Taking antibiotics in the first two years of life can prevent babies from developing a robust immune response to certain vaccines. The new finding provides another cautionary tale against overusing antibiotics, researchers say.

Babies get immunized in their first six months, and receive booster doses in their second year, to protect against certain infectious diseases. Antibiotic use during that time was associated with subpar immune responses to four vaccines babies receive to ward off whooping cough, polio and other diseases, researchers report online April 27 in Pediatrics.

And the more rounds of antibiotics a child received, the more antibody levels to the vaccines dropped below what’s considered protective. Levels induced by the primary series of shots for the polio, diphtheria-tetanus-pertussis, Haemophilus influenzae type b and pneumococcal vaccines fell 5 to 11 percent with each antibiotic course. In the children’s second year, antibody levels generated by booster shots of these vaccines dropped 12 to 21 percent per course.
“If anyone needed yet another reason why overprescription of antibiotics is not a good thing, this paper offers that reason,” says immunologist Bali Pulendran of Stanford University School of Medicine, who was not involved in the study.

Taking antibiotics disrupts the population of bacteria that live in the gut. That’s well known, but researchers are still learning about how that disruption can affect a person’s health. The new study adds to evidence that diminishing the amount and diversity of gut bacteria impacts vaccination. In studies in mice, antibiotics hampered the immune system’s response to vaccines. And a small study in humans found that antibiotics dampened adults’ response to the flu vaccine in those whose prior immune memory for influenza had waned, Pulendran and colleagues reported in 2019.

The study in Pediatrics is the first to report an association between antibiotic use and compromised vaccine responses in children. Michael Pichichero, a pediatric infectious diseases specialist at the Rochester General Hospital Research Institute in New York, and colleagues collected blood samples taken from 560 children during routine visits with their pediatricians. Of those, 342 children had been prescribed close to 1,700 courses of antibiotics and 218 children had not gotten the drugs. The team analyzed whether antibody levels induced by the four vaccines met the threshold considered protective and found levels more often fell short for the kids who had gotten antibiotics.

The type and length of antibiotic treatment also made a difference. Broad spectrum drugs were associated with antibody levels below what is protective, while a more targeted antibiotic was not. Furthermore, a 10-day course, but not a five-day course, reduced vaccine-induced antibody levels.

The researchers didn’t look at whether children in the study with diminished antibody levels were more likely to develop vaccine-preventable diseases. But there has been concern about outbreaks of whooping cough, says Pichichero, which have occurred in the the United States despite vaccination (SN: 4/4/14). Perhaps antibiotic use can help explain these outbreaks, he says.

To see what kinds of changes are occurring in the gut bacteria, Pichichero and colleagues are beginning a study with a new group of children. The researchers will collect stool samples along with blood draws and antibiotic use records. They’d like to follow the children past age 5, beyond the time kids receive another round of booster shots, to learn whether antibiotics also interfere with this next opportunity to develop antibodies.

“Antibiotics are miracle medicines,” says Pichichero. “In no way does this study imply that children who need an antibiotic shouldn’t get it.” But if possible, it should be a narrowly targeted antibiotic for a shorter course, he says. Along with the risk of antibiotic resistance that comes with overuse of the drugs (SN: 1/24/22), the impact antibiotics could have on vaccine-induced immunity “has clinical implications for every individual child.”

Leonardo da Vinci was wrong about trees.

The multitalented, Renaissance genius wrote down his “rule of trees” over 500 years ago. It described the way he thought that trees branch. Though it was a brilliant insight that helped him to draw realistic landscapes, Leonardo’s rule breaks down for many types of trees. Now, a new branching rule — dubbed “Leonardo-like” — works for virtually any leafy tree, researchers report in a paper accepted April 13 in Physical Review E.

“The older Leonardo rule describes the thickness of the branches, while the length of the branch was not taken into account,” says physicist Sergey Grigoriev of the Petersburg Nuclear Physics Institute in Gatchina, Russia. “Therefore, the description using the older rule is not complete.”
Leonardo’s rule says that the thickness of a limb before it branches into smaller ones is the same as the combined thickness of the limbs sprouting from it (SN: 6/1/11). But according to Grigoriev and his colleagues, it’s the surface area that stays the same.

Using surface area as a guide, the new rule incorporates limb widths and lengths, and predicts that long branches end up being thinner than short ones. Unlike Leonardo’s guess, the updated rule works for slender birches as well as it does for sturdy oaks, the team reports.

The connection between the surface area of branches and overall tree structure shows that it’s the living, outer layers that guide tree structure, the researchers say. “The life of a tree flows according to the laws of conservation of area in two-dimensional space,” the authors write in their study, “as if the tree were a two-dimensional object.” In other words, it’s as if just two dimensions — the width of each limb and the distance between branchings on a limb — determine any tree’s structure. As a result, when trees are rendered in two dimensions in a painting or on a screen, the new rule describes them particularly well.
The new Leonardo-like rule is an improvement, says Katherine McCulloh, a botanist at the University of Wisconsin–Madison who was not involved with this study. But she has her doubts about the Russian group’s rationale for it. In most trees, she says, the living portion extends much deeper than the thin surface layer.

“It’s really species-dependent, and even age-dependent,” McCulloh says. “A giant, old oak tree might have a centimeter of living wood … [but] there are certainly tropical tree species that have very deep sapwood and may have living wood for most of their cross sections.”

Still, the fact that the Leonardo-like rule appears to hold for many trees intrigues McCulloh. “To me, it drives home the question of why are [trees] conserving this geometry for their external tissue, and how is that related to the microscopic level differences that we observe in wood,” she says. “It’s a really interesting question.”

To test their rule, Grigoriev and colleagues took photographs of trees from a variety of species and analyzed the branches to confirm that the real-world patterns matched the predictions. The photos offer “a direct measurement of the characteristics of a tree without touching it, which can be important when dealing with a living object,” Grigoriev says.

Though the team hasn’t studied evergreens yet, the rule holds for all of the deciduous trees that the researchers have looked at. “We have applied our methodology to maple, linden, apple,” Grigoriev says, in addition to oak, birch and chestnut. “They show the same general structure and obey the Leonardo-like rule.”

While it’s possible to confirm the rule by measuring branches by hand, it would require climbing into trees and checking all the limbs — a risky exercise for trees and scientists alike. “Note,” the researchers write, “that not a single tree was harmed during these experiments.”