Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis.
BACKGROUND
Infants with atopic dermatitis (AD) have a high risk of developing asthma. We investigated the effect of early intervention with synbiotics, a combination of probiotics and prebiotics, on the prevalence of asthma-like symptoms in infants with AD.


METHODS
In a double-blind, placebo-controlled multicentre trial, ninety infants with AD, age <7\ months, were randomized to receive an extensively hydrolyzed formula with Bifidobacterium breve M-16V and a galacto/fructooligosaccharide mixture (Immunofortis(®) ), or the same formula without synbiotics during 12 weeks. After 1 year, the prevalence of respiratory symptoms and asthma medication use was evaluated, using a validated questionnaire. Also, total serum IgE and specific IgE against aeroallergens were determined.


RESULTS
Seventy-five children (70.7% male, mean age 17.3 months) completed the 1-year follow-up evaluation. The prevalence of 'frequent wheezing' and 'wheezing and/or noisy breathing apart from colds' was significantly lower in the synbiotic than in the placebo group (13.9%vs 34.2%, absolute risk reduction (ARR) -20.3%, 95% CI -39.2% to -1.5%, and 2.8%vs 30.8%, ARR -28.0%, 95% CI -43.3% to -12.5%, respectively). Significantly less children in the synbiotic than in the placebo group had started to use asthma medication after baseline (5.6%vs 25.6%, ARR -20.1%, 95% CI -35.7% to -4.5%). Total IgE levels did not differ between the two groups. No children in the synbiotic and five children (15.2%) in the placebo group developed elevated IgE levels against cat (ARR -15.2%, 95% CI -27.4% to -2.9%).


CONCLUSIONS
These results suggest that this synbiotic mixture prevents asthma-like symptoms in infants with AD.
van der Aa
L B
LB
Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Meibergdreef 9, Amsterdam, the Netherlands. l.b.vanderaa@amc.nl
van Aalderen
W M C
WM
Heymans
H S A
HS
Henk Sillevis Smitt
J
J
Nauta
A J
AJ
Knippels
L M J
LM
Ben Amor
K
K
Sprikkelman
A B
AB
D000818:Animals; D001249:Asthma / Q000473:pathology / Q000517:prevention & control*; D001644:Bifidobacterium; D002415:Cats / Q000276:immunology; D003876:Dermatitis, Atopic / Q000628:therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009844:Oligosaccharides; D011795:Surveys and Questionnaires; D058616:Synbiotics; D016896:Treatment Outcome
D009844:Oligosaccharides