Erika Isolauri

Turku University Hospital, Turku, Varsinais-Suomi, Finland

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Publications (365)1563.54 Total impact

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    ABSTRACT: Our aim was to compare the composition and diversity of Lactobacillus microbiota in infants living in Malawi and south-western Finland. The composition and diversity of the Lactobacillus group was analyzed in the feces of healthy six-month-old infants living in rural Malawi (n = 44) and south-western Finland (n = 31), using the quantitative polymerase chain reaction method (qPCR) and PCR-denaturing gradient gel electrophoresis fingerprinting (DGGE). Malawian infants had higher counts of lactobacilli than their Finnish counterparts (7.45 log cells/g vs. 6.86 log cells/g, p < 0.001, respectively) and the Lactobacillus community was richer and more diverse in the Malawian infants. Leuconostoc citreum and Weissella confusa were the predominant species in both study groups, but Malawian infants were more often colonized by these species (100 % vs. 74.2 % p < 0.001; 95.5 % vs. 41.9 %, p < 0.001, respectively). Moreover, Lactobacillus ruminis, Lactobacillus gasseri, Lactobacillus acidophilus and Lactobacillus mucosae were detected more often in the Malawian infants (59.1 % vs. 0.0 %, p < 0.001; 38.6 % vs. 9.7 %, p = 0.004; 29.5 % vs. 0.0 %, p < 0.001; 22.7 % vs. 3.2 %, p = 0.017, respectively). However, Lactobacillus casei group species were only detected in the Finnish infants. Malawian infants have a more abundant Lactobacillus microbiota with a distinct composition compared to Finnish infants. The environment, including diet and hygiene, may be among the factors influencing these differences.
    Journal of pediatric gastroenterology and nutrition 06/2015; DOI:10.1097/MPG.0000000000000878 · 2.87 Impact Factor
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    ABSTRACT: Overweight and obesity currently constitute a major threat to human wellbeing. Almost half of the female population are currently overweight. Pregnant overweight women are at risk of gestational diabetes impacting the health of the mother and the child, both short- and long-term. Notwithstanding the extensive scientific interest centred on the problem, research efforts have thus far been unable to devise preventive strategies. Recent scientific advances point to a gut microbiota dysbiosis, with ensuing low-grade inflammation as a contributing element, in obesity and its comorbidities. Such findings would suggest a role for specific probiotics in the search for preventive and therapeutic adjunct applications in gestational diabetes. The aim of this paper is to critically review recent demonstrations of the role of intestinal microbes in immune and metabolic regulation, which could be exploited in nutritional management of pregnant women by probiotic bacteria. By modulating specific target functions, probiotic dietary intervention may exert clinical effects beyond the nutritional impact of food. As this approach in pregnancy is new, an overview of the gut microbiota in shaping host metabolism together with the definition of probiotics are presented, and finally, specific targets and potential mechanisms for probiotics in pregnancy are discussed. Pregnancy appears to be the most critical stage for interventions aiming to reduce the risk of non-communicable disease in future generations, beyond the immediate dangers attributable to the health of the mother, labour and the neonate. Specific probiotic interventions during pregnancy thus provide an opportunity to promote the health not only of the mother but also of the child. This article is protected by copyright. All rights reserved.
    Diabetes Obesity and Metabolism 04/2015; DOI:10.1111/dom.12475 · 5.46 Impact Factor
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    ABSTRACT: Recent experimental evidence suggests that gut microbiota may alter function within the nervous system providing new insight on the mechanism of neuropsychiatric disorders. 75 infants who were randomized to receive Lactobacillus rhamnosus GG (ATCC 53103) or placebo during the first six months of life were followed-up for 13 years. Gut microbiota was assessed at the age of 3 weeks, 3, 6, 12, 18, 24 months and 13 years using FISH and qPCR, and indirectly by determining the blood group secretor type at the age of 13 years. The diagnoses of attention deficit hyperactivity disorder (ADHD) and Asperger syndrome (AS) by a child neurologist or psychiatrist were based on ICD-10 diagnostic criteria. At the age of 13 years ADHD or AS was diagnosed in 6/35 (17.1%) children in the placebo and none in the probiotic group (p=0.008). The mean (SD) numbers of Bifidobacterium species bacteria in feces during the first six months of life was lower in affected children 8.26 (1.24)log cells/g than in healthy children 9.12 (0.64) log cells/g; p=0.03. Probiotic supplementation early in life may reduce the risk of neuropsychiatric disorder development later in childhood possible by mechanisms not limited to gut microbiota composition.Pediatric Research (2015); doi:10.1038/pr.2015.51.
    Pediatric Research 03/2015; 77(6). DOI:10.1038/pr.2015.51 · 2.84 Impact Factor
  • E Isolauri, S Salminen
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    ABSTRACT: The composition of the gut microbiota, and thus also the modification of the gut microbiota by specific probiotics or prebiotics early in life, may have an impact on the risk of disease in the child. Above the impact on gut microecology, probiotic effects have been attributed to restoration to normal of increased intestinal permeability, improvement of the intestine's immunological barrier functions, alleviation of the intestinal inflammatory response, and reduced generation of proinflammatory cytokines characteristic of local and systemic allergic inflammation. Recent demonstrations from experimental and clinical studies suggest that the gut microbiota is also involved in the control of body weight and energy metabolism, affecting the two main causes of obesity: energy acquisition and storage, and contributing to insulin resistance and the inflammatory state characterising obesity. Current research focuses both on characterising specific probiotic strains and on how the food matrix and the dietary content interacts with the most efficient probiotic strains. It is important to characterise each probiotic to species and strain level and to select strains with documented properties, the probiotic potential being strain-specific. As any proof of causality requires clinical intervention studies in humans in different populations, rigorous and detailed documentation will enhance reproducibility and circumvent confusion.
    Beneficial Microbes 01/2015; 1(-1):1-5. DOI:10.3920/BM2014.0114 · 1.50 Impact Factor
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    ABSTRACT: Background Bacterial contact in utero modulates fetal and neonatal immune responses. Maternal probiotic supplementation reduces the risk of immune-mediated disease in the infant. We investigated the immunomodulatory properties of live Lactobacillus rhamnosus GG and its SpaC pilus adhesin in human fetal intestinal models.MethodsTNF-α mRNA expression was measured by qPCR in a human fetal intestinal organ culture model exposed to live L. rhamnosus GG and proinflammatory stimuli. Binding of recombinant SpaC pilus protein to intestinal epithelial cells was assessed in human fetal intestinal organ culture and the human fetal intestinal epithelial cell line H4 by immunohistochemistry and immunofluorescence, respectively. TLR-related gene expression in fetal ileal organ culture after exposure to recombinant SpaC was assessed by qPCR.ResultsL. rhamnosus GG significantly attenuates pathogen-induced TNF-α mRNA expression in the human fetal gut. Recombinant SpaC protein was found to adhere to the fetal gut and to modulate varying levels of TLR-related gene expression.Conclusions The human fetal gut is responsive to luminal microbes. L. rhamnosus GG significantly attenuates fetal intestinal inflammatory responses to pathogenic bacteria. The L. rhamnosus GG pilus adhesin SpaC binds to immature human intestinal epithelial cells and directly modulates intestinal epithelial cell innate immune gene expression.Pediatric Research (2015); doi:10.1038/pr.2015.5.
    Pediatric Research 01/2015; 77(4). DOI:10.1038/pr.2015.5 · 2.84 Impact Factor
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    ABSTRACT: The reports on atopic diseases and microbiota in early childhood remain contradictory and both decreased and increased microbiota diversity have been associated with atopic eczema. In this study, the intestinal microbiota signatures associated with the severity of eczema in 6-month-old infants were characterized. Further, the changes in intestinal microbiota composition related to the improvement of this disease 3 months later were assessed. The severity of eczema correlated inversely with microbiota diversity (r=-0.54, P=0.002) and with the abundance of butyrate-producing bacteria (r= -0.52, P=0.005). During the 3 months follow-up, microbiota diversity increased (P<0.001) and SCORAD values decreased (P<0.001) in all infants. This decrease coincided with the increase in bacteria related to butyrate-producing Coprococcus eutactus (r= -0.59, P=0.02). In conclusion, the high diversity of microbiota and high abundance of butyrate-producing bacteria were associated with milder eczema, thus suggesting they have a role in alleviating symptoms of atopic eczema.This article is protected by copyright. All rights reserved.
    Allergy 11/2014; 70(2). DOI:10.1111/all.12549 · 6.00 Impact Factor
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    ABSTRACT: IMPORTANCE Epigenetics encompasses genomic modifications that are due to environmental factors and do not affect the nucleotide sequence. The gut microbiota has an important role in human metabolism and could be a significant environmental factor affecting our epigenome. To investigate the association of gut microbiota with epigenetic changes, we assessed pregnant women and selected the participants based on their predominant gut microbiota for a study on their postpartum methylation profile. Intriguingly, we found that blood DNA methylation patterns were associated with gut microbiota profiles. The gut microbiota profiles, with either Firmicutes or Bacteroidetes as a dominant group, correlated with differential methylation status of gene promoters functionally associated with cardiovascular diseases. Furthermore, differential methylation of gene promoters linked to lipid metabolism and obesity was observed. For the first time, we report here a position of the predominant gut microbiota in epigenetic profiling, suggesting one potential mechanism in obesity with comorbidities, if proven in further in-depth studies.
    mBio 10/2014; 5(6-6). DOI:10.1128/mBio.02113-14 · 6.88 Impact Factor
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    ABSTRACT: Modern civilization is faced with a progressive increase in immune-mediated or inflammatory health problems such as allergic disease, autoimmune disorders and obesity. An extended version of the hygiene hypothesis has been introduced to emphasize the intimate interrelationship between diet, the immune system, microbiome and origins of human disease. the modern infant, particularly when delivered by caesarean section and without the recommended exclusive breast-feeding, may lack sufficient stimulation of the mucosal immune system to generate a tolerogenic immune milieu and instead be prone to develop chronic inflammatory conditions. These deviations may take the form of allergic or autoimmune disease, or predispose the child to higher weight gain and obesity. Moreover, evidence supports the role of first microbial contacts in promoting and maintaining a balanced immune response in early life and recent findings suggest that microbial contact begins prior to birth and is shaped by the maternal microbiota. Maternal microbiota may prove to be a safe and effective target for interventions decreasing the risk of allergic and non-communicable diseases in future generations. These results support the hypothesis that targeting early interaction with microbes might offer an applicable strategy to prevent disease.Pediatric Research (2014); doi:10.1038/pr.2014.173.
    Pediatric Research 10/2014; 77(1-2). DOI:10.1038/pr.2014.173 · 2.84 Impact Factor
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    ABSTRACT: Microbial contact begins prior to birth and continues rapidly thereafter. Few long term follow-up studies have been reported and we therefore characterized the development of intestinal microbiota of ten subjects from the 2(nd) week of life to 13 years of age. PCR-denaturing gradient gel electrophoresis combined with several bacterial group specific primer sets demonstrated the colonization steps of defined bacterial groups in the microbiota. Bifidobacterium species were seen throughout the test period in all subjects. Bacteroides fragilis group and Blautia coccoides-Eubacterium rectale group species were not detected in several subjects during the first 6 months of life but were commonly seen after 12 months of life. Streptococcus group appeared during early life but was not seen in several subjects at the age of 13 years. Although a few species were linked with the increasing age, major bacterial species in the groups did not change dramatically. Rather considerable changes were found in the relative abundances of each bacterial species. Clustering analysis of total bacterial flora indicated that the microbiota changed considerably between 6 months and 12 months of life, and, at the age of 12 months, the intestinal microbiota was already converted toward a profile characteristic of an adult microbiota. Probiotic supplementation in the beginning of life did not have major impacts on later microbiota development.
    Anaerobe 06/2014; 28. DOI:10.1016/j.anaerobe.2014.06.006 · 2.36 Impact Factor
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    ABSTRACT: As pregnancy may trigger overweight in women, new means for its prevention are being sought. The aim here was to investigate the effect of individual dietary counselling during and after pregnancy on post-partum weight and waist circumference up to 4 years post-partum. A cohort of women (n = 256) were randomized to receive repeated individual dietary counselling by a nutritionist during and after pregnancy, or as controls not receiving dietary counselling, from the first trimester of pregnancy until 6 months after delivery. Counselling aimed to bring dietary intake into line with recommendations, with particular focus on the increase in the intake of unsaturated fatty acids instead of saturated. Pre-pregnancy weight was taken from welfare clinic records. Weight and waist circumference were measured at 4 years after delivery. The proportion of overweight women increased from 26% prior to pregnancy to 30% at 4 years after delivery among women receiving dietary counselling, as against considerably more, from 32% to 57%, among controls. The prevalence of central adiposity was 31% in women receiving dietary counselling, 64% in controls. Likewise, both the risk of overweight (odds ratio: 0.23, 0.08-0.63, P = 0.005) and central adiposity (odds ratio: 0.18, 0.06-0.52, P = 0.002) were lower in women receiving dietary counselling compared with controls. Repeated dietary counselling initiated in early pregnancy can be beneficial in long-term weight control after delivery.
    Maternal and Child Nutrition 02/2014; DOI:10.1111/mcn.12115 · 2.97 Impact Factor
  • Henriina Hermansson, Ulla Hoppu, Erika Isolauri
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    ABSTRACT: Background: Caesarean section rates have increased in parallel with those of obesity. Decreased levels of adiponectin, an adipocyte-derived metabolic hormone present in abundant concentrations in cord blood and breast milk, have been documented in association with obesity in children and adults. Objective: To determine whether the mode of delivery affects adiponectin concentrations in cord blood of healthy term infants. Methods: The cord blood adiponectin concentration was measured in 159 consecutive term infants, of whom 131 (82.4%) were born by vaginal delivery, 15 (9.4%) by nonelective caesarean section and 13 (8.2%) by elective caesarean section. Results: The mean adiponectin level was significantly lower in infants born by elective caesarean section compared with those born by vaginal delivery: 15.3 µg/ml (SD = 6.8) and 21.6 µg/ml (SD = 7.3), respectively (p = 0.015). This difference remained significant after adjustment for the infants' gender and birth weight as well as maternal weight and weight gain during pregnancy. Conclusion: Elective caesarean section may carry a risk of obesity independently of maternal risk factors. © 2014 S. Karger AG, Basel.
    Neonatology 01/2014; 105(3):172-174. DOI:10.1159/000357178 · 2.37 Impact Factor
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    ABSTRACT: Microbial contact begins prior to birth and continues rapidly thereafter. Few long term follow-up studies have been reported and we therefore characterized the development of intestinal microbiota of ten subjects from the 2nd week of life to 13 years of age. PCR-denaturing gradient gel electrophoresis combined with several bacterial group specific primer sets demonstrated the colonization steps of defined bacterial groups in the microbiota. Bifidobacterium species were seen throughout the test period in all subjects. Bacteroides fragilis group and Blautia coccoides-Eubacterium rectale group species were not detected in several subjects during the first 6 months of life but were commonly seen after 12 months of life. Streptococcus group appeared during early life but was not seen in several subjects at the age of 13 years. Although a few species were linked with the increasing age, major bacterial species in the groups did not change dramatically. Rather considerable changes were found in the relative abundances of each bacterial species. Clustering analysis of total bacterial flora indicated that the microbiota changed considerably between 6 months and 12 months of life, and, at the age of 12 months, the intestinal microbiota was already converted toward a profile characteristic of an adult microbiota. Probiotic supplementation in the beginning of life did not have major impacts on later microbiota development.
    Anaerobe 01/2014; · 2.36 Impact Factor
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    ABSTRACT: Abstract We aimed to explore whether maternal dietary counseling to increase the intake of unsaturated fatty acids (FA) is reflected in infant FA status. Serum cholesteryl ester (CE) and triacylglycerol (TAG) FA were analyzed from infants of 45 women randomized to receive dietary counseling from the first trimester of pregnancy and 45 control women. Counseling resulted in a higher intake of polyunsaturated FA and a lower intake of saturated FA. The dietary intake was reflected in cord blood TAGs: the n-6 to n-3 FA ratio was lower [mean difference -0.50 (95%CI -0.95 to -0.06)] and the sum of n-3 FA was higher in the intervention than in the control group [1.46 (0.44 to 2.48)% of total FA]. Reasons for the lack of changes in the cord blood CE fraction and FA fractions at 1-month remain unclear, but may indicate that the changes achieved in the maternal diet through counseling were too modest.
    International Journal of Food Sciences and Nutrition 11/2013; DOI:10.3109/09637486.2013.854744 · 1.20 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the effects of dietary counseling on blood lipid concentrations during and after pregnancy. Partcipants (N = 256) were randomized into three study groups: dietary counseling with probiotics or placebo and a control group at first trimester of pregnancy. Diet quality was evaluated from food records by an index of healthy eating and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, apolipoproteins A-I and B, and lipoprotein (a) were measured at the first and third trimesters of pregnancy and 1, 6, and 12 mo postpartum. During pregnancy, no differences in lipid values were noted among the groups, but postpartum TC and LDL-C were lower in both dietary counseling groups compared with controls (P = 0.027 and P = 0.012, respectively). Higher points on the healthy eating index, normal weight, and regular exercise were associated with a more favorable lipid profile at 12 mo after delivery. Maternal dietary counseling may lower maternal TC and LDL-C levels postpartum. A healthy lifestyle during pregnancy and postpartum may benefit women's cardiovascular health.
    Nutrition 10/2013; 30(2). DOI:10.1016/j.nut.2013.07.009 · 3.05 Impact Factor
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    ABSTRACT: Simple and safe strategies for the prevention of viral respiratory tract infections (RTIs) are needed. We hypothesized that early prebiotic or probiotic supplementation would reduce the risk of virus-associated RTIs during the first year of life in a cohort of preterm infants. In this randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov no. NCT00167700), 94 preterm infants (gestational age, ≥32 + 0 and ≤36 + 6 weeks; birth weight, >1500 g) treated at Turku University Hospital, Turku, Finland, were allocated to receive oral prebiotics (galacto-oligosaccharide and polydextrose mixture, 1:1), a probiotic (Lactobacillus rhamnosus GG, ATCC 53103), or placebo (microcrystalline cellulose) between days 3 and 60 of life. The primary outcome was the incidence of clinically defined virus-associated RTI episodes confirmed from nasal swabs by using nucleic acid testing. Secondary outcomes were the severity and duration of RTIs. A significantly lower incidence of RTIs was detected in infants receiving prebiotics (rate ratio [RR], 0.24; 95% CI, 0.12-0.49; P < .001) or probiotics (RR, 0.50; 95% CI, 0.28-0.90; P = .022) compared with those receiving placebo. Also, the incidence of rhinovirus-induced episodes, which comprised 80% of all RTI episodes, was found to be significantly lower in the prebiotic (RR, 0.31; 95% CI, 0.14-0.66; P = .003) and probiotic (RR, 0.49; 95% CI, 0.24-1.00; P = .051) groups compared with the placebo group. No differences emerged among the study groups in rhinovirus RNA load during infections, duration of rhinovirus RNA shedding, duration or severity of rhinovirus infections, or occurrence of rhinovirus RNA in asymptomatic infants. Gut microbiota modification with specific prebiotics and probiotics might offer a novel and cost-effective means to reduce the risk of rhinovirus infections.
    The Journal of allergy and clinical immunology 10/2013; 133(2). DOI:10.1016/j.jaci.2013.08.020 · 11.25 Impact Factor
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    ABSTRACT: To find out whether there is an association between when complementary feeding is introduced and the appearance of atopic eczema in children with a family history of allergy. This prospective study followed 256 mother and child pairs until the child was four-years-old. Repeated skin prick testing was performed and a clinical diagnosis of eczema made by a physician. The mothers kept a continuous diary about the introduction of complementary feeding. To control for the possible reverse causation of delaying complementary food introduction due to presumed child allergy, parental suspicions of allergic reactions were recorded. The introduction of cereals and fish after seven-months-of-age was associated with an increased risk of atopic eczema. However, when the parents' suspicions that their child may be exhibiting symptoms of allergic disease were taken into account, this effect was no longer significant. We found no evidence that the timing of the introduction of complementary feeding increased the risk of atopic eczema in a high-risk cohort, when parental suspicions were taken into account. Therefore, it seems that families with a history of allergy can safely comply with current feeding recommendations, although confirmation in further studies is warranted. This article is protected by copyright. All rights reserved.
    Acta Paediatrica 10/2013; 103(2). DOI:10.1111/apa.12458 · 1.84 Impact Factor
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    ABSTRACT: Background/Objectives:The mother is an important mediator to the infant of polyunsaturated fatty acids (PUFA), the essential constituents of membranes particularly in the brain and retina. We here aimed in a prospective study initiated in early pregnancy to establish whether serum fatty acid (FA) compositions and concentrations in the mother can be modified by dietary means emphasizing counseling on a recommended diet.Subjects/Methods:Ninety women in the first trimester of pregnancy were randomized into intervention (n=45) or control (n=45) groups. The intervention comprised individual dietary counseling advocating choice of foods that will increase the intake of unsaturated and reduce that of saturated FA. To support this, appropriate products, including spreads, were provided for consumption at home. Dietary intakes were measured from food records and serum phospholipids, cholesteryl esters and triacylglycerols FA were analyzed by gas chromatography.Results:Dietary counseling resulted in lower intake of saturated and higher intake of unsaturated FA compared with the controls. These changes were reflected in higher proportions of serum phospholipid PUFA (mean difference between groups 0.61% (95% confidence interval, CI 0.05-1.17), P=0.03), docosahexaenoic acid (0.5% (0.15-0.85), P=0.01), sum of n-3 FA (0.61% (0.07-1.15), P=0.03) and lower ratio of n-6/n-3 FA (-0.42% (-0.81-0.03), P=0.03) in the intervention group at the third trimester of pregnancy but not at 1 month postpartum. Similar changes were seen in the FA of cholesteryl esters and triacylglycerols.Conclusion:Maternal serum n-3 FA status during pregnancy can be improved by dietary means emphasizing the importance of dietary advice.European Journal of Clinical Nutrition advance online publication, 18 September 2013; doi:10.1038/ejcn.2013.169.
    European journal of clinical nutrition 09/2013; DOI:10.1038/ejcn.2013.169 · 2.95 Impact Factor
  • 08/2013; 167(10). DOI:10.1001/jamapediatrics.2013.99
  • Merja Nermes, Seppo Salminen, Erika Isolauri
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    ABSTRACT: A balanced gut microbiota is crucial for the development of healthy immunoregulation and gut barrier function to allow brisk immune responses to pathogens and systemic hyporesponsiveness to harmless antigens such as food. Although the first allergic disease to manifest itself, atopic eczema, is not equivalent to food allergy, pre- and postnatal administration of specific probiotic strains has emerged as a promising tool for the prevention of this condition, with potential implications for food allergy development. For food allergy proper, however, we lack markers and risk factors and mechanisms, i.e., targets for preventive measures. The focus here is therefore on the treatment. Indeed, the potential of specific probiotic strains to alleviate food allergy resides in their ability to modify antigens, repair gut barrier functions, balance altered microbiota, and restore local and systemic immune regulation. In patients with multiple food allergies, induction of oral tolerance by specific probiotics continues to attract research interest.
    Current Allergy and Asthma Reports 08/2013; DOI:10.1007/s11882-013-0381-9 · 2.45 Impact Factor
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    ABSTRACT: To evaluate the impact of early prebiotic and probiotic intervention on preterm infants' well-being, crying, growth, and microbiological programming. Ninety-four preterm infants (gestational age 32-36 weeks and birth weight >1500 g) randomized to receive prebiotics (mixture of galacto-oligosaccharide and polydextrose 1:1), probiotics (Lactobacillus rhamnosus GG), or placebo during the first 2 months of life were followed up for 1 year. Infants were categorized based on the extent of crying and irritability during the first 2 months of life, and their gut microbiota was investigated by fluorescence in situ hybridization (n = 66) and quantitative polymerase chain reaction (n = 63). A total of 27 of 94 infants (29%) infants were classified as excessive criers, significantly less frequently in the prebiotic and the probiotic groups than in the placebo group (19% vs 19% vs 47%, respectively; P = .02). The placebo group had a higher percentage of Clostridium histolyticum group bacteria in their stools than did the probiotic group (13.9% vs 8.9%, respectively; P = .05). There were no adverse events related to either supplementation. Early prebiotic and probiotic supplementation may alleviate symptoms associated with crying and fussing in preterm infants. This original finding may offer new therapeutic and preventive measures for this common disturbance in early life.
    The Journal of pediatrics 07/2013; 163(5). DOI:10.1016/j.jpeds.2013.05.035 · 3.74 Impact Factor

Publication Stats

22k Citations
1,563.54 Total Impact Points

Institutions

  • 1998–2015
    • Turku University Hospital
      • Department of Pediatrics
      Turku, Varsinais-Suomi, Finland
  • 1997–2015
    • University of Turku
      • • Department of Paediatrics
      • • Division of Political Science
      • • Department of Biochemistry and Food Chemistry
      Turku, Varsinais-Suomi, Finland
    • Royal Free London NHS Foundation Trust
      Londinium, England, United Kingdom
  • 2012
    • Spanish National Research Council
      • Department of Plant Biotechnology
      Madrid, Madrid, Spain
  • 1983–2012
    • University of Tampere
      • • Department of Paediatrics
      • • Medical School
      Tammerfors, Pirkanmaa, Finland
  • 2007
    • University of Kuopio
      • Department of Clinical Nutrition
      Kuopio, Eastern Finland Province, Finland
  • 1995–2007
    • University of Helsinki
      • Veterinary Biosciences
      Helsinki, Uusimaa, Finland
  • 2002
    • British Society of Paediatric Gastroenterology Hepatology and Nutrition
      United Kingdom
  • 2001
    • Satakunta Hospital District
      Björneborg, Province of Western Finland, Finland
  • 1999
    • Valio Ltd
      Helsinki, Southern Finland Province, Finland
    • Turku centre for biotechnology, finland
      Turku, Province of Western Finland, Finland
  • 1996–1997
    • Tampere University Hospital (TAUH)
      Tammerfors, Province of Western Finland, Finland