A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age

Guido Moro ¹, S Arslanoglu ¹, B Stahl ², J Jelinek ², U Wahn ³ and G Boehm ^2*

¹ Center for Infant Nutrition, Macedonio Melloni Maternity Hospital, Milan, Italy
² Numico Research Germany, Friedrichsdorf, Germany
³ Charité Campus Virchow Klinikum, Berlin, Germany

^* To whom correspondence should be addressed. E-mail: guenther.boehm{at}milupa.de.

Accepted 19 June 2006

Abstract

Objective: Oligosaccharides may alter postnatal immune development by influencing the constitution of gastrointestinal bacterial flora. In this study we investigated the effect of a prebiotic mixture of galacto- and long chain fructo-oligosaccharides on the incidence of atopic dermatitis (AD) during the first six months of life in formula fed infants at high risk of atopy.

Design: Prospective, double-blind, randomised, placebo controlled trial.

Patients: 259 infants at risk for atopy were enrolled. 102 infants in the prebiotic group and 104 infants in the placebo group completed the study.

Interventions: If bottle feeding was started, the infant was randomly assigned to one of two hydrolysed protein formula groups (0.8 g/100 ml prebiotics or maltodextrine as placebo).

Main outcome measures: All infants were examined for clinical evidence of atopic dermatitis. In a subgroup of 98 infants, faecal flora was analysed.

Results: Ten infants (9.8 %; 95 CI: 5.4 - 17.1%) in the intervention group and 24 infants (23.1 %; 95 CI: 16.0 - 32.1 %) in the control group developed AD. The sever-ity of the dermatitis was not affected by diet. Prebiotic supplements were associated with a significantly higher number of faecal bifidobacteria compared with controls but there was no significant difference in lactobacilli counts.

Conclusion: These data demonstrate for the first time a beneficial effect of prebiotics on the development of atopic dermatitis in a high risk population of infants. Although the mechanism of this effect requires further investigation, it appears likely that oligo-saccharides modulate postnatal immune development by altering bowel flora and have a potential role in primary allergy prevention during infancy.

Keywords: Infant nutrition, atopic dermatitis, immune modulation, prebiotics

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