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A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial.
J Allergy Clin Immunol. 2008 Oct; 122(4):788-794.JA

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.

CONCLUSION

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+Show Affiliations

Wellington Asthma Research Group, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. Electronic address: kristin.wickens@otago.ac.nz.Department of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland, New Zealand.Department of Paediatrics, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.Department of Paediatrics, University of Auckland, Auckland, New Zealand.Immunology Department, Auckland Hospital, Auckland, New Zealand.Department of Microbiology and Immunology, University of Otago, Wellington, New Zealand.Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.Wellington Asthma Research Group, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18762327

Citation

Wickens, Kristin, et al. "A Differential Effect of 2 Probiotics in the Prevention of Eczema and Atopy: a Double-blind, Randomized, Placebo-controlled Trial." The Journal of Allergy and Clinical Immunology, vol. 122, no. 4, 2008, pp. 788-794.
Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2008;122(4):788-794.
Wickens, K., Black, P. N., Stanley, T. V., Mitchell, E., Fitzharris, P., Tannock, G. W., Purdie, G., & Crane, J. (2008). A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. The Journal of Allergy and Clinical Immunology, 122(4), 788-794. https://doi.org/10.1016/j.jaci.2008.07.011
Wickens K, et al. A Differential Effect of 2 Probiotics in the Prevention of Eczema and Atopy: a Double-blind, Randomized, Placebo-controlled Trial. J Allergy Clin Immunol. 2008;122(4):788-794. PubMed PMID: 18762327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. AU - Wickens,Kristin, AU - Black,Peter N, AU - Stanley,Thorsten V, AU - Mitchell,Edwin, AU - Fitzharris,Penny, AU - Tannock,Gerald W, AU - Purdie,Gordon, AU - Crane,Julian, AU - ,, Y1 - 2008/08/31/ PY - 2008/04/09/received PY - 2008/07/03/revised PY - 2008/07/14/accepted PY - 2008/9/3/pubmed PY - 2008/12/17/medline PY - 2008/9/3/entrez SP - 788 EP - 794 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 122 IS - 4 N2 - 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. CONCLUSION: 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. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/18762327/A_differential_effect_of_2_probiotics_in_the_prevention_of_eczema_and_atopy:_a_double_blind_randomized_placebo_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(08)01319-5 DB - PRIME DP - Unbound Medicine ER -