L. rhamnosus probiotic shows long-lasting anti-eczema benefits for kids: RCT

By Stephen DANIELLS

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L. rhamnosus probiotic shows long-lasting anti-eczema benefits for kids: RCT
Daily supplements containing the probiotic Lactobacillus rhamnosus HN001 strain may reduce the incidence of eczema and skin sensitivity in children, according to data from a double-blind randomized placebo-controlled trial.

Giving mothers-to-be supplements of Lactobacillus rhamnosus​ HN001, and continuing the supplementation with the infants until two years of age led to a 44% lower incidence of eczema in children up to the age of six, compared to placebo.

Researchers from the Wellington Asthma Research Group at the University of Otago in New Zealand also report that no effects were observed when Bifidobacterium animalis​ subsp lactis​ HN019 were used instead of HN001.

“Importantly, our data shows that HN001 did not simply provide protection against eczema during the 2-year intervention period, but that protection persisted for 4 years after cessation of HN001 supplementation,” ​they wrote in Clinical & Experimental Allergy​. “HN001 also reduced the risk of having eczema at 6 years.”

Probiotics for AD

Eczema, also known as atopic dermatitis, is one of the first signs of allergy during the early days of life and is said to be due to delayed development of the immune system. It is a common inflammatory skin disorder, which occurs in early childhood and may persists into adult life. 

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According to the American Academy of Dermatologists, eczema affects between 10 to 20% of all infants, but almost half of these kids will 'grow out' of it between the ages of 5 & 15.

Current treatments focus on alleviating symptoms, but probiotics have been studied for over 20 years for their therapeutic benefits for the condition, with numerous studies identifying significant strain-specific benefits.

It has been reported that probiotics may influence allergy risk via two mechanisms. The first relates to bacterial effects on gut barrier function, while the second relates to influencing the immune system.

The new data from New Zealand found that, by the age of two, both probiotic supplementation regimes led to a presence of HN001 and HN019 in the infant guts, but this was no longer observed by age 4.

Since the effects of HN001 were still evident at age six, the researchers noted that this “suggests that this probiotic had immunomodulatory effects during the first 2 years of life which have persisted to the sixth year”​.

Study details

The researchers, led by Dr Kristin Wickens, investigated the effects of probiotic supplements containing L. rhamnosus​ HN001 (six billion colony forming units per day) or B. animalis​ subsp lactis​ HN019 (nine billion cfu) or placebo in mothers and infants. Mothers-to-be received the supplements daily from 35 weeks gestation until birth, and during six months of breastfeeding. After this time, the infants received the supplements directly until the age of two. The children were followed until the age of six, and complete data from about 300 kids was available.

Results showed that children in the L. rhamnosus​ HN001 group had over 40% lower cumulative prevalence of eczema, compared to placebo.

In addition, skin prick test sensitization was also reduced by about 30% in the HN001 group. No effects were observed for HN019, which suggests that the benefits of L. rhamnosus​ HN001 may be species specific.

“While evidence, including a Cochrane review, supports a role for probiotics containing L. rhamnosus in the prevention of eczema, our study is the first to show a significant effect of a probiotic on skin prick test responses by 6 years,”​ wrote Dr Wickens and her co-workers.

“The protection provided by HN001 was much weaker for HN019 indicating that not all probiotics are the same. This provides further support for a role of HN001, not just in eczema prevention, but possibly also in long-term prevention of atopic sensitization.”

Source: Clinical & Experimental Allergy
2013 Sep, Volume 43, Number 9, Pages 1048-1057. doi: 10.1111/cea.12154.
“Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization?”
Authors: K. Wickens, T.V. Stanley, E.A. Mitchell, C. Barthow, P. Fitzharris, G. Purdie, R. Siebers, P.N. Black, J. Crane

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