Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization?. Issue 9 (20th August 2013)

• Record Type: Journal Article
• Authors: Wickens, K.; Stanley, T. V.; Mitchell, E. A.; Barthow, C.; Fitzharris, P.; Purdie, G.; Siebers, R.; Black, P. N.; Crane, J.
• Is Part Of: Clinical & experimental allergy. Volume 43:Issue 9(2013:Sep.)
• Page Start: 1048
• Page End: 1057
• Publication Date: 2013-08-20
• Subjects: Allergy -- Periodicals; Immunology -- Periodicals; 616.97
• DOI: 10.1111/cea.12154
• Languages: English
• ISSNs: 0954-7894

Abstract

<abstract abstract-type="main" id="cea12154-abs-0001"> <title>Summary</title> <sec id="cea12154-sec-0001" sec-type="section"> <title>Background</title> <p>The role of probiotics in prevention of allergic disease is still not clear; efficacy may depend on the timing, dose, duration, and specific probiotic used. Using a double‐blind randomized placebo‐controlled trial (Australian New Zealand Clinical Trials Registry: ACTRN12607000518460), we have shown that in a high‐risk birth cohort, maternal supplementation from 35 weeks gestation until 6 months if breastfeeding and infant supplementation from birth until 2 years with <italic>Lactobacillus rhamnosus </italic>HN001 (HN001) (6 × 10<sup>9</sup> cfu/day) halved the cumulative prevalence of eczema at 2 and 4 years. <italic>Bifidobacterium animalis</italic> subsp <italic>lactis </italic>HN019 (HN019) (9 × 10<sup>9</sup> cfu/day) had no significant effect.</p> </sec> <sec id="cea12154-sec-0002" sec-type="section"> <title>Objective</title> <p>To determine whether differences in effects of HN001 and HN019 on eczema persist to age 6 years, and to investigate effects on sensitization.</p> </sec> <sec id="cea12154-sec-0003" sec-type="section"> <title>Methods</title> <p>Standard procedures were used to assess eczema (The UK Working Party's Criteria), eczema severity (SCORAD), atopic sensitization [skin prick tests (SPT), total and specific IgE] and standard questions used for asthma, wheeze, and rhinoconjunctivitis.</p> </sec> <sec id="cea12154-sec-0004" sec-type="section"> <title>Results</title> <p>HN001 was associated with significantly lower cumulative prevalence of eczema (HR = 0.56, 95% CI 0.39–0.80), SCORAD ≥ 10 (HR = 0.69, 0.49–0.98) and SPT sensitization (HR = 0.69, 95% CI 0.48–0.99). The point prevalence of eczema (RR = 0.66, 95% CI 0.44–1.00), SCORAD ≥ 10 (RR = 0.62, 95% CI 0.38–1.01) and SPT sensitization (RR = 0.72, 95% CI 0.53–1.00) were also reduced among children taking HN001. HN019 had no significant effect on any outcome.</p> </sec> <sec id="cea12154-sec-0005" sec-type="section"> <title>Conclusion and Clinical Relevance</title> <p>This study provides evidence for the efficacy of the probiotic <italic>L. rhamnosus </italic>HN001 in preventing the development of eczema and possibly also atopic sensitization in high risk infants to age 6 years. The absence of a similar effect for HN019 indicates that benefits may be species specific.</p> </sec> </abstract>