title: A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial.
abstract: BACKGROUND
  The role of probiotics in prevention of allergic disease is still not clearly established, although early reports suggested Lactobacillus GG halved the risk of eczema at 2 years.
  
  
  OBJECTIVE
  To determine whether probiotic supplementation in early life could prevent development of eczema and atopy at 2 years.
  
  
  METHODS
  Double-blind, randomized placebo-controlled trial of infants at risk of allergic disease. Pregnant women were randomized to take Lactobacillus rhamnosus HN001 (L rhamnosus), Bifidobacterium animalis subsp lactis strain HN019 or placebo daily from 35 weeks gestation until 6 months if breast-feeding, and their infants were randomized to receive the same treatment from birth to 2 years (n = 474). The infant's cumulative prevalence of eczema and point prevalence of atopy, using skin prick tests to common allergens, was assessed at 2 years.
  
  
  RESULTS
  Infants receiving L rhamnosus had a significantly (P = .01) reduced risk of eczema (hazard ratio [HR], 0.51; 95% CI, 0.30-0.85) compared with placebo, but this was not the case for B animalis subsp lactis (HR, 0.90; 95% CI, 0.58-1.41). There was no significant effect of L rhamnosus (HR, 0.74; 95% CI, 0.46-1.18) or B animalis subsp lactis (HR, 0.82; 95% CI, 0.52-1.28) on atopy. L rhamnosus (71.5%) was more likely than B animalis subsp lactis (22.6%) to be present in the feces at 3 months, although detection rates were similar by 24 months.
  
  
  CONCLUSIONS
  We found that supplementation with L rhamnosus, but not B animalis subsp lactis, substantially reduced the cumulative prevalence of eczema, but not atopy, by 2 years. Understanding how Lactobacilli act to prevent eczema requires further investigation.
authors.affiliation: Wellington Asthma Research Group, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. Electronic address: kristin.wickens@otago.ac.nz.
authors.forename: Kristin
authors.initials: K
authors.lastname: Wickens
authors.affiliation: Department of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland, New Zealand.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Black
authors.affiliation: Department of Paediatrics, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
authors.forename: Thorsten V
authors.initials: TV
authors.lastname: Stanley
authors.affiliation: Department of Paediatrics, University of Auckland, Auckland, New Zealand.
authors.forename: Edwin
authors.initials: E
authors.lastname: Mitchell
authors.affiliation: Immunology Department, Auckland Hospital, Auckland, New Zealand.
authors.forename: Penny
authors.initials: P
authors.lastname: Fitzharris
authors.affiliation: Department of Microbiology and Immunology, University of Otago, Wellington, New Zealand.
authors.forename: Gerald W
authors.initials: GW
authors.lastname: Tannock
authors.affiliation: Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
authors.forename: Gordon
authors.initials: G
authors.lastname: Purdie
authors.affiliation: Wellington Asthma Research Group, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
authors.forename: Julian
authors.initials: J
authors.lastname: Crane