Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Meibergdreef 9, Amsterdam, the Netherlands.
Allergy. 2011 Feb;66(2):170-7. doi: 10.1111/j.1398-9995.2010.02416.x.
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.
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.
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%).
These results suggest that this synbiotic mixture prevents asthma-like symptoms in infants with AD.
特应性皮炎(AD)患儿发生哮喘的风险较高。我们研究了早期干预使用合生剂(益生菌和益生元的组合)对 AD 婴儿发生哮喘样症状的影响。
在一项双盲、安慰剂对照的多中心试验中,90 名年龄<7 个月的 AD 婴儿被随机分配接受含有短双歧杆菌 M-16V 和半乳糖/果糖低聚糖混合物(Immunofortis(®))的深度水解配方或相同配方但不含合生剂,干预 12 周。1 年后,使用经过验证的问卷评估呼吸症状和哮喘药物使用的发生率。还测定了总血清 IgE 和针对气传过敏原的特异性 IgE。
75 名儿童(70.7%为男性,平均年龄 17.3 个月)完成了 1 年的随访评估。与安慰剂组相比,合生剂组“频繁喘息”和“喘息和/或感冒以外的呼吸声粗”的发生率显著降低(13.9%比 34.2%,绝对风险降低(ARR)-20.3%,95%CI-39.2%至-1.5%;2.8%比 30.8%,ARR-28.0%,95%CI-43.3%至-12.5%)。与安慰剂组相比,合生剂组开始使用哮喘药物的儿童明显更少(5.6%比 25.6%,ARR-20.1%,95%CI-35.7%至-4.5%)。两组的总 IgE 水平没有差异。在合生剂组中没有儿童,而在安慰剂组中有 5 名儿童(15.2%)出现针对猫的 IgE 水平升高(ARR-15.2%,95%CI-27.4%至-2.9%)。
这些结果表明,这种合生剂混合物可预防 AD 婴儿发生哮喘样症状。