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Probiotics ineffective for preventing asthma, eczema in infants
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The use of Lactobacillus rhamnosus GG, a probiotic, is unable to prevent asthma or eczema in children at 2 years of age when used in the first 6 months of life.
“On the basis of the hygiene hypothesis, which suggests that the absence of infectious exposure at a critical point in immune system development could lead to greater risk of allergic diseases, it is thought that probiotic exposure could theoretically affect immune system development and reduce the subsequent risk for the development of allergic disease,” Michael D. Cabana, MD, MPH, from the departments of pediatrics, epidemiology and biostatistics, and the Phillip R. Lee Institute for Health Policy Studies at the University of California, San Francisco, and colleagues wrote.
To examine the effects of probiotic use in infants within the first 6 months of life on the development of asthma and eczema, the researchers conducted a randomized, double-blind controlled trial in which high-risk infants received Lactobacillus rhamnosus GG (LGG) supplementation to prevent asthma, allergic rhinitis and eczema. Ninety-two intervention infants were given 10 billion colony-forming units and 225 mg of inulin. Control infants (n = 92) received only 325 mg of inulin.
Cabana and colleagues estimated disease incidences for those who supplemented LGG and those who did not using survival analysis method. They also used these methods to examine the efficacy of the probiotic in preventing or delaying the three conditions.
Participants were enrolled over 6 years (median follow-up: 4.6 years; 95% retention rate at 2 years). The incidence of eczema at 2 years was 30.9% in the control group (95% CI, 21.4%-40.4%) and 28.7% in the LGG group (95% CI, 19.4%-38.0%), with a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P =.83).
The rate of asthma at 5 years was 17.4% (95% CI, 7.6%-27.1%) in the control group and 9.7% in the LGG group (95% CI, 2.7-16.6%), with a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P =.25).
“Given the multitude of factors that may affect the risk of allergic disease, the effect of supplementation with a single probiotic species may only be discernible in high-risk infants who are also born into high-risk scenarios because of altered gastrointestinal microbiota development such as cesarean delivery, early broad spectrum antibiotic exposure and perhaps lack of breast milk exposure,” Cabana and colleagues wrote. – by Katherine Bortz
Disclosure: The researchers provide no relevant financial disclosures.
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