Probiotics in primary prevention of atopic disease:: a randomised placebo-controlled trial
Probiotics in primary prevention of atopic disease:: a randomised placebo-controlled trial
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DOI：
10.1016/s0140-6736(00)04259-8
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发表时间：
2001-04-07
期刊：
影响因子：
168.9
通讯作者：
Isolauri, E
中科院分区：
文献类型：
--
作者：
Kalliomäki, M;Salminen, S;Isolauri, E
背景 逆转特应性疾病发生频率的逐渐增加将是西方社会医疗保健和福祉的重要突破。在卫生假说中，这种增加归因于生命早期接触微生物的减少。益生菌是健康肠道微生物群中潜在有益细菌的培养物。我们评估了乳杆菌 GG 对特应性疾病的作用（它在幼年时是安全的，并且可有效治疗过敏性炎症和食物过敏）。 方法 在一项双盲、随机安慰剂对照试验中，我们在产前给至少一名一级亲属（或伴侣）患有特应性湿疹的母亲注射了乳杆菌 GG。过敏性鼻炎或哮喘，以及产后 6 个月内的婴儿。慢性复发性特应性湿疹是出生后最初几年特应性疾病的主要症状，也是主要终点。结果 132 名 2 岁儿童中，有 46 名 (35%) 被诊断出特应性湿疹。其中六名儿童被诊断出患有哮喘，一名儿童被诊断出患有过敏性鼻炎。益生菌组出现特应性湿疹的频率是安慰剂组的一半（15/64 [23%] vs 31/68 [46%]；相对风险 0.51 [95% CI 0.32-0.84]）。需要治疗的人数为 4.5 (95% CI 2.6-15.6)。 解释 乳杆菌 GG 可有效预防高危儿童的早期特应性疾病。因此，肠道微生物群可能是迄今为止尚未开发的天然免疫调节剂和益生菌来源，可用于预防特应性疾病。
Background 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. We assessed the effect on atopic disease of Lactobacillus GG (which is safe at an early age and effective in treatment of allergic inflammation and food allergy).Methods In a double-blind, randomised placebo-controlled trial we gave Lactobacillus GG prenatally to mothers who had at least one first-degree relative (or partner) with atopic eczema. allergic rhinitis, or asthma, and postnatally for 6 months to their infants. Chronic recurring atopic eczema, which is the main sign of atopic disease in the first years of life, was the primary endpoint.Findings Atopic eczema was diagnosed in 46 of 132 (35%) children aged 2 years. Asthma was diagnosed in six of these children and allergic rhinitis in one. The frequency of atopic eczema in the probiotic group was half that of the placebo group (15/64 [23%] vs 31/68 [46%]; relative risk 0.51 [95% CI 0.32-0.84]). The number needed to treat was 4.5 (95% CI 2.6-15.6).Interpretations Lactobacillus GG was effective in prevention of early atopic disease in children at high risk. Thus, gut microflora might be a hitherto unexplored source of natural immunomodulators and probiotics, for prevention of atopic disease.