Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis

Authors

  • L. B. van der Aa,

    1. Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Center
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  • W. M. C. van Aalderen,

    1. Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Center
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  • H. S. A. Heymans,

    1. Department of Pediatrics, Emma Children’s Hospital, Academic Medical Center
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  • J. Henk Sillevis Smitt,

    1. Department of Dermatology, Academic Medical Center, Amsterdam
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  • A. J. Nauta,

    1. Danone Research – Centre of Specialised Nutrition, Wageningen, the Netherlands
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  • L. M. J. Knippels,

    1. Danone Research – Centre of Specialised Nutrition, Wageningen, the Netherlands
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  • K. Ben Amor,

    1. Danone Research – Centre of Specialised Nutrition, Wageningen, the Netherlands
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  • A. B. Sprikkelman,

    1. Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Center
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  • the Synbad Study Group

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    • E. K. George, MD, PhD, Department of Pediatrics, Medical Center Alkmaar, Alkmaar, the Netherlands.
      N. J. van den Berg, MD, Department of Pediatrics, FlevoHospital, Almere, the Netherlands.
      D. Bosman, MD, PhD, Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
      G. A. M. Tytgat, MD, PhD, Department of Pediatrics, Zaans Medical Center, Zaandam, the Netherlands.
      E. Ree, MD, Department of Pediatrics, Sint Lucas Andreas Hospital, Amsterdam, the Netherlands.
      M. A. van Houten, MD, PhD, Department of Pediatrics, Spaarne Hospital, Hoofddorp, the Netherlands.


Leontien B. van der Aa, Department of Pediatric Respiratory Medicine and Allergy, Emma Children’s Hospital, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
Tel.: +31205662968
Fax: +31206917735
E-mail: l.b.vanderaa@amc.nl

Abstract

To cite this article: van der Aa LB, van Aalderen WMC, Heymans HSA, Henk Sillevis Smitt J, Nauta AJ, Knippels LMJ, Ben Amor K, Sprikkelman AB, the Synbad Study Group. Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis. Allergy 2011; 66: 170–177.

Abstract

Background:  Infants with atopic dermatitis (AD) have a high risk of developing asthma. We investigated the effect of early intervention with synbiotics, a combination of probiotics and prebiotics, on the prevalence of asthma-like symptoms in infants with AD.

Methods:  In a double-blind, placebo-controlled multicentre trial, ninety infants with AD, age <7 months, were randomized to receive an extensively hydrolyzed formula with Bifidobacterium breve M-16V and a galacto/fructooligosaccharide mixture (Immunofortis®), or the same formula without synbiotics during 12 weeks. After 1 year, the prevalence of respiratory symptoms and asthma medication use was evaluated, using a validated questionnaire. Also, total serum IgE and specific IgE against aeroallergens were determined.

Findings:  Seventy-five children (70.7% male, mean age 17.3 months) 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 group (13.9%vs 34.2%, absolute risk reduction (ARR) −20.3%, 95% CI −39.2% to −1.5%, and 2.8%vs 30.8%, ARR −28.0%, 95% CI −43.3% to −12.5%, respectively). Significantly less children in the synbiotic than in the placebo group had started to use asthma medication after baseline (5.6%vs 25.6%, ARR −20.1%, 95% CI −35.7% to −4.5%). Total IgE levels did not differ between the two groups. No children in the synbiotic and five children (15.2%) in the placebo group developed elevated IgE levels against cat (ARR −15.2%, 95% CI −27.4% to −2.9%).

Conclusion:  These results suggest that this synbiotic mixture prevents asthma-like symptoms in infants with AD.

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