PURPOSE OF THE STUDY.
Infants with atopic dermatitis (AD) are at high risk of developing asthma. These researchers sought to examine the effect of early intervention with synbiotics, a combination of probiotics and prebiotics, on the prevalence of asthma-like symptoms in infants with AD.
Ninety term infants less than 7 months of age with AD were recruited from 2005 to 2007 in the Netherlands. Inclusion criteria included an AD score (Severity Scoring of Atopic Dermatitis [SCORAD]) of >15, exclusive formula feeding at the time of enrollment, no other major medical problems, and no use of probiotics or immunomodulatory medications during the 4 weeks before enrollment.
In a double-blind, placebo-controlled multicenter trial, infants were randomly assigned to receive an extensively hydrolyzed formula with Bifidobacterium breve M-16V and a galacto-oligosaccharide/fructo-oligosaccharide mixture or the same formula without the synbiotics during a 12-week period. After 1 year, the prevalence of respiratory symptoms and asthma medication use was evaluated by using a validated questionnaire, and the total serum immunoglobulin E (IgE) level and level of specific IgE against aeroallergens were determined.
Seventy-five children 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 groups (13.9% vs 34.2% [absolute risk reduction (ARR): −20.3%] and 2.8% vs 30.8% [ARR: −28.0%], respectively). Significantly fewer children in the symbiotic than in the placebo group had started to use asthma medication after baseline (5.6% vs 25.6% [ARR: −20.1%]). There were no differences in total IgE levels between groups. However, no children in the synbiotic group and 5 children (15.2%) in the placebo group developed an elevated IgE level against cat (ARR: −15.2%).
This study found a significant benefit in the prevention of asthma-like symptoms in infants with AD followed for 1-year after a 12-week trial of a synbiotic mixture.
Results of this prospective study support the concept that a specific probiotic and prebiotic mixture might be effective in reducing the prevalence of asthma-like symptoms in the near term. Variable results have been noted in other studies that used only probiotics. Larger clinical studies and a longer longitudinal follow-up period to determine whether this mixture might ultimately prevent the development of asthma are needed.
- Copyright © 2011 by the American Academy of Pediatrics