P. N. Black: deceased.
Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization?
Article first published online: 20 AUG 2013
© 2013 John Wiley & Sons Ltd
Clinical & Experimental Allergy
Volume 43, Issue 9, pages 1048–1057, September 2013
How to Cite
Clinical & Experimental Allergy, 2013; (43) 1048–1057., , , , , , , , .
- Issue published online: 20 AUG 2013
- Article first published online: 20 AUG 2013
- Accepted manuscript online: 5 JUN 2013 10:46AM EST
- Manuscript Accepted: 2 JUN 2013
- Manuscript Revised: 25 APR 2013
- Manuscript Received: 21 JAN 2013
- Health Research Council
- atopic sensitization;
- Bifidobacterium animalis subsp lactis HN019;
- Lactobacillus rhamnosus HN001;
- randomized controlled trial;
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 Lactobacillus rhamnosus HN001 (HN001) (6 × 109 cfu/day) halved the cumulative prevalence of eczema at 2 and 4 years. Bifidobacterium animalis subsp lactis HN019 (HN019) (9 × 109 cfu/day) had no significant effect.
To determine whether differences in effects of HN001 and HN019 on eczema persist to age 6 years, and to investigate effects on sensitization.
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.
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.
Conclusion and Clinical Relevance
This study provides evidence for the efficacy of the probiotic L. rhamnosus 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.