Pre- and probiotics show promise against childhood eczema - review

By Stephen Daniells

- Last updated on GMT

Related tags: Probiotics, Prebiotics, Allergy

Supplements of prebiotics and probiotics may prevent eczema and
other allergic diseases and food reactions in infants who might be
susceptible, according to two recent reviews.

Data covering over 2,000 infants from eight studies led the Australian researchers to report that the probiotic strain Lactobacillus rhamnosus​, and the prebiotics galacto- and fructo-oligosaccharides showed benefits for a range of allergic diseases. Despite these initial positive results, review co-author John Sinn from the Royal North Shore Hospital said that the use of pre- and probiotics to prevent childhood allergies and food hypersensitivities is still growing, with only a limited number of studies to date reporting positive results. "The concept… of adding probiotics and prebiotics to an infant's diet to prevent allergy is still in its infancy and more studies are needed to confirm the limited benefits shown so far,"​ he said. Consumers are more aware of probiotics than prebiotics, but interest in the latter is increasing as evidence suggests that prebiotics could be even more useful than the probiotic bacteria that they feed. For the probiotics review, Sinn analysed 12 studies with half of these reporting outcomes of 1,549 infants up to 6 months old. Researchers compared infants who ingested probiotics added to breast milk or formula to those in a control group given a placebo or no intervention at all. The probiotics were typically consumed by the mother during the last weeks of pregnancy and when breastfeeding, or added the probiotics to formula for the first six months. The reviewers report that probiotics might help prevent eczema in infants and one study suggested this benefit might last up to four years of age. They identified the probiotic Lactobacillus rhamnosus​ as the strain with the most potential in this area. "Studies using​ Lactobacillus rhamnosus showed some benefit in preventing the onset of eczema,"​ said Sinn. "However, the benefits were not shown in other common allergic symptoms such as asthma, allergic rhinitis, food hypersensitivity and food allergy."​ For the prebiotics review, seven studies were included with only two reported on the outcomes of allergies for 432 infants. Again, the studies infants who had prebiotics added to breast milk or infant formula for six months to a control group given either a placebo or no intervention at all. "In the studies that analyzed allergy as an outcome, the galactose oligosaccharide was made from lactose and the fructose oligosaccharide was made from chicory root [an herb], all of which are natural substances,"​ explained Sinn. A significant reduction in the eczema in infants at high risk of the condition was observed in one study, while the others reported no benefits, leading the reviewers to conclude that there was insufficient evidence to support the addition of prebiotics to infants' milk or formula to prevent allergies. Eczema, also known as atopic dermatitis (AD), is one of the first signs of allergy during the early days of life and is said to be due to delayed development of the immune system. According to the American Academy of Dermatologists it affects between 10 to 20 per cent of all infants, but almost half of these kids will 'grow out' of eczema between the ages of five and 15. The researchers called for further research to explore these issues in greater detail. Commenting independently on the research, Sunita Vohra from the University of Alberta said: "At this time, probiotics seem promising, but the evidence is preliminary. These reviews allow clinicians to be aware of potential new therapies, so they can decide if the risk-to-benefit profile is appropriate for their patients."​ Both reviews disclose that Sinn has been an invited speaker to industry-funded meetings. Prebiotic ingredients, or those that boost the growth of beneficial probiotic bacteria in the gut, are worth about €90 million in the European marketplace but are forecast to reach €179.7 million by 2010, according to Frost & Sullivan. Source: Cochrane Database of Systematic Reviews​ 2007, Issue 4. "Prebiotics in infants for prevention of allergic disease and food hypersensitivity" ​Authors: D.A. Osborn, J.K. Sinn

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