Reduced occurrence of early atopic dermatitis because of immunoactive prebiotics among low-atopy-risk infants. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age Effects of probiotics on atopic dermatitis: a randomised controlled trial Probiotic Supplement Reduces Atopic Dermatitis in Preschool Children Effect of a New Synbiotic Mixture on Atopic Dermatitis in Children: a Randomized-Controlled Trial Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Evaluation of diet and growth in children with and without atopic eczema: follow-up study from birth to 4 years. Effect of Lactobacillus sakei supplementation in children with atopic eczema-dermatitis syndrome. Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial FOXP3 mRNA expression at 6 months of age is higher in infants who develop atopic dermatitis, but is not affected by giving probiotics from birth. Randomized, Double-Blind, Placebo-Controlled Trial of Probiotics for Primary Prevention: No Clinical Effects of Lactobacillus GG Supplementation Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. Gamma-linolenic acid supplementation for prophylaxis of atopic dermatitis--a randomized controlled trial in infants at high familial risk. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Efficacy of Probiotic Therapy on Atopic Dermatitis in Children: A Randomized, Double-blind, Placebo-controlled Trial
BACKGROUND Most infants developing atopic dermatitis have a low risk for atopy . Primary prevention of atopic dermatitis is difficult . OBJECTIVE To assess the effect of supplementation of an infant and follow-on formula with prebiotic and immunoactive oligosaccharides on the occurrence of atopic dermatitis in the first year of life . METHODS Healthy term infants from 5 European countries with low atopy risk were recruited before the age of 8 weeks , either having started with formula feeding or being on full breast-feeding ( breast-feeding group ) . Formula-fed infants were r and omized to feeding with a regular formula containing a specific mixture of neutral oligosaccharides and pectin-derived acidic oligosaccharides ( prebiotic formula group ) or regular formula without oligosaccharides ( control formula group ) . RESULTS A total of 414 infants were r and omized to the prebiotic group and 416 infants to the control group . A total of 300 infants were followed in the breast-feeding group . Up to the first birthday , atopic dermatitis occurred in significantly fewer infants from the prebiotic group ( 5.7 % ) than from the control group ( 9.7 % ; P = .04 ) . The cumulative incidence of atopic dermatitis in the prebiotic group was in the low range of the breast-feeding group ( 7.3 % ) . In a Cox regression model , the rate of atopic dermatitis was significantly lower by 44 % in the prebiotic group versus the control group ( P = .04 ) . The number needed to prevent 1 case of atopic dermatitis by supplementation of prebiotics was 25 infants . CONCLUSION Formula supplementation with a specific mixture of oligosaccharides was effective as primary prevention of atopic dermatitis in low atopy risk infants Background : Oligosaccharides may alter postnatal immune development by influencing the constitution of gastrointestinal bacterial flora . Aims : To investigate 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 . Methods : Prospect i ve , double-blind , r and omised , placebo controlled trial ; 259 infants at risk for atopy were enrolled . A total of 102 infants in the prebiotic group and 104 infants in the placebo group completed the study . If bottle feeding was started , the infant was r and omly assigned to one of two hydrolysed protein formula groups ( 0.8 g/100 ml prebiotics or maltodextrine as placebo ) . 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 severity 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 : Results show 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 oligosaccharides modulate postnatal immune development by altering bowel flora and have a potential role in primary allergy prevention during infancy Background : The aim of the study was to investigate the effects of probiotics on  moderate or severe atopic dermatitis ( AD ) in young children . Methods : Fifty six children aged 6–18 months with moderate or severe AD were recruited into a r and omised double blind placebo controlled trial in Perth , Western Australia ; 53 children completed the study . The children were given a probiotic ( 1 × 109Lactobacillus fermentum VRI-033 PCC ; Probiomics ) or an equivalent volume of placebo , twice daily for 8 weeks . A final assessment at 16 weeks was performed . Results : The main outcome measures were severity and extent of AD at the end of the study , as measured by the Severity Scoring of Atopic Dermatitis ( SCORAD ) index . The reduction in the SCORAD index over time was significant in the probiotic group ( p = 0.03 ) but not the placebo group . Significantly more children receiving probiotics ( n = 24 , 92 % ) had a SCORAD index that was better than baseline at week 16 compared with the placebo group ( n = 17 , 63 % ) ( p = 0.01 ) . At the completion of the study more children in the probiotic group had mild AD ( n = 14 , 54 % ) compared to the placebo group ( n = 8 , 30 % ) . Conclusion : Supplementation with probiotic L fermentum VRI-003 PCC is beneficial in improving the extent and severity of AD  in young children with moderate or severe disease Abstract Background : The role of probiotics in the treatment of atopic dermatitis ( AD ) remains controversial . A recent systematic review of the available evidence called for further clinical trials with new probiotic formulations . Objective : To assess the clinical efficacy and impact of Lactobacillus acidophilus DDS-1 , Bifidobacterium lactis UABLA-12 with fructo-oligosaccharide on peripheral blood lymphocyte subsets in preschool children with moderate-to-severe AD . Method : R and omized , double-blind , placebo-controlled , prospect i ve trial of 90 children aged 1–3 years with moderate-to-severe AD who were treated with a mixture of L. acidophilus DDS-1 , B. lactis UABLA-12 with fructo-oligosaccharide at a dosage of 5 billion colony-forming units twice daily for 8 weeks versus placebo . The primary outcome measure was the percentage change in Scoring of Atopic Dermatitis ( SCORAD ) value . Other outcome measures were changes in Infant Dermatitis Quality Of Life ( IDQOL ) and Dermatitis Family Impact ( DFI ) scores , frequency and amount of topical corticosteroid used , and lymphocyte subsets in peripheral blood measured by laser flow cytometry . Results : At the final visit , the percentage decrease in SCORAD was 33.7 % in the probiotic group compared with 19.4 % in the placebo group ( p = 0.001 ) . Children receiving probiotic showed a greater decrease in the mean [ SD ] SCORAD score than did children from the placebo group at week 8 ( −14.2 [ 9.9 ] vs −7.8 [ 7.7 ] , respectively ; p = 0.001 ) . IDQOL and DFI scores decreased significantly from baseline by 33.0 % and 35.2 % in the probiotic group and by 19.0 % and 23.8 % in the placebo group , respectively ( p = 0.013 , p = 0.010 ) . Use of topical corticosteroids during the 8-week trial period averaged 7.7 g less in probiotic patients ( p = 0.006 ) . CD3 , CD16 , and CD22 lymphocyte subsets remained unchanged , whereas the percentage of CD4 , and the percentage and absolute count of CD25 decreased , and the percentage and absolute count of CD8 increased in the probiotic group at week 8 ( p < 0.007 vs placebo ) . There was a significant correlation between CD4 percentage , CD25 percentage , CD25 absolute count , and SCORAD values ( r = 0.642 , r = 0.746 , r = 0.733 , respectively ; p < 0.05 ) in the probiotic group at week 8 . Conclusion : The administration of a probiotic mixture containing L. acidophilus DDS-1 , B. lactis UABLA- 12 , and fructo-oligosaccharide was associated with significant clinical improvement in children with AD , with corresponding lymphocyte subset changes in peripheral blood . The efficacy of probiotic therapy in adults with AD requires further investigation Objective Atopic dermatitis ( AD ) is the most common chronic relapsing skin disease seen in infancy and childhood . The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders . Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases . We studied the clinical and immunologic effects of a new symbiotic ( a mixture of seven probiotic strains of bacteria and Fructooligosaccharide ) in infants and children with AD . Methods In a r and omized , double-blind , placebo-controlled study , 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks . The Severity Scoring of Atopic Dermatitis ( SCORAD ) index was recorded at baseline and also at 4 and 8 weeks of treatment . Findings There was no significant difference between the probiotic and placebo group in baseline characteristics including sex , age , family history , corticosteroid usage and prick testing . Mean age was 23 months . The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group ( P=0.001 ) . No specific effect was demonstrated of the probiotics employed on cytokine profile ( P=0.4 , P=0.6 ) . Egg white was the most common ( 45 % ) allergen followed by peanut and cow 's milk . Conclusion This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinical ly improve the severity of  AD in young children . Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD Controversy exists regarding the preventive effect of probiotics on the development of  eczema or atopic dermatitis .  We investigated whether supplementation of probiotics prevents the development of  eczema in infants at high risk . In a r and omized , double-blind , placebo-controlled trial , 112 pregnant women with a family history of allergic diseases received a once-daily supplement , either a mixture of Bifidobacterium bifidum BGN4 , B. lactis AD011 , and Lactobacillus acidophilus AD031 , or placebo , starting at 4 - 8 wks before delivery and continuing until 6 months after delivery . Infants were exclusively breast-fed during the first 3 months , and were subsequently fed with breastmilk or cow 's milk formula from 4 to 6 months of age . Clinical symptoms of the infants were monitored until 1 yr of age , when the total and specific IgE against common food allergens were measured . A total of 68 infants completed the study . The prevalence of eczema at 1 yr in the probiotic group was significantly lower than in the placebo group ( 18.2 % vs. 40.0 % , p=0.048 ) . The cumulative incidence of eczema during the first 12 months was reduced significantly in probiotic group ( 36.4 % vs. 62.9 % , p=0.029 ) ; however , there was no difference in serum total IgE level or the sensitization against food allergens between the two groups . Prenatal and postnatal supplementation with a mixture of B. bifidum BGN4 , B. lactis AD011 , and L. acidophilus AD031 is an effective approach in preventing the development of eczema in infants at high risk of allergy during the first year of life BACKGROUND The increase in allergic diseases is attributed to a relative lack of microbial stimulation of the infantile gut immune system . Probiotics , live health-promoting microbes , might offer such stimulation . OBJECTIVE We studied the effect of a mixture of 4 probiotic bacterial strains along with prebiotic galacto-oligosaccharides in preventing allergic diseases . METHODS We r and omized 1223 pregnant women carrying high-risk children to use a probiotic preparation or a placebo for 2 to 4 weeks before delivery . Their infants received the same probiotics plus galacto-oligosaccharides ( n = 461 ) or a placebo ( n = 464 ) for 6 months . At 2 years , we evaluated the cumulative incidence of allergic diseases ( food allergy , eczema , asthma , and allergic rhinitis ) and IgE sensitization ( positive skin prick test response or serum antigen-specific IgE level > 0.7 kU/L ) . Fecal bacteria were analyzed during treatment and at age 2 years . RESULTS Probiotic treatment compared with placebo showed no effect on the cumulative incidence of allergic diseases but tended to reduce IgE-associated ( atopic ) diseases ( odds ratio [ OR ] , 0.71 ; 95 % CI , 0.50 - 1.00 ; P = .052 ) . Probiotic treatment reduced eczema ( OR , 0.74 ; 95 % CI , 0.55 - 0.98 ; P = .035 ) and atopic eczema ( OR , 0.66 ; 95 % CI , 0.46 - 0.95 ; P = .025 ) . Lactobacilli and bifidobacteria more frequently ( P < .001 ) colonized the guts of supplemented infants . CONCLUSION Probiotic treatment showed no effect on the incidence of all allergic diseases by age 2 years but significantly prevented eczema and especially atopic eczema . The results suggest an inverse association between atopic diseases and colonization of the gut by probiotics . CLINICAL IMPLICATION S The prevention of atopic eczema in high-risk infants is possible by modulating the infant 's gut microbiota with probiotics and prebiotics Current research into dietary factors contributing to the development of allergic diseases is directed towards new active approaches instead of passive elimination diets . The present study aim ed to investigate the explanatory role of the diet in a probiotic intervention study on the appearance of atopic eczema ( AE ) in childhood and the safety of perinatal supplementation with probiotics ( Lactobacillus rhamnosus strain GG ; ATCC 53 103 ) . A prospect i ve follow-up study from birth to 48 months of children ( n 159 ) with a family history of allergic disease was carried out . Outcome measures included growth , dietary intake assessed with 4 d food diaries and their association with AE by logistic regression models . Increased intakes of retinol , Ca and Zn , with perinatal administration of probiotics , reduced the risk of AE , whilst an increase in intake of ascorbic acid increased the likelihood of AE . Perinatal administration of probiotics was safe , as it did not influence the height ( mean difference 0.04 ( 95 % CI -0.33 , 0.40 ) sd scores , P=0.852 ) or the weight-for-height ( mean difference -3.35 ( 95 % CI -7.07 , 0.37)% , P=0.077 ) of the children at 48 months with and without perinatal administration of probiotics . Up to 48 months , AE did not affect height ( mean difference -0.05 ( 95 % CI -0.42 , 0.33 ) sd scores , P=0.815 ) , but mean weight-for-height in children with AE was -5.1 % ( 95 % CI -8.9 , -1.2 % ) lower compared with children without ( P=0.010 ) . The joint effects of nutrients and probiotics need to be considered in active prevention and management schemes for allergic diseases BACKGROUND Probiotics have been suggested to be useful in children with atopic eczema-dermatitis syndrome ( AEDS ) . OBJECTIVE To assess the clinical effect of Lactobacillus sakei supplementation in children with AEDS . METHODS In a double-blind , placebo-controlled trial , children aged 2 to 10 years with AEDS with a minimum SCORing of Atopic Dermatitis ( SCORAD ) score of 25 were r and omized to receive either daily L sakei KCTC 10755BP or daily placebo supplementation for 12 weeks . Changes in SCORAD scores and serum chemokine levels from baseline were evaluated . RESULTS Eighty-eight children were enrolled , and 45 were allocated to probiotic treatment . Seventy-five children completed the study , with 4 dropouts in the probiotic group and 9 in the placebo group . At week 12 , SCORAD total scores adjusted by pretreatment values were lower after probiotic treatment than after placebo treatment ( P = .01 ) . There was a 31 % ( 13.1-point ) improvement in mean disease activity with probiotic use compared with a 13 % ( 5.2-point ) improvement with placebo use ( P = .008 ) . Significant differences in favor of probiotic treatment were also observed in proportions of patients achieving improvement of at least 30 % and 50 % . Compared with placebo , probiotic administration was associated with lower pretreatment-adjusted serum levels of CCL17 and CCL27 ( P = .03 for both ) , which were significantly correlated with SCORAD total score ( r = 0.59 and 0.63 , respectively ; P < .001 ) . CONCLUSIONS Supplementation of L sakei in children with AEDS was associated with a substantial clinical improvement and a significant decrease in chemokine levels , reflecting the severity of AEDS Polyunsaturated fatty acids ( PUFAs ) are components of cell membranes and may play an immunomodulating role in the pathogenesis of atopic dermatitis ( AD ) . The goal was to determine the impact of PUFAs on AD by dietary supplementation of infants . Based on the parents ' decision on their babies ' primary feeding , mothers and newborns were r and omized to the supplementation with gamma-linolenic acid ( GLA ) or placebo for up to 6 months . Breastfed infants received GLA by supplementing their mothers . Formula diet was commercial whey hydrolysate unsupplemented with PUFAs .  Of 131 eligible infants , 24 developed AD within the first year of life . Of these , nine belonged to the exclusively breastfed group ( n = 58 ) , 14 to the combined-fed group ( n = 53 ) , and one to the never breastfed group ( n = 20 ) . We could not find an influence of GLA on the development of AD . In subjects with AD , at 1 yr of age the serum-immunoglobulin E ( IgE ) was the lowest in the GLA-supplemented group A-subjects . In the GLA-supplemented group , GLA-levels in breast milk were similar in atopic and non-atopic infants . In the non-supplemented group the GLA-content of breast milk was 0.07 % of total fatty acids in atopic infants vs. 0.17 % in non-atopic infants ( p < 0.01 ) . Dietary GLA-supplementation could not prevent AD . Interestingly , the number of infants developing AD was the lowest in never breastfed children . In infants suffering from AD , GLA-supplementation seemed to reduce total IgE in the first year of life Background Perinatal probiotics supplementation has been shown to be effective in the primary prevention of  atopic dermatitis ( AD ) in early childhood , although the long term effects of probiotics on AD and other allergic diseases is less certain . We have previously reported a significant reduction in the cumulative incidence of AD at 2 years after maternal probiotic supplementation . In this study we present the effects of perinatal probiotics given to women from a general population on allergy related diseases in their offspring at 6 years . Methods Four hundred and fifteen pregnant women were r and omised to receive  probiotic or placebo milk  in a double-blinded trial from 36 week gestation until 3 months postpartum . Probiotic milk contained Lactobacillus rhamnosos GG , L. acidophilus La-5 and Bifidobacterium animalis subsp . lactis Bb-12 . At 6 years , children were re-assessed for AD , atopic sensitisation , asthma and allergic rhinoconjunctivitis ( ARC ) . Results At 6 years , 81 and 82 children were assessed for AD in the probiotic and placebo groups , respectively . In a multiple imputation analysis , there was as trend towards a lower cumulative incidence of AD in the probiotic group compared to the placebo group ( OR 0.64 , 95 % CI 0.39 - 1.07 , p = 0.086 ; NNT = 10 ) . This finding was statistically significantly in the complete case analysis ( OR 0.48 , 95 % CI 0.25 - 0.92 , p = 0.027 , NNT = 6 ) . The prevalence of asthma and atopic sensitisation , and the cumulative incidence of ARC were not significantly affected by the probiotic regime at 6 years of age . Conclusions Maternal probiotic ingestion alone may be sufficient for long term reduction in the cumulative incidence of AD , but not other allergy related diseases . Trial registration Clinical Trials.gov identifier : Factors that influence immune regulation in early life may be implicated in the rise in allergic disease , including reduced microbial burden . The aim of the study was to examine the infant regulatory T-cell function in relation to ( a ) probiotic supplementation for the first 6 months of life and ( b ) the subsequent development of an early allergic phenotype . Two hundred and thirty-one allergic , pregnant women were recruited into a r and omized , controlled trial . The infants received either a probiotic or placebo daily for the first 6 months of life . One hundred and seventy-eight children completed the study , with blood sample s available from 118 ( 60 placebo ; 58 probiotic ) .  CD4(+)CD25(+)CTLA4(+)T-regulatory phenotype and allergen-induced FOXP3 mRNA expression were compared in relation to this intervention as well as according to evidence of early disease ( atopic dermatitis ) . The administration of probiotics was not associated with any significant differences in the proportion of circulating CD4(+)CD25(+)CTLA4(+)cells , or in the resting expression of FOXP3 . There were also no relationships between these parameters and patterns of gut colonization , and this probiotic did not reduce the risk of atopic dermatitis . Children who developed  atopic dermatitis ( n = 36/118 ) had significantly higher induced FOXP3 expression following stimulation with both house dust mite ( HDM ) ( p = 0.017 ) and ovalbumin ( OVA ) allergens ( p = 0.021 ) than those that did not develop atopic dermatitis . Although this relationship was seen in both the probiotic and placebo groups , it was more pronounced in the probiotic group . However , regression analysis demonstrated that higher allergen-induced FOXP3 expression was predicted by the presence of atopic dermatitis ( p = 0.018 ) rather than probiotics supplementation ( p = 0.217 ) . The higher levels of allergen-induced FOXP3 in atopic dermatitis suggest activation of these compensatory mechanisms rather than a primary defect in this pathway . Probiotic supplementation and gut colonization did not appear to substantially modify these regulatory pathways , or the risk of developing atopic dermatitis BACKGROUND . The value of probiotics for primary prevention is controversial . Published trials vary considerably in study design and the applied probiotics , thereby limiting comparability of the results . OBJECTIVE . The purpose of this trial was to study the preventive effect of the probiotic Lactobacillus GG on the development of atopic dermatitis . METHODS . In a double-blind , placebo-controlled prospect i ve trial , 105 pregnant women from families with ≥1 member ( mother , father , or child ) with an atopic disease were r and omly assigned to receive either the probiotic Lactobacillus GG ( American Type Culture Collection 53103 ; 5 × 109 colony-forming units of Lactobacillus GG twice daily ) or placebo .  Ninety-four families ( 89.5 % ) completed the trial . The supplementation period started 4 to 6 weeks before expected delivery , followed by a postnatal period of 6 months . The primary end point was the occurrence of atopic dermatitis at the age of 2 years . Secondary outcomes were severity of atopic dermatitis , recurrent episodes of wheezing bronchitis , and allergic sensitization at the age of 2 years . RESULTS . Atopic dermatitis was diagnosed in 14 ( 28 % ) of 50 in the Lactobacillus GG group and in 12 ( 27.3 % ) of 44 in the placebo group . The risk of atopic dermatitis in children on probiotics relative to placebo was 0.96 ( confidence interval 0.38–2.33 ) . Severity of atopic dermatitis was comparable between the 2 groups . Notably , children with recurrent ( ≥5 ) episodes of wheezing bronchitis were more frequent in the Lactobacillus GG group ( 26 % ; n = 13 ) , as compared with the placebo group ( 9.1 % ; n = 4 ) . No difference was observed between both groups in total immunoglobulin E concentrations or numbers of specific sensitization to inhalant allergens . CONCLUSIONS . Supplementation with Lactobacillus GG during pregnancy and early infancy neither reduced the incidence of atopic dermatitis nor altered the severity of atopic dermatitis in affected children but was associated with an increased rate of recurrent episodes of wheezing bronchitis . Therefore , Lactobacillus GG can not be generally recommended for primary prevention BACKGROUND Probiotics have shown promising potential in reducing the risk of eczema in infants . Optimal probiotic intervention regimen remains to be determined . OBJECTIVE We investigated whether maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of developing eczema in high-risk infants . METHODS This was a parallel , double-blind placebo-controlled trial of 241 mother-infant pairs . Mothers with allergic disease and atopic sensitization were r and omly assigned to receive ( 1 ) Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 ( LPR+BL999 ) , ( 2 ) L paracasei ST11 and B longum BL999 ( ST11+BL999 ) , or ( 3 ) placebo , beginning 2 months before delivery and during the first 2 months of breast-feeding . The infants were followed until the age of 24 months . Skin prick tests were performed at the ages of 6 , 12 , and 24 months . RESULTS Altogether 205 infants completed the follow-up and were included in the analyses . The risk of developing eczema during the first 24 months of life was significantly reduced in infants of mothers receiving LPR+BL999 ( odds ratio [ OR ] , 0.17 ; 95 % CI , 0.08 - 0.35 ; P < .001 ) and ST11+BL999 ( OR , 0.16 ; 95 % CI , 0.08 - 0.35 ; P < .001 ) . The respective ORs for chronically persistent eczema were 0.30 ( 95 % CI , 0.12 - 0.80 ; P = .016 ) and 0.17 ( 95 % CI , 0.05 - 0.56 ; P = .003 ) . Probiotics had no effect on the risk of atopic sensitization in the infants . No adverse effects were related to the use of probiotics . CONCLUSION Prevention regimen with specific probiotics administered to the pregnant and breast-feeding mother , that is , prenatally and postnatally , is safe and effective in reducing the risk of eczema in infants with allergic mothers positive for skin prick test BACKGROUND Studies suggest that low concentrations of n-6 long-chain polyenes in early life are correlated to atopic disease in later life . OBJECTIVE The purpose of the study was to investigate the possible preventive effect of gamma-linolenic acid ( GLA ) supplementation on the development of  atopic dermatitis in infants at risk . DESIGN In a double-blind , r and omized , placebo-controlled trial , formula-fed infants ( n = 118 ) with a maternal history of atopic disease received borage oil supplement ( containing 100 mg GLA ) or sunflower oil supplement as a placebo daily for the first 6 mo of life . Main outcome measures were the incidence of atopic dermatitis in the first year of life ( by UK Working Party criteria ) , the severity of atopic dermatitis ( SCORing Atopic Dermatitis ; SCORAD ) , and the total serum immunoglobulin E ( IgE ) concentration at the age of 1 y. RESULTS The intention-to-treat analysis showed a favorable trend for severity of atopic dermatitis associated with GLA supplementation ( x+/- SD SCORAD : 6.32 + /- 5.32 ) in the GLA-supplemented group as compared with 8.28 + /- 6.54 in the placebo group ( P = 0.09 ; P = 0.06 after adjustment for total serum IgE at baseline , age 1 wk ) , but no significant effects on the other atopic outcomes . The increase in GLA concentrations in plasma phospholipids between baseline and 3 mo was negatively associated with the severity of atopic dermatitis at 1 y ( Spearman 's correlation coefficient = -0.233 , P = 0.013 ) . There was no significant effect on total serum IgE concentration . CONCLUSION Early supplementation with GLA in children at high familial risk does not prevent the expression of atopy as reflected by total serum IgE , but it tends to alleviate the severity of atopic dermatitis in later infancy in these children The prevalence of atopic diseases is increasing throughout the Western world , and means of primary prevention are needed to reverse this trend . The role of breast-feeding , the best source of infant nutrition , in protection against atopic disease remains elusive . In this double-blinded , placebo-controlled study of 62 mother-infant pairs , it is shown that administering probiotics to the pregnant and lactating mother increased the immunoprotective potential of breast milk , as assessed by the amount of anti-inflammatory transforming growth factor beta2 ( TGF-beta2 ) in the milk ( 2885 pg/mL [ 95 % CI , 1624 - 4146 ] in mothers receiving probiotics vs 1340 pg/mL [ 95 % CI , 978 - 1702 ] in mothers receiving placebo ; P = .018 ) . The risk of developing atopic eczema during the first 2 years of life in infants whose mothers received  probiotics  was significantly reduced in comparison with that in infants whose mothers received placebo ( 15 % and 47 % , respectively ; relative risk , 0.32 [ 95 % CI , 0.12 - 0.85 ] ; P = .0098 ) .  Maternal atopy was a clear risk factor for atopic eczema in the infant . The infants most likely to benefit from maternal probiotic supplementation were those with an elevated cord blood IgE concentration . Administering probiotics during pregnancy and breast-feeding thus offers a safe and effective mode of promoting the immunoprotective potential of breast-feeding and provides protection against atopic eczema during the first 2 years of life Purpose To evaluate a therapeutic efficacy of probiotics mixture ( probiotics ) in the treatment of children with mild-to-moderate atopic dermatitis ( AD ) . Methods R and omized , double-blind , placebo-controlled , parallel trial with a washout period of 2 weeks and an intervention period for 6 weeks , conducted from November 2010 to October 2011 . One hundred children with mild to moderate AD ( 2 - 9 years old ) were r and omly allocated to the probiotics ( Lactobacilluss casei , Lactobacillus rhamnosus , Lactobacillus plantarum , and Bifidobacterium lactis ) or placebo groups . The assessment of efficacy was based on the change in eczema area severity index ( EASI ) , visual analogue scale for pruritus ( VASP ) , fecal cell counts of each strains ( log10[cell counts/g stool ] ) , and serum cytokine levels ( Interleukin-4 [ IL-4 ] ; IL-10 ; Tumor necrosis factor alpha , [ TNF-α ] ) in weeks 0 and 6 . Results Demographics and baseline characteristics at the week 0 were not significantly different between the 2 groups . The significant increments in fecal-cell counts were observed in the probiotcs group at week 6 ( P=0.00 ) , while the cytokine levels between the 2 groups were not significantly different in week 6 ( IL-4 , P=0.50 ; IL-10 , P=0.58 ; TNF-α , P=0.82 ) . The probiotics significantly improved clinical severity after 6 weeks ' intervention of probiotics ; however , the placebo group also showed significant improvement ( EASI ; P=0.00 , VASP ; P=0.00 ) . Conclusions Our findings showed that probiotics successfully colonized in the intestine after 6 weeks ' intervention ; nevertheless , we could not find an additional therapeutic or immunomodulatory effects on the treatment of AD . Further long-term studies will be necessary to clarify the therapeutic efficacy of probiotics
The best evidence lies with probiotics supplementation in mothers and infants in preventing development and reducing severity of AD .
Specifically , Lactobacillus rhamnosus GG was effective in long-term prevention of AD development .
γ-Linolenic acid reduced severity of AD .
Supplementation with prebiotics and black currant seed oil ( γ-linolenic acid and ω-3 combination ) was effective in reducing the development of AD .
Certain types of nutrient supplementation are beneficial in preventing AD development and reducing its severity .
OBJECTIVE To identify whether nutrient supplementation with probiotics , prebiotics , formula , or fatty acids prevents the development of  atopic dermatitis ( AD ) or reduces the severity of AD in newborns to children younger than 3 years .