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Published on: January 27, 2019
Perinatal probiotic intervention prevented allergic disease in a Caesarean-delivered subgroup at 13-year follow-up
Sampo Kallio1, Anna Kaarina Kukkonen2, Erkki Savilahti1
1Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Early probiotic intervention showed no overall benefit for preventing allergic diseases up to 13 years. However, it protected infants born via Cesarean section from developing allergies and eczema.
Area of Science:
- Immunology
- Microbiology
- Pediatrics
Background:
- Long-term effects of probiotic intervention for primary prevention of allergic diseases remain unclear.
- Previous findings indicated reduced eczema incidence up to age 10 years in a probiotic intervention trial.
Purpose of the Study:
- To investigate the long-term impact of early probiotic administration on the prevalence of allergic diseases up to 13 years of age.
Main Methods:
- A double-blind, placebo-controlled trial involving 1223 pregnant women at high risk for allergies.
- Probiotic or placebo was administered from 36 weeks gestation until birth, with infants receiving the same regimen for the first six months.
- Follow-up at 13 years included questionnaires and blood sample collection.
Main Results:
- No significant differences in overall doctor-diagnosed allergic disease or allergy prevalence between probiotic and placebo groups.
- Increased inhalant-specific IgE sensitization was observed in the probiotic group (59.3% vs. 49.8%, P=0.040).
- A post hoc analysis revealed reduced allergy (41.5% vs. 67.9%, P=0.006) and eczema (18.9% vs. 37.5%, P=0.031) in the Caesarean-delivered subgroup receiving probiotics. Wheezing attacks were less frequent in the probiotic group overall (8.5% vs. 14.7%, P=0.013).
Conclusions:
- Probiotic intervention demonstrated a protective effect against allergic disease and eczema specifically in the subgroup of infants delivered via Cesarean section.
- The overall cohort did not show a significant preventive effect of probiotics on allergic diseases up to 13 years of age.
Background:
The long-term effects of probiotic intervention for primary prevention of allergic diseases are not well known. We previously reported less eczema until 10 years in our probiotic intervention trial.
Objective:
To investigate the effect of early probiotic intervention on the prevalence of allergic diseases up to 13 years of age.
Methods:
Pregnant women (n = 1223) carrying a child at a high risk of allergy (at least one parent with allergic disease) were randomized to receive a mixture of probiotics (Lactobacillus rhamnosusGG and LC705, Bifidobacterium breve Bb99 and Propionibacterium freudenreichii) or placebo in a double-blind manner from 36 weeks of gestation until birth. Their infants received the same product for the first six months (registration number NCT00298337). At 13-year follow-up, the participants were requested to return a questionnaire and to provide a blood sample.
Results:
A questionnaire was returned by 642 participants (63.1% of intention-to-treat infants), and 459 provided a blood sample. In the whole cohort, there were no statistically significant differences in doctor-diagnosed allergic disease (55.2% and 59.0%, probiotic and placebo group, respectively) or allergic disease (47.9% and 51.6%) based on the ISAAC questionnaire data. Inhalant-specific IgE sensitization (>0.7 kU/L) was 59.3% in the probiotic group and 49.8% in the placebo group (P = 0.040). In a post hoc analysis made in Caesarean-delivered subgroup, allergy was reported in 41.5% of the probiotic group and 67.9% of the placebo group (P = 0.006), and eczema in 18.9% and 37.5%, respectively (P = 0.031). In the whole cohort, 8.5% of the probiotic group had suffered from wheezing attacks during the previous 12 months vs 14.7% in the placebo group (P = 0.013). There were no statistically significant differences discovered between the characteristics of the participating group and the dropout group.
Conclusions:
Probiotic intervention protected Caesarean-delivered subgroup from allergic disease and eczema, but not the total cohort.
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