Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial.
BACKGROUND
The increase in allergic diseases is attributed to a relative lack of microbial stimulation of the infantile gut immune system. Probiotics, live health-promoting microbes, might offer such stimulation.


OBJECTIVE
We studied the effect of a mixture of 4 probiotic bacterial strains along with prebiotic galacto-oligosaccharides in preventing allergic diseases.


METHODS
We randomized 1223 pregnant women carrying high-risk children to use a probiotic preparation or a placebo for 2 to 4 weeks before delivery. Their infants received the same probiotics plus galacto-oligosaccharides (n = 461) or a placebo (n = 464) for 6 months. At 2 years, we evaluated the cumulative incidence of allergic diseases (food allergy, eczema, asthma, and allergic rhinitis) and IgE sensitization (positive skin prick test response or serum antigen-specific IgE level >0.7 kU/L). Fecal bacteria were analyzed during treatment and at age 2 years.


RESULTS
Probiotic treatment compared with placebo showed no effect on the cumulative incidence of allergic diseases but tended to reduce IgE-associated (atopic) diseases (odds ratio [OR], 0.71; 95% CI, 0.50-1.00; P = .052). Probiotic treatment reduced eczema (OR, 0.74; 95% CI, 0.55-0.98; P = .035) and atopic eczema (OR, 0.66; 95% CI, 0.46-0.95; P = .025). Lactobacilli and bifidobacteria more frequently (P < .001) colonized the guts of supplemented infants.


CONCLUSIONS
Probiotic treatment showed no effect on the incidence of all allergic diseases by age 2 years but significantly prevented eczema and especially atopic eczema. The results suggest an inverse association between atopic diseases and colonization of the gut by probiotics.


CONCLUSIONS
The prevention of atopic eczema in high-risk infants is possible by modulating the infant's gut microbiota with probiotics and prebiotics.
Kukkonen
Kaarina
K
Skin and Allergy Hospital, University of Helsinki, Finland. kaarina.kukkonen@hus.fi
Savilahti
Erkki
E
Haahtela
Tari
T
Juntunen-Backman
Kaisu
K
Korpela
Riitta
R
Poussa
Tuija
T
Tuure
Tuula
T
Kuitunen
Mikael
M
D001644:Bifidobacterium / Q000302:isolation & purification; D002675:Child, Preschool; D004311:Double-Blind Method; D004485:Eczema / Q000517:prevention & control*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000517:prevention & control; D007223:Infant; D007231:Infant, Newborn; D052201:Lacticaseibacillus rhamnosus / Q000302:isolation & purification; D008297:Male; D009844:Oligosaccharides; D011247:Pregnancy; D019936:Probiotics / Q000627:therapeutic use*; D011424:Propionibacterium / Q000302:isolation & purification
D009844:Oligosaccharides