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Published on: January 27, 2019
Probiotics in the prevention of eczema: a randomised controlled trial
Stephen J Allen1, Sue Jordan2, Melanie Storey1
1College of Medicine, Swansea University, Swansea, UK.
Insights
This study found that a high-dose probiotic did not prevent eczema in children. However, it did reduce allergic sensitization to common foods, leading to fewer cases of atopic eczema.
Area of Science:
- Immunology
- Pediatrics
- Microbiology
Background:
- Eczema is a common inflammatory skin condition in infants and children.
- Early life interventions, including probiotics, are being investigated for eczema prevention.
- A specific multistrain, high-dose probiotic was tested for its efficacy.
Purpose of the Study:
- To evaluate the effectiveness of a multistrain, high-dose probiotic in preventing eczema.
- To assess the probiotic's impact on allergic sensitization in infants.
- To determine if probiotic supplementation reduces the incidence of atopic eczema.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Pregnant women and their infants received either the probiotic or placebo from 36 weeks gestation until 6 months of age.
- Eczema diagnosis, skin prick tests, and clinical examinations were performed at 6 months and 2 years.
Main Results:
- The cumulative frequency of diagnosed eczema at 2 years was similar between the probiotic and placebo groups (34.1% vs. 32.4%).
- Probiotic use significantly reduced skin prick sensitivity to common allergens at 2 years (10.5% vs. 18.5%).
- The incidence of atopic eczema was lower in the probiotic group (5.3% vs. 12.1%).
Conclusions:
- The tested probiotic did not prevent eczema or reduce its severity.
- The probiotic demonstrated a potential to prevent atopic sensitization to food allergens.
- This suggests a possible role in reducing the incidence of atopic eczema in early childhood.
Objective:
To evaluate a multistrain, high-dose probiotic in the prevention of eczema.
Design:
A randomised, double-blind, placebo-controlled, parallel group trial.
Settings:
Antenatal clinics, research clinic, children at home.
Patients:
Pregnant women and their infants.
Interventions:
Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20; total of 10(10) organisms/day) or matching placebo.
Main Outcome Measure:
Diagnosed eczema at age 2 years. Infants were followed up by questionnaire. Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years.
Results:
The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic (73/214, 34.1%) and placebo arms (72/222, 32.4%; OR 1.07, 95% CI 0.72 to 1.6). Among the secondary outcomes, the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic (18/171; 10.5%) compared with the placebo arm (32/173; 18.5%; OR 0.52, 95% CI 0.28 to 0.98). The statistically significant differences between the arms were mainly in sensitisation to cow's milk and hen's egg proteins at 6 months. Atopic eczema occurred in 9/171 (5.3%) children in the probiotic arm and 21/173 (12.1%) in the placebo arm (OR 0.40, 95% CI 0.18 to 0.91).
Conclusions:
The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity. However, the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood.
Trial Registration Number:
ISRCTN26287422.
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