High intestinal IgA associates with reduced risk of IgE-associated allergic diseases.
Development of oral tolerance and its stimulation by probiotics are still incomprehensible. Microbial stimulation of the gut may induce a subtle inflammation and induce secretion of mucosal IgA, which participates in antigen elimination. In a cohort of allergy-prone infants receiving probiotics and prebiotics or placebo we studied intestinal IgA and inflammation in the development of eczema, food allergy, asthma, and rhinitis (allergic diseases). We performed a nested unmatched case-control study of 237 infants participating in a randomized double-blind placebo-controlled allergy-prevention trial using a combination of four probiotic strains pre-natally and during 6 months form birth. We measured faecal IgA, alpha1-antitrypsin (alpha1-AT), tumour necrosis factor-alpha (TNF-alpha), and calprotectin at the age of 3 and 6 months. By age 2 yr, 124 infants had developed allergic disease or IgE-sensitization (cases) and 113 had not (controls). In infants with high faecal IgA concentration at the age of 6 months, the risk of having any allergic disease before the age of 2 yr tended to reduce [odds ratio (OR: 0.52)] and the risk for any IgE-associated (atopic) disease reduced significantly (OR: 0.49). High faecal calprotectin at the age of 6 months associated also with lower risk for IgE-associated diseases up to age 2 yr (OR: 0.49). All faecal inflammation markers (alpha1-AT, TNF-alpha, and calprotectin) correlated positively with faecal IgA (p < 0.001). Probiotics tended to augment faecal IgA (p = 0.085) and significantly increased faecal alpha1-AT (p = 0.001). High intestinal IgA in early life associates with minimal intestinal inflammation and indicates reduced risk for IgE-associated allergic diseases.
Kukkonen
Kaarina
K
The Skin and Allergy Hospital, Department of Pediatric Allergology, University of Helsinki, Helsinki, Finland. kaarina.kukkonen@hus.fi
Kuitunen
Mikael
M
Haahtela
Tari
T
Korpela
Riitta
R
Poussa
Tuija
T
Savilahti
Erkki
E
D016022:Case-Control Studies; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D007070:Immunoglobulin A / Q000096:biosynthesis*; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation; D007413:Intestinal Mucosa / Q000276:immunology / Q000378:metabolism; D007422:Intestines / Q000276:immunology*; D008297:Male; D011247:Pregnancy; D019936:Probiotics / Q000008:administration & dosage; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
D007070:Immunoglobulin A; D007073:Immunoglobulin E