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Published on: August 7, 2017
Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis
L B van der Aa1, W M C van Aalderen, H S A Heymans
1Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Meibergdreef 9, Amsterdam, the Netherlands. l.b.vanderaa@amc.nl
Insights
Early synbiotic intervention significantly reduced asthma-like symptoms and medication use in infants with atopic dermatitis (AD). This combination of probiotics and prebiotics shows promise for preventing childhood asthma development.
Area of Science:
- Pediatric Allergy and Immunology
- Gastroenterology
- Microbiome Research
Background:
- Infants with atopic dermatitis (AD) face a heightened risk of developing asthma.
- Early life interventions are crucial for managing AD and preventing comorbidities like asthma.
Purpose of the Study:
- To evaluate the efficacy of early synbiotic intervention in reducing asthma-like symptoms in infants with AD.
- To assess the impact of synbiotics on respiratory symptoms, asthma medication use, and allergic sensitization.
Main Methods:
- A double-blind, placebo-controlled multicentre trial involving ninety infants with AD (age <7 months).
- Participants received either an extensively hydrolyzed formula with synbiotics (Bifidobacterium breve M-16V and oligosaccharides) or a placebo formula for 12 weeks.
- Evaluations included respiratory symptoms, asthma medication use, total IgE, and specific IgE against aeroallergens after 1 year.
Main Results:
- The synbiotic group showed significantly lower prevalence of 'frequent wheezing' (13.9% vs 34.2%) and 'wheezing and/or noisy breathing' (2.8% vs 30.8%) compared to placebo.
- Fewer children in the synbiotic group initiated asthma medication use (5.6% vs 25.6%).
- A significant reduction in elevated IgE levels against cat allergen was observed in the synbiotic group (0% vs 15.2%).
Conclusions:
- The synbiotic mixture demonstrated a preventive effect on asthma-like symptoms in infants with atopic dermatitis.
- Early synbiotic intervention may be a valuable strategy to reduce the risk of asthma development in high-risk infants.
- Synbiotics may also play a role in modulating allergic sensitization in infants with AD.
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.
Findings:
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%).
Conclusion:
These results suggest that this synbiotic mixture prevents asthma-like symptoms in infants with AD.
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