The prevalence of non-communicable diseases, also known as chronic diseases, is increasing worldwide and altered gut microbiota has been related to their early onset. Probiotic intervention during the perinatal period has been proposed as a way to reduce the risk of some of these diseases, but long-term efficacy and safety studies are lacking.
A recent study, led by Dr. Erika Isolauri, a professor of paediatrics at the University of Turku and chief physician at the Department of Paediatrics at Turku University Hospital in Finland, has found that perinatal probiotic administration is safe and may have the long-term effect of decreasing allergy prevalence.
The researchers combined data from four double-blind, randomized, placebo-controlled trials conducted in a single tertiary centre in Turku, Finland, between 1997-2012 (with 10-15 years of follow-up). Studies I (here) and IV (here) used Lactobacillus rhamnosus strain GG alone in the probiotic group (LGG and LGG ATCC 53103, respectively). Study II (here) used both Lactobacillus rhamnosus strain GG ATCC 53103 and Bifidobacterium lactis Bb12 in the probiotic group, whereas the study III (here) used two kind of probiotic combinations: Lactobacillus rhamnosus LPR + Bifidobacterium longum BL999 and Lactobacillus paracasei ST11 + Bifidobacterium longum BL999. Outcome measures included diagnosis of asthma, allergic rhinitis, or atopy based on ISAAC criteria, and overweight or obesity defined by international age-and sex-specific body mass index cutoffs. Included children had a heightened allergy risk (atopic disease in a first-degree relative) or preterm birth and were seen at baseline and at a 2-year follow-up visit.
Altogether 303 mother-infant pairs (placebo group: n = 140; probiotic group: n = 163) were included in the analysis. Children receiving perinatal combined probiotics (combined probiotic group) showed no differences in allergic disease (atopic eczema, allergic rhinitis, food allergy, or asthma) prevalence compared to placebo. However, a subgroup of the probiotic group consisting of 133 children receiving LGG as a single strain or LGG mixed with other probiotics (the LGG group) had a significantly (p=0.048) decreased prevalence of allergic disease (59 of 133, 44.4%), as compared to placebo (79 of 140, 56.4%). The perinatal probiotic intervention proved safe in long-term follow-up.
The prevalence of asthma, food allergy, allergic rhinitis and atopic eczema in the children receiving probiotics perinatally was not statistically different from that in children given placebo. Breastfeeding for 6 months or longer was related to a decreased risk of overweight. Besides this, children who regularly consumed probiotic-containing products showed a tendency to a decreased risk of overweight.
In conclusion, perinatal probiotic administration is safe in long-term follow-up. LGG administered alone or in combination with other defined probiotics may lead to a lower risk of developing allergic disease.
Lundelin K, Poussa T, Salminen S, Isolauri E. Long-term safety and efficacy of perinatal probiotic intervention: Evidence from a follow-up study of four randomized, double-blind, placebo-controlled trials. Pediatr Allergy Immunol. 2017; 28(2):170-5. doi: 10.1111/pai.12675.