Wellington Asthma Research Group, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
Clin Exp Allergy. 2013 Sep;43(9):1048-57. doi: 10.1111/cea.12154.
The role of probiotics in prevention of allergic disease is still not clear; efficacy may depend on the timing, dose, duration, and specific probiotic used. Using a double-blind randomized placebo-controlled trial (Australian New Zealand Clinical Trials Registry: ACTRN12607000518460), we have shown that in a high-risk birth cohort, maternal supplementation from 35 weeks gestation until 6 months if breastfeeding and infant supplementation from birth until 2 years with Lactobacillus rhamnosus HN001 (HN001) (6 × 10(9) cfu/day) halved the cumulative prevalence of eczema at 2 and 4 years. Bifidobacterium animalis subsp lactis HN019 (HN019) (9 × 10(9) cfu/day) had no significant effect.
To determine whether differences in effects of HN001 and HN019 on eczema persist to age 6 years, and to investigate effects on sensitization.
Standard procedures were used to assess eczema (The UK Working Party's Criteria), eczema severity (SCORAD), atopic sensitization [skin prick tests (SPT), total and specific IgE] and standard questions used for asthma, wheeze, and rhinoconjunctivitis.
HN001 was associated with significantly lower cumulative prevalence of eczema (HR = 0.56, 95% CI 0.39-0.80), SCORAD ≥ 10 (HR = 0.69, 0.49-0.98) and SPT sensitization (HR = 0.69, 95% CI 0.48-0.99). The point prevalence of eczema (RR = 0.66, 95% CI 0.44-1.00), SCORAD ≥ 10 (RR = 0.62, 95% CI 0.38-1.01) and SPT sensitization (RR = 0.72, 95% CI 0.53-1.00) were also reduced among children taking HN001. HN019 had no significant effect on any outcome.
This study provides evidence for the efficacy of the probiotic L. rhamnosus HN001 in preventing the development of eczema and possibly also atopic sensitization in high risk infants to age 6 years. The absence of a similar effect for HN019 indicates that benefits may be species specific.
益生菌在预防过敏疾病中的作用尚不清楚；疗效可能取决于时间、剂量、持续时间和使用的特定益生菌。我们采用双盲随机安慰剂对照试验（澳大利亚新西兰临床试验注册处：ACTRN12607000518460），结果表明，在高危出生队列中，母亲从 35 周妊娠开始补充，直至母乳喂养 6 个月，如果母乳喂养，则从出生开始至 2 岁补充鼠李糖乳杆菌 HN001（HN001）（6×10(9)cfu/天），可将 2 岁和 4 岁时湿疹的累积患病率减半。双歧杆菌动物亚种乳杆菌 HN019（HN019）（9×10(9)cfu/天）则无显著效果。
确定 HN001 和 HN019 对湿疹的影响是否持续到 6 岁，并研究其对过敏的影响。
采用英国工作组标准评估湿疹（标准程序）（湿疹、湿疹严重程度（SCORAD）、特应性致敏（皮肤点刺试验（SPT）、总 IgE 和特异性 IgE）和用于哮喘、喘息和鼻结膜炎的标准问题。
HN001 与湿疹（HR=0.56，95%CI 0.39-0.80）、SCORAD≥10（HR=0.69，0.49-0.98）和 SPT 致敏（HR=0.69，95%CI 0.48-0.99）的累积患病率显著降低。湿疹的点患病率（RR=0.66，95%CI 0.44-1.00）、SCORAD≥10（RR=0.62，95%CI 0.38-1.01）和 SPT 致敏（RR=0.72，95%CI 0.53-1.00）也有所降低。HN019 对任何结果均无显著影响。
本研究为益生菌 Lactobacillus rhamnosus HN001 在预防高危婴儿湿疹和可能的特应性致敏方面的疗效提供了证据，至 6 岁。HN019 没有类似效果表明，益处可能是特定于物种的。
