Modification of the intestinal microbiota by administration of probiotic bacteria may be a potential approach to prevent allergic disease. We aimed to study primary prevention of allergic disease in high-risk children by pre- and postnatal supplementation of selected probiotic bacteria. In a double-blind, randomized, placebo-controlled trial, a mixture of probiotic bacteria selected by in vitro experiments (Bifidobacterium bifidum, Bifidobacterium lactis, and Lactococcus lactis; OMNi-BiOTiC® PANDA) was prenatally administered to mothers of high-risk children (i.e. with a positive family history of allergic disease) and to their offspring for the first 12 months of life.
The results of the intervention were remarkable. Parental-reported eczema during the first 3 months of life was significantly lower in the probiotic group as compared with placebo, 6/50 (12%) vs. 15/52 (29%) (p < 0.05). Cumulative incidence of parental-reported eczema at 1 and 2 years continued to stay lower in the intervention group, namely 23/50 (46%) vs. 31/48 (64%) and 27/50 (54%) vs. 34/48 (71%), respectively. In addition, the intervention group was significantly more frequently colonized with higher numbers of probiotic Lactococcus lactis. Furthermore, at the age of 3 months, the serum concentration of interleukin 5 (IL-5), an important allergy-promoting cytokine, was decreased by half in the probiotic-group as compared with the placebo-group (146 pg/ml vs. 72 pg/ml ≈ 50%; p < 0.05).
The particular combination of probiotic bacteria used in the study showed a clearly preventive effect on the incidence of eczema in high-risk children, sustained during the first 2 years of life. In accordance with previous studies, the effect already appears to become established within the first 3 months of life by means of an enduring downregulation of Th2 (humoral immune response) in favor of Th1 (cellular immune response) (cf. Niers 2005). The prerequisite for this is a probiotic-enriched intestinal flora, which today only exists in children who grow up in rural areas under natural conditions.
Stimulated by the positive results of this study, we conducted another investigation to see whether the effect of the chosen probiotic would also transfer to the field of infant colic. As part of this investigation, OMNi-BiOTiC® PANDA was made available to young infants from the day of their birth on. The participating mothers filled out a questionnaire daily during the first 4 months of the newborn's life. The primary endpoint of the investigation was the occurrence of 3-month colics. To do so the focus was laid on the duration of screaming bouts, measured in minutes per day. Excessive screaming was defined as lasting for at least more than 180 minutes a day.
Due to the continuous administration of OMNi-BiOTiC® PANDA, the vast majority of the tested infants did not reach the requested 180 minutes of crying per day. Of the children examined, only 4.90% showed the characteristics of excessive crying, as it is typical of 3-month colics (minimum: 3 times per week), while the general prevalence rate in the population equals roughly 30% (Ståhlberg, 1984).
These results indicate that the administration of probiotic bacteria leads to a modification of the intestinal microbiota and thus might be a potential approach to prevent allergic diseases.