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No effect of probiotics on respiratory allergies: a seven-year follow-up of a randomized controlled trial in infancy

Authors

  • Thomas R. Abrahamsson,

    Corresponding author
    • Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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  • Ted Jakobsson,

    1. Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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  • Bengt Björkstén,

    1. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
    2. School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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  • Göran Oldaeus,

    1. Department of Pediatrics, County Hospital Ryhov, Jönköping, Sweden
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  • Maria C. Jenmalm

    1. Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
    2. Division of Inflammation Medicine, Department of Clinical and Experimental Medicine, Unit of Autoimmunity and Immune Regulation, Linköping University, Linköping, Sweden
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Correspondence

Thomas Abrahamsson, Division of Paediatrics, Linköping University Hospital, SE-581 85 Linköping, Sweden

Tel.: +46-(10)-103 0000

Fax: +46-(13)-148265.

E-mail: thomas.abrahamsson@lio.se

Abstract

Background

Supplementation with the probiotic Lactobacillus reuteri reduced the incidence of IgE-associated allergic disease in infancy. This treatment might therefore also reduce the risk of asthma and allergic rhinoconjunctivitis in school age.

Objective

To evaluate whether perinatal and infant supplementation with L. reuteri reduced the prevalence of respiratory allergic disease in school age and to explore whether this supplementation was associated with any long-term side effects.

Methods

A randomized, placebo-controlled trial with oral supplementation with Lreuteri ATCC 55730 (1 × 108 CFU) during the last month of gestation and through the first year of life comprising 232 families with allergic disease, of whom 184 completed a 7-yr follow-up. The primary outcomes at 7 yr of age were allergic disease and skin prick test reactivity (ClinicalTrials.gov ID NCT01285830).

Results

The prevalence of asthma (15% in the probiotic vs. 16% in placebo group), allergic rhinoconjunctivitis (27% vs. 20%), eczema (21% vs. 19%) and skin prick test reactivity (29% vs. 26%) was similar in the probiotic and placebo group. Growth indices and gastrointestinal symptoms were similar in the two groups. No severe adverse events were reported.

Conclusion

The effect of L. reuteri on sensitization and IgE-associated eczema in infancy did not lead to a lower prevalence of respiratory allergic disease in school age. Thus, the effect of L. reuteri on the immune system seems to be transient. Administration of L. reuteri during the last weeks of gestation and in infancy was not associated with any long-term side effects.

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