Author(s): Kuitunen M, Kukkonen K, JuntunenBackman K, Korpela R, Poussa T,
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Abstract BACKGROUND: Less microbial exposure in early childhood is associated with more allergic disease later. Allergic children have a different fecal microflora, with less lactobacilli and bifidobacteria. Beneficial effects regarding the development of allergy have been suggested to come through probiotic supplementation. OBJECTIVE: We sought to study the effect of probiotic and prebiotic supplementation in preventing allergies. METHODS: In a double-blinded, placebo-controlled study we randomized 1223 mothers with infants at high risk for allergy to receive a probiotic mixture (2 lactobacilli, bifidobacteria, and propionibacteria) or placebo during the last month of pregnancy and their infants to receive it from birth until age 6 months. Infants also received a prebiotic galacto-oligosaccharide or placebo. At 5 years, we evaluated the cumulative incidence of allergic diseases (eczema, food allergy, allergic rhinitis, and asthma) and IgE sensitization. RESULTS: Of the 1018 intent-to-treat infants, 891 (88\%) attended the 5-year visit. Frequencies of allergic and IgE-associated allergic disease and sensitization in the probiotic and placebo groups were similar: 52.6\% versus 54.9\% and 29.5\% versus 26.6\%, respectively, and 41.3\% in both. No significant difference appeared in frequencies of eczema (39.3\% vs 43.3\%), atopic eczema (24.0\% vs 25.1\%), allergic rhinitis (20.7\% vs 19.1\%), or asthma (13.0\% vs 14.1\%) between groups. However, less IgE-associated allergic disease occurred in cesarean-delivered children receiving probiotics (24.3\% vs 40.5\%; odds ratio, 0.47; 95\% CI, 0.23\% to 0.96\%; P = .035). CONCLUSIONS: No allergy-preventive effect that extended to age 5 years was achieved with perinatal supplementation of probiotic bacteria to high-risk mothers and children. It conferred protection only to cesarean-delivered children.
This article was published in J Allergy Clin Immunol
and referenced in Journal of Allergy & Therapy