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.
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.