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Effects of Lactobacillus rhamnosus HN001 in early life on the cumulative prevalence of allergic disease to 11 years

  • 2018-11-14
  • Pediatric Allergy and Immunology 29(8)
    • K. Wickens
    • C. Barthow
    • E. Mitchell
    • Janice Kang
    • N. van Zyl
    • G. Purdie
    • T. Stanley
    • P. Fitzharris
    • R. Murphy
    • J. Crane

Abstract

Background: In a two-centre randomized placebo-controlled trial of Lactobacillus rhamnosus HN001 (HN001) (6 × 109 colony-forming units [cfu]) or Bifidobacterium lactis HN019 (HN019) (9 × 109 cfu) taken daily from 35-week gestation to 6 months' post-partum in mothers while breastfeeding and from birth to age 2 years in infants, we showed that HN001 significantly protected against eczema development at 2, 4 and 6 years and atopic sensitization at 6 years. There was no effect of HN019. We report here the findings for 11 year outcomes.

Methods: At age 11 years, eczema was defined as previously using the UK Working Party's Diagnostic Criteria. Asthma, wheeze, hay fever and rhinitis were defined based on the International Study of Asthma and Allergies in Childhood (ISAAC) questions. Atopic sensitization was defined as one or more positive responses (mean wheal diameter ≥3 mm) to a panel of food and aeroallergens. Analysis was intention-to-treat using hazard ratios to assess probiotic effects on the 11-year lifetime prevalence and relative risks for point or 12-month prevalence at 11 years.

Results: Early childhood HN001 supplementation was associated with significant reductions in the 12-month prevalence of eczema at age 11 years (relative risk [RR] = 0.46, 95% CI 0.25-0.86, P = 0.015) and hay fever (RR = 0.73, 95% CI 0.53-1.00, P = 0.047). For the lifetime prevalence, HN001 was associated with a significant reduction in atopic sensitization (hazard ratio [HR] = 0.71, 95% CI 0.51-1.00, P = 0.048), eczema (HR = 0.58, 95% CI 0.41-0.82, P = 0.002) and wheeze (HR = 0.76, 95% CI 0.57-0.99, P = 0.046). HN019 had no significant effect on these outcomes.

Conclusion: This is the first early probiotic intervention to show positive outcomes for at least the first decade of life across the spectrum of allergic disease.

Keywords: Bifidobacterium lactis HN019; Lactobacillus rhamnosus HN001; asthma; eczema; hay fever; probiotics; randomized controlled trial; rhinitis; wheeze.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lacticaseibacillus rhamnosus R0011Reduced Eczema PrevalenceBeneficial
Moderate
Lacticaseibacillus rhamnosus R0011Reduced Hay Fever PrevalenceBeneficial
Small
Lacticaseibacillus rhamnosus R0011Reduced Lifetime Prevalence of WheezeBeneficial
Small
Lacticaseibacillus rhamnosus R0011Reduced Prevalence of Atopic SensitizationBeneficial
Small
Lactobacillus rhamnosus MAK79L08RReduced Eczema PrevalenceBeneficial
Moderate
Lactobacillus rhamnosus MAK79L08RReduced Hay Fever PrevalenceBeneficial
Small
Lactobacillus rhamnosus MAK79L08RReduced Lifetime Prevalence of WheezeBeneficial
Small
Lactobacillus rhamnosus MAK79L08RReduced Prevalence of Atopic SensitizationBeneficial
Small
Lactobacillus rhamnosus NH001Reduced 12-Month Prevalence of Eczema at Age 11 YearsBeneficial
Moderate
Lactobacillus rhamnosus NH001Reduced Eczema PrevalenceBeneficial
Moderate
Lactobacillus rhamnosus NH001Reduced Hay Fever PrevalenceBeneficial
Small
Lactobacillus rhamnosus NH001Reduced Lifetime Prevalence of Atopic SensitizationBeneficial
Small
Lactobacillus rhamnosus NH001Reduced Lifetime Prevalence of WheezeBeneficial
Small
Lactobacillus rhamnosus R0011Reduced Eczema PrevalenceBeneficial
Moderate
Lactobacillus rhamnosus R0011Reduced Hay Fever PrevalenceBeneficial
Small
Lactobacillus rhamnosus R0011Reduced Lifetime Prevalence of WheezeBeneficial
Small
Lactobacillus rhamnosus R0011Reduced Prevalence of Atopic SensitizationBeneficial
Small
Lactobacillus rhamnosus VPro 11Reduced Wheeze PrevalenceBeneficial
Small
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