Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy.
Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy.
J Pediatr. 2019 Oct;213:137-142.e2. doi: 10.1016/j.jpeds.2019.06.004. Epub 2019 Jul 18.
To investigate whether the addition of the probiotic Lactobacillus rhamnosus GG (LGG) to the extensively hydrolyzed casein formula (EHCF) for cow's milk allergy (CMA) treatment could reduce the occurrence of functional gastrointestinal disorders (FGIDs).
This cohort study included children with a positive history for CMA in the first year of life who were treated with EHCF alone or in combination with LGG and had evidence of immune tolerance acquisition to cow's milk for at least 12 months. FGID was diagnosed according to the Rome III diagnostic criteria by investigators unaware of previous treatment. A cohort of consecutive healthy children was also evaluated as a control population.
A total of 330 subjects were included, 110 per cohort (EHCF, EHCF+LGG, and healthy controls). The rate of subjects with ≥1 FGID was significantly lower in the EHCF+LGG cohort compared with the EHCF cohort (40% vs 16.4%; P < .05). In the EHCF+LGG cohort, a lower incidence was observed for all components of the main study outcome. The prevalence of FGIDs in the healthy cohort was lower than that in the EHCF cohort and similar to that in the EHCF+LGG cohort. The incidence rate ratio of FGIDs for the EHCF+LGG cohort vs the EHCF cohort (0.40; 95% CI, 0.25-0.65; P < .001) was unmodified after correction for age at CMA diagnosis, breastfeeding, weaning time, and presence of a first-degree relative with an FGID.
These results confirm the increased risk for developing FGIDs in children with CMA and suggest that EHCF+LGG could reduce this risk.
研究在治疗牛奶过敏（CMA）时，添加鼠李糖乳杆菌 GG（LGG）是否会降低广泛水解酪蛋白配方（EHCF）的功能性胃肠疾病（FGIDs）的发生率。
本队列研究纳入了生命第一年有 CMA 阳性史、接受 EHCF 单独或联合 LGG 治疗且对牛奶有免疫耐受的儿童，且至少有 12 个月的证据。FGID 根据研究人员不知道先前治疗情况的 Rome III 诊断标准进行诊断。还评估了一组连续的健康儿童作为对照人群。
共纳入 330 例受试者，每组 110 例（EHCF、EHCF+LGG 和健康对照组）。与 EHCF 组相比，EHCF+LGG 组有≥1 种 FGID 的受试者比例明显较低（40% vs 16.4%；P<.05）。在 EHCF+LGG 组，主要研究结果的所有组成部分的发生率均较低。健康组的 FGIDs 患病率低于 EHCF 组，与 EHCF+LGG 组相似。EHCF+LGG 组 FGIDs 的发病率比（EHCF+LGG 组与 EHCF 组的 0.40；95%CI，0.25-0.65；P<.001）在调整 CMA 诊断时的年龄、母乳喂养、断奶时间和一级亲属 FGIDs 存在后无变化。
这些结果证实了 CMA 儿童发生 FGIDs 的风险增加，并表明 EHCF+LGG 可能降低这种风险。
