Probiotics in prevention of IgE-associated eczema
A prospective, double blind, randomised, placebo-controlled trial with the objective to prevent eczema and sensitization in infants born in families with allergic disease by oral supplementation with the probiotic Lactobacillus reuteri.
The study included 232 families, of whom 188 completed the study. The mothers received Lactobacillus reuteri ATCC 55730 (1 × 10^8 colony forming units) daily from gestational week 36 until delivery. Their babies then continued with the same product and dose from birth until 12 months of age and were followed up for another year.
Primary outcome was allergic disease, with or without positive skin prick test or circulating IgE to food allergens (tests indicating that sensitization has taken place). At two years of age the incidence of eczema was eczema during the second year, 8% versus 20% (P=0.02). Skin prick test reactivity was also less common in the Lactobacillus reuteri group compared to the placebo group, significantly so for infants with mothers with allergies, 14% versus 31% (P =0.02). Wheeze and other potentially allergic diseases were not affected.
Conclusion: Lactobacillus reuteri had no preventive effect on total incidence of infant eczema. At 2 years of age, however, the Lactobacillus reuteri supplemented infants had less IgE-associated eczema (i.e. eczema with hyperreactivity to allergy-causing substances such as egg and milk) and therefore possibly run a reduced risk to develop later respiratory allergic disease.