Allergy, in the form of atopic diseases, is a chronic disorder of increasing importance in economically more-developed countries. Reversal of the progressive increase in frequency of atopic disease would be an important breakthrough for health care and wellbeing in Western societies. In the hygiene hypothesis this increase is attributed to reduced microbial exposure in early life.
Probiotics are cultures of potentially beneficial bacteria of the healthy gut microflora.
Marko Kalliomäki and colleagues from Turku University Central Hospital, Finland, did a randomized, placebo-controlled trial to assess the effect on atopic disease of Lactobacillus GG (a probiotic which is safe at an early age and effective in the treatment of allergic inflammation and food allergy).
Lactobacillus GG or placebo was given prenatally to mothers who themselves suffered from atopic eczema, allergic rhinitis, or asthma (or they had at least one first-degree relative or partner with atopic disease).
|Frequency of atopic eczema in the probiotic group was half that of the placebo group.|
After delivery, mothers had the option to consume probiotics themselves, or to give them to their infants for 6 months. Chronic recurring atopic eczema (the main sign of atopic disease in the first years of life) was the primary endpoint.
Atopic eczema was diagnosed in 46 of 132 (35%) children aged 2 years. Asthma was diagnosed in 6 of these children and allergic rhinitis in one.
The frequency of atopic eczema in the probiotic group was half that of the placebo group (15 of 64 [23%] compared with 31 of 68 [46%]).
Marko Kalliomäki comments, "Our results suggest that gut microflora have unique, yet largely unexplored, endogenous immunomodulatory properties. These properties might be indispensable in the fight against the increasing frequency of atopic, and possibly other, immunological diseases".
In an accompanying Commentary, Dr Simon Murch from the Royal Free and University College School of Medicine, London, England, comments, "These figures are remarkable, and, if confirmed in other studies and applicable to other allergic diseases, probiotics would represent an important therapeutic advance."
However he cautions that larger studies will be required before probiotics can be more widely recommended for perinatal use.