菌群干预与儿科过敏性疾病——微生态制剂
剖腹产亚组围产期的益生菌干预可预防过敏性疾病：13年的随访
Perinatal probiotic intervention prevented allergic disease in a Caesarean-delivered subgroup at 13-year follow-up
Kallio et al. Clin Exp Allergy（2018）
DOI 10.1111/cea.13321.
过敏性疾病的发病率逐年增加，尤其是儿童患病率的增加与微生物接触减少有关，如生活在农场里的孩子，较少发生过敏性疾病，这可能与较多的微生物接触有关。
许多研究报道生命早期肠道微生物的组成与过敏性疾病相关，非过敏性疾病的儿童肠道菌群多样性更高。而孕妇在产前、产后以及新生儿补充益生菌可以预防湿疹，降低过敏性疾病如湿疹、过敏性鼻炎等的发病率。
Abstract
BACKGROUND: The long-term effects of probiotic intervention for primary prevention of allergic diseases are not well known. We previously reported less eczema until 10 years in our probiotic intervention trial.
OBJECTIVE: To investigate the effect of early probiotic intervention on the prevalence of allergic diseases up to 13 years of age.
METHODS: Pregnant women (n = 1223) carrying a child at a high risk of allergy (at least one parent with allergic disease) were randomized to receive a mixture of probiotics (Lactobacillus rhamnosusGG and LC705, Bifidobacterium breve Bb99 and Propionibacterium freudenreichii) or placebo in a double-blind manner from 36 weeks of gestation until birth. Their infants received the same product for the first six months (registration number NCT00298337). At 13-year follow-up, the participants were requested to return a questionnaire and to provide a blood sample.
RESULTS: A questionnaire was returned by 642 participants (63.1% of intention-to-treat infants), and 459 provided a blood sample. In the whole cohort, there were no statistically significant differences in doctor-diagnosed allergic disease (55.2% and 59.0%, probiotic and placebo group, respectively) or allergic disease (47.9% and 51.6%) based on the ISAAC questionnaire data. Inhalant-specific IgE sensitization (>0.7 kU/L) was 59.3% in the probiotic group and 49.8% in the placebo group (P = 0.040). In a post hoc analysis made in Caesarean-delivered subgroup, allergy was reported in 41.5% of the probiotic group and 67.9% of the placebo group (P = 0.006), and eczema in 18.9% and 37.5%, respectively (P = 0.031). In the whole cohort, 8.5% of the probiotic group had suffered from wheezing attacks during the previous 12 months vs 14.7% in the placebo group (P = 0.013). There were no statistically significant differences discovered between the characteristics of the participating group and the dropout group.
CONCLUSIONS: Probiotic intervention protected Caesarean-delivered subgroup from allergic disease and eczema, but not the total cohort.
关键词：肠道微生物；过敏性疾病；围产期益生菌干预
研究对象：怀有高过敏疾病风险婴儿的孕妇（n=1223名）
入组标准：父母双方中至少有一位患过哮喘、过敏性鼻炎或湿疹，并且经过医生确诊。
实验方法： 随机双盲对照实验，1223名怀有高过敏疾病风险婴儿的孕妇，随机分组，实验组在孕36周的时候接受益生菌粉干预；益生菌粉含四种益生菌：鼠李糖乳杆菌GG（5×10^9 CFU）、鼠李糖乳杆菌LC705（5×10^9 CFU）、短双歧杆菌Bb99 （2 × 10^8 CFU）和费氏丙酸杆菌（2 × 10^9 CFU），孕妇每天服用两次，直至分娩；婴幼儿出生后接受相同的益生菌+0.8g低聚半乳糖干预，每天一次，直至出生后6个月。对照组服用安慰剂，问卷随访13年，并收集血液样本。
检测方法：问卷及血液样本检测
研究结果：
益生菌与安慰剂组过敏疾病发生率无显著差异，吸入特异性IgE的致敏作用分别为59.3%和49.8%（p=0.040）；
剖腹产亚组中，益生菌和安慰剂组过敏疾病发生率分别为41.5%和67.9%，湿疹发生率为18.9%和37.5%，近一年哮喘发生率为8.5%和14.7%，均有显著差异；
益生菌可改善剖腹产婴儿的过敏性疾病。
结论：
益生菌的干预可以预防剖腹产婴幼儿患过敏性疾病和湿疹，但不是所有的婴幼儿。
知几未来研究院正在搭建一个“疾病-肠道菌群”知识库。
你可以在公众号对话框回复“IBD”或“肠易激综合征”，查看与疾病相关的菌群；
也可以回复“双歧杆菌”或“Hp”，查看与细菌相关的疾病。
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