

- Stanley Falkow.
Stanford microbiologist.

what do we research?

To tackle these complex questions, our lab has developed an expertise in translating human cohort discoveries into animal models using principally the workflow below 

Research Approaches 

Our lab is involved in clinical and preclinical research. Using Next Generation Sequencing of microbiome samples with Metabolomics and Immunological Profiling in both humans and animal models of diseases, we aim to decipher the role of the Bacterial Microbiome and fungal microbiome Mycobiome in chronic diseases. These include Asthma inflammatory bowel disease IBD, Obesity, Stress Axis & Neurodevelopment

Research flow overview 

technical expertises in early-life microbiome

Clinical studies

Longitudinal observational studies
Preterm and term infants

Microbial ecology 

Sequencing 16S, 18S, ITS
Multivariate statistical models
Microbial network interactions

in vivo models

Murin models
Gnotobiotic conditions
International Microbiome Center

Research topics OVERVIEW


Asthma is one of the most common immune-mediated diseases affecting children and adults worldwide. Asthma is a complex condition that develops by a combination of both environmental and genetic factors. Amongst the many environmental factors that influence asthma incidence, early-life alterations to the gut microbiome are strongly associated with asthma susceptibility in children. Data from diverse population-based studies repeatedly show that factors such as birth via Caesarian (C-section), exclusive formula feeding, urban (vs. farm) living, prenatal and neonatal use of antibiotics, among others also known to directly influence the composition and function of the gut microbiome, increase the risk of children for being diagnosed with asthma by school age. The Arrieta lab aims to characterize how various environmental factors impact the microbiome and the specific microbial signatures that may predispose infants to asthma.


The gut microbiome and the brain communicate bi-directionally via several host- and microbially-derived signaling mechanisms, forming the microbiome-gut-brain axis. The hypothalamic-pituitary-adrenal (HPA) axis is the principal regulator of the stress response in the body through the release of glucocorticoids such as cortisol. The microbiome has been causally implicated in HPA axis programming in early life in rodents, however, understandings in humans remain limited. Given the gut microbiome and the brain undergo periods of significant development in parallel in early life, and the microbiome-gut-brain axis is increasingly recognized as a key mechanism by which the microbiome influences host development and health outcomes, our lab seeks to better understand this relationship through both translational and clinical studies. 

metabolic syndromE & obesity

It has been previously established that the microbiome plays a crucial role in host metabolism and metabolic development. Additionally, the immune system, which has also been found to be regulated by the microbiome, has been implicated in the metabolic inflammation that accompanies obesity. While the role of bacterial commensals has been extensively investigated, the fungal population (mycobiome) remains understudied in this context. For this reason, the Arrieta lab aims to take a multi-kingdom approach to explore how commensal microbes modulate host metabolism as well as the immunological consequences of this relationship. We also plan to determine how the microbiome can be harnessed for therapeutic benefit in a metabolic context.

colonization resistance

The Arrieta lab’s interest in the microbiome also extends past early life to the microbiome’s role in metabolism, immune function and colonization resistance. It is known that certain microbiome metabolites, such as SCFAs, can limit some pathogen’s ability to infect their hosts, and the Arrieta lab, along with some fantastic collaborators, is investigating the role of some novel microbiome-produced small aromatic molecules (MPSAMs).  The effect of these molecules on colonization resistance against and virulence factors of Salmonella and EPEC infection, as well as their role in regulating host immune and metabolic functions is currently being investigated.

microbial ecology

A central goal of the Arrieta lab is to advance our ecological understandings of the early life gut microbiome, as this is fundamental to generating meaningful progress in health outcome-related microbiome research. The microbiome is a complex, multi-kingdom ecosystem, however, most research to date has focused only on characterizing the composition and functional role of bacteria. This provides an incomplete portrayal of the complex ecological dynamics occurring both within the gut and in relation to host physiological processes. Research from our lab has shown that bacteria and fungi are engaged in several symbiotic relationships, including in relation to immune responses, although much remains to be elucidated in understanding these interactions. The Arrieta lab continuously seeks to better characterize interkingdom dynamics occurring within the gut microbiome and understand their varied influences on the development and function of host physiological systems. 

Visit the BLOOM  Website


Alberta BLOOM is an important research initiative at the University of Calgary aiming to discover how the maternal and infant microbiome impact infant and child health. The Arrieta lab leads a clinical cohort study of premature infants born in Calgary called the Alberta BLOOM Study. This study follows premature infants from birth to three years of age, collecting comprehensive biological and clinical data that enables us to examine microbiome development during this period through a number of lenses. Given colonization patterns of the premature infant gut microbiome are known to differ from term-born infants, our goal is to better understand how these early alterations may impact infant development and long-term health outcomes, and to determine whether microbiome-based therapeutics may be employed to improve health outcomes in this population.

Check out our Website

LATEST Research Publications


Long-term and trimester-specific effects of prenatal stress on the child gut microbiota. 

Rojas L, van de Wouw M, Wang Y, Vaghef-Mehrabani E, Dewey D, Reimer RA, Letourneau N, Campbell T, Arrieta MC, Giesbrecht GF.

Psychoneuroendocrinology. 2023 Sep 9;158:106380. doi: 10.1016/j.psyneuen.2023.106380. Online ahead of print.

PMID: 37696229

Exploring associations between the gut microbiota and full-scale intelligence in preschool children. 

van de Wouw M, Rojas L, Vaghef-Mehrabani E, Wang Y, Fichter C, Workentine ML, Dewey D, Arrieta MC, Reimer RA, Tomfohr-Madsen L, Giesbrecht GF.

Neurosci Lett. 2023 Jul 27;810:137357. doi: 10.1016/j.neulet.2023.137357. Epub 2023 Jun 22.

PMID: 37355156

Maturational patterns of the infant gut mycobiome are associated with early-life body mass index. 

Gutierrez MW, Mercer EM, Moossavi S, Laforest-Lapointe I, Reyna ME, Becker AB, Simons E, Mandhane PJ, Turvey SE, Moraes TJ, Sears MR, Subbarao P, Azad MB, Arrieta MC.

Cell Rep Med. 2023 Feb 21;4(2):100928. doi: 10.1016/j.xcrm.2023.100928. Epub 2023 Feb 2.

PMID: 36736319 Free PMC article.

Supplementation with a probiotic mixture accelerates gut microbiome maturation and reduces intestinal inflammation in extremely preterm infants. 

Samara J, Moossavi S, Alshaikh B, Ortega VA, Pettersen VK, Ferdous T, Hoops SL, Soraisham A, Vayalumkal J, Dersch-Mills D, Gerber JS, Mukhopadhyay S, Puopolo K, Tompkins TA, Knights D, Walter J, Amin H, Arrieta MC.

Cell Host Microbe. 2022 May 11;30(5):696-711.e5. doi: 10.1016/j.chom.2022.04.005.

PMID: 35550672 Clinical Trial.

Correction to: "Molding" immunity-modulation of mucosal and systemic immunity by the intestinal mycobiome in health and disease. 

Gutierrez MW, van Tilburg Bernardes E, Changirwa D, McDonald B, Arrieta MC.

Mucosal Immunol. 2022 Apr;15(4):797. doi: 10.1038/s41385-022-00523-w.

PMID: 35545698 No abstract available.

Multi-strain probiotics for extremely preterm infants: a randomized controlled trial. 

Alshaikh B, Samara J, Moossavi S, Ferdous T, Soraisham A, Dersch-Mills D, Arrieta MC, Amin H.

Pediatr Res. 2022 Dec;92(6):1663-1670. doi: 10.1038/s41390-022-02004-z. Epub 2022 Mar 21.

PMID: 35314794 Clinical Trial.

Metaproteomic profiling of fungal gut colonization in gnotobiotic mice. 

Pettersen VK, Dufour A, Arrieta MC.

Anim Microbiome. 2022 Feb 22;4(1):14. doi: 10.1186/s42523-022-00163-2.

PMID: 35193703 Free PMC article.

Exposure to Parasitic Protists and Helminths Changes the Intestinal Community Structure of Bacterial Communities in a Cohort of Mother-Child Binomials from a Semirural Setting in Mexico. 

Partida-Rodriguez O, Nieves-Ramirez M, Laforest-Lapointe I, Brown EM, Parfrey L, Valadez-Salazar A, Thorson L, Morán P, Gonzalez E, Rascon E, Magaña U, Hernandez E, Rojas-Velázquez L, Torres J, Arrieta MC, Ximenez C, Finlay BB.

mSphere. 2021 Aug 25;6(4):e0008321. doi: 10.1128/mSphere.00083-21. Epub 2021 Aug 18.

PMID: 34406855 Free PMC article.

The human gut microbiome and health inequities. 

Amato KR, Arrieta MC, Azad MB, Bailey MT, Broussard JL, Bruggeling CE, Claud EC, Costello EK, Davenport ER, Dutilh BE, Swain Ewald HA, Ewald P, Hanlon EC, Julion W, Keshavarzian A, Maurice CF, Miller GE, Preidis GA, Segurel L, Singer B, Subramanian S, Zhao L, Kuzawa CW.

Proc Natl Acad Sci U S A. 2021 Jun 22;118(25):e2017947118. doi: 10.1073/pnas.2017947118.

PMID: 34161260 Free PMC article.

Concurrent Prebiotic Intake Reverses Insulin Resistance Induced by Early-Life Pulsed Antibiotic in Rats. 

Klancic T, Laforest-Lapointe I, Wong J, Choo A, Nettleton JE, Chleilat F, Arrieta MC, Reimer RA.

Biomedicines. 2021 Jan 12;9(1):66. doi: 10.3390/biomedicines9010066.

PMID: 33445530 Free PMC article.

Maternal consumption of artificially sweetened beverages during pregnancy is associated with infant gut microbiota and metabolic modifications and increased infant body mass index. 

Laforest-Lapointe I, Becker AB, Mandhane PJ, Turvey SE, Moraes TJ, Sears MR, Subbarao P, Sycuro LK, Azad MB, Arrieta MC.

Gut Microbes. 2021 Jan-Dec;13(1):1-15. doi: 10.1080/19490976.2020.1857513.

PMID: 33382954 Free PMC article.

Sputum microbiota in adults with CF associates with response to inhaled tobramycin. 

Heirali A, Thornton C, Acosta N, Somayaji R, Laforest Lapointe I, Storey D, Rabin H, Waddell B, Rossi L, Arrieta MC, Surette M, Parkins MD.

Thorax. 2020 Dec;75(12):1058-1064. doi: 10.1136/thoraxjnl-2019-214191. Epub 2020 Nov 2.

PMID: 33139451

Prebiotic Oligofructose Prevents Antibiotic-Induced Obesity Risk and Improves Metabolic and Gut Microbiota Profiles in Rat Dams and Offspring. 

Klancic T, Laforest-Lapointe I, Choo A, Nettleton JE, Chleilat F, Noye Tuplin EW, Alukic E, Cho NA, Nicolucci AC, Arrieta MC, Reimer RA.

Mol Nutr Food Res. 2020 Aug;64(16):e2000288. doi: 10.1002/mnfr.202000288. Epub 2020 Jul 12.

PMID: 32610365

Intestinal fungi are causally implicated in microbiome assembly and immune development in mice. 

van Tilburg Bernardes E, Pettersen VK, Gutierrez MW, Laforest-Lapointe I, Jendzjowsky NG, Cavin JB, Vicentini FA, Keenan CM, Ramay HR, Samara J, MacNaughton WK, Wilson RJA, Kelly MM, McCoy KD, Sharkey KA, Arrieta MC.

Nat Commun. 2020 May 22;11(1):2577. doi: 10.1038/s41467-020-16431-1.

PMID: 32444671 Free PMC article.

Microbial Eukaryotes: a Missing Link in Gut Microbiome Studies. 

Laforest-Lapointe I, Arrieta MC.

mSystems. 2018 Mar 13;3(2):e00201-17. doi: 10.1128/mSystems.00201-17. eCollection 2018 Mar-Apr.

PMID: 29556538 Free PMC article.

Associations between infant fungal and bacterial dysbiosis and childhood atopic wheeze in a nonindustrialized setting. 

Arrieta MC, Arévalo A, Stiemsma L, Dimitriu P, Chico ME, Loor S, Vaca M, Boutin RCT, Morien E, Jin M, Turvey SE, Walter J, Parfrey LW, Cooper PJ, Finlay B.

J Allergy Clin Immunol. 2018 Aug;142(2):424-434.e10. doi: 10.1016/j.jaci.2017.08.041. Epub 2017 Dec 11.

PMID: 29241587 Free PMC article.

Probiotics supplementation and length of hospital stay in neonates with gastrointestinal surgery. 

Mugarab-Samedi V, Howlett A, Hicks M, Arrieta MC, Beaudry P, Dersch-Mills D, Alshaikh B.

Int J Surg Protoc. 2017 Oct 18;6:13-16. doi: 10.1016/j.isjp.2017.10.001. eCollection 2017.

PMID: 31851737 Free PMC article.

Shifts in Lachnospira and Clostridium sp. in the 3-month stool microbiome are associated with preschool age asthma. 

Stiemsma LT, Arrieta MC, Dimitriu PA, Cheng J, Thorson L, Lefebvre DL, Azad MB, Subbarao P, Mandhane P, Becker A, Sears MR, Kollmann TR; Canadian Healthy Infant Longitudinal Development (CHILD) Study Investigators; Mohn WW, Finlay BB, Turvey SE.

Clin Sci (Lond). 2016 Dec 1;130(23):2199-2207. doi: 10.1042/CS20160349. Epub 2016 Sep 15.

PMID: 27634868

Nutrient Deprivation Affects Salmonella Invasion and Its Interaction with the Gastrointestinal Microbiota. 

Yurist-Doutsch S, Arrieta MC, Tupin A, Valdez Y, Antunes LC, Yen R, Finlay BB.

PLoS One. 2016 Jul 20;11(7):e0159676. doi: 10.1371/journal.pone.0159676. eCollection 2016.

PMID: 27437699 Free PMC article.

Human Microbiota-Associated Mice: A Model with Challenges. 

Arrieta MC, Walter J, Finlay BB.

Cell Host Microbe. 2016 May 11;19(5):575-8. doi: 10.1016/j.chom.2016.04.014.

PMID: 27173924

A humanized microbiota mouse model of ovalbumin-induced lung inflammation. 

Arrieta MC, Sadarangani M, Brown EM, Russell SL, Nimmo M, Dean J, Turvey SE, Chan ES, Finlay BB.

Gut Microbes. 2016 Jul 3;7(4):342-352. doi: 10.1080/19490976.2016.1182293. Epub 2016 Apr 26.

PMID: 27115049 Free PMC article.

Early infancy microbial and metabolic alterations affect risk of childhood asthma. 

Arrieta MC, Stiemsma LT, Dimitriu PA, Thorson L, Russell S, Yurist-Doutsch S, Kuzeljevic B, Gold MJ, Britton HM, Lefebvre DL, Subbarao P, Mandhane P, Becker A, McNagny KM, Sears MR, Kollmann T; CHILD Study Investigators; Mohn WW, Turvey SE, Finlay BB.

Sci Transl Med. 2015 Sep 30;7(307):307ra152. doi: 10.1126/scitranslmed.aab2271.

PMID: 26424567

Diet and specific microbial exposure trigger features of environmental enteropathy in a novel murine model. 

Brown EM, Wlodarska M, Willing BP, Vonaesch P, Han J, Reynolds LA, Arrieta MC, Uhrig M, Scholz R, Partida O, Borchers CH, Sansonetti PJ, Finlay BB.

Nat Commun. 2015 Aug 4;6:7806. doi: 10.1038/ncomms8806.

PMID: 26241678 Free PMC article.

Increasing small intestinal permeability worsens colitis in the IL-10-/- mouse and prevents the induction of oral tolerance to ovalbumin. 

Arrieta MC, Madsen KL, Field CJ, Meddings JB.

Inflamm Bowel Dis. 2015 Jan;21(1):8-18. doi: 10.1097/MIB.0000000000000253.

PMID: 25517593

Intestinal permeability in children with food allergy on specific elimination diets. 

Järvinen KM, Konstantinou GN, Pilapil M, Arrieta MC, Noone S, Sampson HA, Meddings J, Nowak-Węgrzyn A.

Pediatr Allergy Immunol. 2013 Sep;24(6):589-95. doi: 10.1111/pai.12106. Epub 2013 Aug 2.

PMID: 23909601 Free PMC article.

The commensal microbiota drives immune homeostasis. 

Arrieta MC, Finlay BB.

Front Immunol. 2012 Mar 5;3:33. doi: 10.3389/fimmu.2012.00033. eCollection 2012.

PMID: 22566917 Free PMC article.


Latest reviews


The global human gut microbiome: genes, lifestyles, and diet. 

Parizadeh M, Arrieta MC.

Trends Mol Med. 2023 Oct;29(10):789-801. doi: 10.1016/j.molmed.2023.07.002. Epub 2023 Jul 27.

PMID: 37516570 Review.

Principles and Terminology for Host-Microbiome-Drug Interactions. 

Heirali A, Moossavi S, Arrieta MC, Coburn B.

Open Forum Infect Dis. 2023 Apr 12;10(5):ofad195. doi: 10.1093/ofid/ofad195. eCollection 2023 May.

PMID: 37180590 Free PMC article.

Probiotics to improve the gut microbiome in premature infants: are we there yet? 

Mercer EM, Arrieta MC.

Gut Microbes. 2023 Jan-Dec;15(1):2201160. doi: 10.1080/19490976.2023.2201160.

PMID: 37122152 Free PMC article. Review.

Questioning the fetal microbiome illustrates pitfalls of low-biomass microbial studies. 

Kennedy KM, de Goffau MC, Perez-Muñoz ME, Arrieta MC, Bäckhed F, Bork P, Braun T, Bushman FD, Dore J, de Vos WM, Earl AM, Eisen JA, Elovitz MA, Ganal-Vonarburg SC, Gänzle MG, Garrett WS, Hall LJ, Hornef MW, Huttenhower C, Konnikova L, Lebeer S, Macpherson AJ, Massey RC, McHardy AC, Koren O, Lawley TD, Ley RE, O'Mahony L, O'Toole PW, Pamer EG, Parkhill J, Raes J, Rattei T, Salonen A, Segal E, Segata N, Shanahan F, Sloboda DM, Smith GCS, Sokol H, Spector TD, Surette MG, Tannock GW, Walker AW, Yassour M, Walter J.

Nature. 2023 Jan;613(7945):639-649. doi: 10.1038/s41586-022-05546-8. Epub 2023 Jan 25.

PMID: 36697862 Review.

The rise to power of the microbiome: power and sample size calculation for microbiome studies. 

Ferdous T, Jiang L, Dinu I, Groizeleau J, Kozyrskyj AL, Greenwood CMT, Arrieta MC.

Mucosal Immunol. 2022 Jun;15(6):1060-1070. doi: 10.1038/s41385-022-00548-1. Epub 2022 Jul 22.

PMID: 35869146 Review.

"Molding" immunity-modulation of mucosal and systemic immunity by the intestinal mycobiome in health and disease. 

Gutierrez MW, van Tilburg Bernardes E, Changirwa D, McDonald B, Arrieta MC.

Mucosal Immunol. 2022 Apr;15(4):573-583. doi: 10.1038/s41385-022-00515-w. Epub 2022 Apr 26.

PMID: 35474360 Review.

Gut-on-chip for ecological and causal human gut microbiome research. 

Moossavi S, Arrieta MC, Sanati-Nezhad A, Bishehsari F.

Trends Microbiol. 2022 Aug;30(8):710-721. doi: 10.1016/j.tim.2022.01.014. Epub 2022 Feb 18.

PMID: 35190251 Review.

Inferring early-life host and microbiome functions by mass spectrometry-based metaproteomics and metabolomics. 

Pettersen VK, Antunes LCM, Dufour A, Arrieta MC.

Comput Struct Biotechnol J. 2021 Dec 20;20:274-286. doi: 10.1016/j.csbj.2021.12.012. eCollection 2022.

PMID: 35024099 Free PMC article. Review.

The intestinal mycobiome as a determinant of host immune and metabolic health. 

Gutierrez MW, Arrieta MC.

Curr Opin Microbiol. 2021 Aug;62:8-13. doi: 10.1016/j.mib.2021.04.004. Epub 2021 May 13.

PMID: 33993019 Review.

Evolutionary Significance of the Neuroendocrine Stress Axis on Vertebrate Immunity and the Influence of the Microbiome on Early-Life Stress Regulation and Health Outcomes. 

Ortega VA, Mercer EM, Giesbrecht GF, Arrieta MC.

Front Microbiol. 2021 Apr 7;12:634539. doi: 10.3389/fmicb.2021.634539. eCollection 2021.

PMID: 33897639 Free PMC article. Review.

The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods. 

Marco ML, Sanders ME, Gänzle M, Arrieta MC, Cotter PD, De Vuyst L, Hill C, Holzapfel W, Lebeer S, Merenstein D, Reid G, Wolfe BE, Hutkins R.

Nat Rev Gastroenterol Hepatol. 2021 Mar;18(3):196-208. doi: 10.1038/s41575-020-00390-5. Epub 2021 Jan 4.

PMID: 33398112 Free PMC article. Review.

The Fungal Microbiome and Asthma. 

van Tilburg Bernardes E, Gutierrez MW, Arrieta MC.

Front Cell Infect Microbiol. 2020 Nov 26;10:583418. doi: 10.3389/fcimb.2020.583418. eCollection 2020.

PMID: 33324573 Free PMC article. Review.

Host-microbiome intestinal interactions during early life: considerations for atopy and asthma development. 

Pettersen VK, Arrieta MC.

Curr Opin Allergy Clin Immunol. 2020 Apr;20(2):138-148. doi: 10.1097/ACI.0000000000000629.

PMID: 32004178 Review.

The association between early life antibiotic use and allergic disease in young children: recent insights and their implications. 

Obiakor CV, Tun HM, Bridgman SL, Arrieta MC, Kozyrskyj AL.

Expert Rev Clin Immunol. 2018 Oct;14(10):841-855. doi: 10.1080/1744666X.2018.1521271. Epub 2018 Sep 29.

PMID: 30198345 Review.

Hygiene Hypothesis in Asthma Development: Is Hygiene to Blame? 

van Tilburg Bernardes E, Arrieta MC.

Arch Med Res. 2017 Nov;48(8):717-726. doi: 10.1016/j.arcmed.2017.11.009. Epub 2017 Dec 7.

PMID: 29224909 Review.

Patterns of Early-Life Gut Microbial Colonization during Human Immune Development: An Ecological Perspective. 

Laforest-Lapointe I, Arrieta MC.

Front Immunol. 2017 Jul 10;8:788. doi: 10.3389/fimmu.2017.00788. eCollection 2017.

PMID: 28740492 Free PMC article. Review.

A critical assessment of the "sterile womb" and "in utero colonization" hypotheses: implications for research on the pioneer infant microbiome. 

Perez-Muñoz ME, Arrieta MC, Ramer-Tait AE, Walter J.

Microbiome. 2017 Apr 28;5(1):48. doi: 10.1186/s40168-017-0268-4.

PMID: 28454555 Free PMC article. Review.

The intestinal microbiota and allergic asthma. 

Arrieta MC, Finlay B.

J Infect. 2014 Nov;69 Suppl 1:S53-5. doi: 10.1016/j.jinf.2014.07.015. Epub 2014 Sep 26.

PMID: 25264162 Review.

Gastrointestinal microbiota-mediated control of enteric pathogens. 

Yurist-Doutsch S, Arrieta MC, Vogt SL, Finlay BB.

Annu Rev Genet. 2014;48:361-82. doi: 10.1146/annurev-genet-120213-092421. Epub 2014 Sep 10.

PMID: 25251855 Review.

The intestinal microbiome in early life: health and disease. 

Arrieta MC, Stiemsma LT, Amenyogbe N, Brown EM, Finlay B.

Front Immunol. 2014 Sep 5;5:427. doi: 10.3389/fimmu.2014.00427. eCollection 2014.

PMID: 25250028 Free PMC article. Review.

Effects of antibiotics on human microbiota and subsequent disease. 

Keeney KM, Yurist-Doutsch S, Arrieta MC, Finlay BB.

Annu Rev Microbiol. 2014;68:217-35. doi: 10.1146/annurev-micro-091313-103456. Epub 2014 Jun 2.

PMID: 24995874 Review.

A fresh look at the hygiene hypothesis: how intestinal microbial exposure drives immune effector responses in atopic disease. 

Brown EM, Arrieta MC, Finlay BB.

Semin Immunol. 2013 Nov 30;25(5):378-87. doi: 10.1016/j.smim.2013.09.003. Epub 2013 Oct 25.

PMID: 24209708 Review.

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