title: Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial.
abstract: 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.
authors.affiliation: Skin and Allergy Hospital, University of Helsinki, Finland. kaarina.kukkonen@hus.fi
authors.forename: Kaarina
authors.initials: K
authors.lastname: Kukkonen
authors.forename: Erkki
authors.initials: E
authors.lastname: Savilahti
authors.forename: Tari
authors.initials: T
authors.lastname: Haahtela
authors.forename: Kaisu
authors.initials: K
authors.lastname: Juntunen-Backman
authors.forename: Riitta
authors.initials: R
authors.lastname: Korpela
authors.forename: Tuija
authors.initials: T
authors.lastname: Poussa
authors.forename: Tuula
authors.initials: T
authors.lastname: Tuure
authors.forename: Mikael
authors.initials: M
authors.lastname: Kuitunen
mesh_terms: 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
chemical_list: D009844:Oligosaccharides