Early Dietary Intervention with a Mixture of Prebiotic Oligosaccharides Reduces the Incidence of Allergic Manifestations and Infections during the first two Years of Life

Center for Infant Nutrition, Macedonio Melloni Hospital, University of Milan, Milan 20129, Italy.
Journal of Nutrition (Impact Factor: 3.88). 06/2008; 138(6):1091-5.
Source: PubMed


A mixture of neutral short-chain galactooligosaccharides (scGOS) and long-chain fructooligosaccharides (lcFOS) has been shown to reduce the incidence of atopic dermatitis (AD) and infectious episodes during the first 6 mo of life. This dual protection occurred through the intervention period. The present study evaluated if these protective effects were lasting beyond the intervention period. In a prospective, randomized, double-blind, placebo-controlled design, healthy term infants with a parental history of atopy were fed either a prebiotic-supplemented (8 g/L scGOS/lcFOS) or placebo-supplemented (8 g/L maltodextrin) hypoallergenic formula during the first 6 mo of life. Following this intervention period, blind follow-up continued until 2 y of life. Primary endpoints were cumulative incidence of allergic manifestations. Secondary endpoints were number of infectious episodes and growth. Of 152 participants, 134 infants (68 in placebo, 66 in intervention group) completed the follow-up. During this period, infants in the scGOS/lcFOS group had significantly lower incidence of allergic manifestations. Cumulative incidences for AD, recurrent wheezing, and allergic urticaria were higher in the placebo group, (27.9, 20.6, and 10.3%, respectively) than in the intervention group (13.6, 7.6, and 1.5%) (P < 0.05). Infants in the scGOS/lcFOS group had fewer episodes of physician-diagnosed overall and upper respiratory tract infections (P < 0.01), fever episodes (P < 0.00001), and fewer antibiotic prescriptions (P < 0.05). Growth was normal and similar in both groups. Early dietary intervention with oligosaccharide prebiotics has a protective effect against both allergic manifestations and infections. The observed dual protection lasting beyond the intervention period suggests that an immune modulating effect through the intestinal flora modification may be the principal mechanism of action.

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    • "Upper limit Z-value p-value Arslanoglu et al., 2008 Moro et al., 2006 Passeron et al., 2006 Wu et al., 2012 "
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    ABSTRACT: The incidence of allergic diseases has increased in recent decades. Therefore, the aim of this systematic review was to assess the efficacy of prebiotics for the prevention and treatment of allergic manifestations in children. We sought to conduct a systematic review of the effectiveness of prebiotics in the prevention and treatment of allergic diseases in children. We searched the MEDLINE, EMBASE, Cochrane Library, LILACS, SciELO, IBECS, Web of Science and Clinical Trials databases as well as Google Scholar and the references of the articles identified. Randomised clinical trials, in which one of the treatments was performed with prebiotics and the control group was treated with placebo, were included in the review. The data selection were performed by two reviewers, and the study quality was evaluated according to the Consolidated Standards of Reporting Trials (CONSORT) items, according to the recommendations for improving the quality of reports of randomised clinical trials. The selected studies showed heterogeneity with regard to the participants, albeit with similar outcomes. The treatment group size ranged from 134 to 259 children, and the studies compared prebiotic to placebo treatment in each group. In general, these articles showed a trend toward less allergic reactions in the groups receiving active therapy with prebiotics. Although there was a trend for reduced allergic symptoms following the administration of prebiotics, there was not sufficient evidence to establish that such treatment is effective for the prevention of allergies in children.
    10/2013; 1(1). DOI:10.1002/iid3.8
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    • "Breast milk contains several interesting immune modulating components with specific modulating potentials, which are known to have a clear role in immune mediated disease resistance later in life [16]. Specific oligosaccharides are known to modulate immune responses, as they can improve the immune balance in infants, resulting in lower incidence of infections and simultaneously can have an impact on allergy related symptoms [17]. Prebiotic oligosaccharides can have a direct effect via activation or inhibition of cellular receptors on immune competent cells [18] and may act indirectly through microbiota-dependent mechanisms (i.e. "
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    ABSTRACT: Prophylactic vaccinations are generally performed to protect naïve individuals with or without suppressed immune responsiveness. In a mouse model for Influenza vaccinations the specific alterations of CD4(+)CD25(+)Foxp3(+) regulatory T-cells (Tregs) in the immune modulation induced by orally supplied oligosaccharides containing scGOS/lcFOS/pAOS was assessed. This dietary intervention increased vaccine specific DTH responses. In addition, a significant increased percentage of T-bet(+) (Th1) activated CD69(+)CD4(+) T cells (p<0.001) and reduced percentage of Gata-3(+) (Th2) activated CD69(+)CD4(+)T cells (p<0.001) was detected in the mesenteric lymph nodes (MLN) of mice receiving scGOS/lcFOS/pAOS compared to control mice. Although no difference in the number or percentage of Tregs (CD4(+)Foxp3(+)) could be determined after scGOS/lcFOS/pAOS intervention, the percentage of CXCR3 (+) /T-bet(+) (Th1-Tregs) was significantly reduced (p<0.05) in mice receiving scGOS/lcFOS/pAOS as compared to mice receiving placebo diets. Moreover, although no absolute difference in suppressive capacity could be detected, an alteration in cytokine profile suggests a regulatory T cell shift towards a reducing Th1 suppression profile, supporting an improved vaccination response. These data are indicative for improved vaccine responsiveness due to reduced Th1 suppressive capacity in the Treg population of mice fed the oligosaccharide specific diet, showing compartmentalization within the Treg population. The modulation of Tregs to control immune responses provides an additional arm of intervention using alternative strategies possibly leading to the development of improved vaccines.
    PLoS ONE 09/2013; 8(9):e75148. DOI:10.1371/journal.pone.0075148 · 3.23 Impact Factor
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    • "Study showed that the use of this prebiotic oligosaccharide mixture (scGOS/lcFOS) can significant reduction of the total number of infections, respiratory tract infections, fever episodes, and antibiotic prescriptions during the first 2 y of life. The atopic dermatitis (AD), cumulative incidence of other allergy-associated symptoms, like recurrent wheezing and allergic urticaria, was also significantly lower in the sGOS/lcFOS group compared with the placebo group [9]. Our hypothesis was that this mixture of prebiotic oligosaccharides could mimic the immune modulatory function of HMO on local immunity factors, protect mucous membranes of the digestive system, and lead to a reduction in the incidence of allergic and infectious diseases in formula-fed infants. "
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    ABSTRACT: Aim The aim of our open prospective randomized nutritional intervention study was to evaluate the effect of feeding with a standard infant formula enriched with the specific mixture of oligosaccharides on local digestive immunity system and further development of allergic and infectious diseases in young children. Material and methods Depending on the type of feeding the infants were divided into 3 groups (with random allocation to one of the formula feeding groups): 80 infants who were breastfed, 80 infants consuming the formula supplemented with oligosaccharides, 80 infants fed with a standard formula. Results Breastfed infants had the highest content of Bifidobacteria and Lactobacilli in feces (9.047 ± 1.075 and 7.26 ± 0.65 CFU/g accordingly). In infants fed with formula supplemented with scGOS/lcFOS fecal concentrations of Bifidobacteria and Lactobacilli were similar to those in breastfed infants (8.92 ± 1.011 and 7.22 ± 0.74 CFU/g accordingly). It was found that infants fed with breast milk and supplemented formula had significantly less allergic reactions to food products compared to the babies from the third group (3.92% and 4.84% vs. 16.98% accordingly; p < 0,05). Conclusions The mixture of prebiotic oligosaccharides (scGOS/lcFOS – 9:1; 8 g/L) has a similar to breast milk positive impact on the factors of local digestive immunity system in formula-fed infants. This effect may reduce the risk of allergic and infectious diseases in children aged up to 18 months of life, compared with babies fed with the standard formula without oligosaccharides.
    Pediatria polska 09/2013; 88(5):398–404. DOI:10.1016/j.pepo.2013.07.002
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