<i>Lactobacillus</i> GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial

<jats:sec><jats:label /><jats:p> <jats:bold>To cite this article:</jats:bold> Boyle RJ, Ismail IH, Kivivuori S, Licciardi PV, Robins‐Browne RM, Mah L‐J, Axelrad C, Moore S, Donath S, Carlin JB, Lahtinen SJ, Tang MLK. <jats:italic>Lactobacillus</jats:italic> GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. <jats:italic>Allergy</jats:italic> 2011; <jats:bold>66</jats:bold>: 509–516.</jats:p></jats:sec><jats:sec><jats:title>Abstract</jats:title><jats:p><jats:bold>Background: </jats:bold> Probiotic supplementation in early life may be effective for preventing eczema. Previous studies have suggested that prenatal administration may be particularly important for beneficial effects.</jats:p><jats:p><jats:bold>Objective: </jats:bold> We examined whether prenatal treatment with the probiotic <jats:italic>Lactobacillus rhamnosus</jats:italic> GG (LGG) can influence the risk of eczema during infancy.</jats:p><jats:p><jats:bold>Methods: </jats:bold> We recruited 250 pregnant women carrying infants at high risk of allergic disease to a randomized controlled trial of probiotic supplementation (LGG 1.8 × 10<jats:sup>10</jats:sup> cfu/day) from 36 weeks gestation until delivery. Infants were assessed during their first year for eczema or allergic sensitization. Immunological investigations were performed in a subgroup. Umbilical cord blood was examined for dendritic cell and regulatory T cell numbers and production of TGFβ, IL‐10, IL‐12, IL‐13, IFN‐γ and TNFα. Maternal breast milk was examined for total IgA, soluble CD14 and TGFβ.</jats:p><jats:p><jats:bold>Results: </jats:bold> Prenatal probiotic treatment was not associated with reduced risk of eczema (34% probiotic, 39% placebo; RR 0.88; 95% CI 0.63, 1.22) or IgE‐associated eczema (18% probiotic, 19% placebo; RR 0.94; 95% CI 0.53, 1.68). Prenatal probiotic treatment was not associated with any change in cord blood immune markers, but was associated with decreased breast milk soluble CD14 and IgA levels.</jats:p><jats:p><jats:bold>Conclusions: </jats:bold> Prenatal treatment with <jats:italic>Lactobacillus rhamnosus</jats:italic> GG was not sufficient for preventing eczema. If probiotics are effective for preventing eczema, then a postnatal component to treatment or possibly an alternative probiotic strain is necessary.</jats:p></jats:sec>