Intan Hakimah Ismail

Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial.

To cite this article: 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. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy 2011; 66: 509–516.

Reduced gut microbial diversity in early life is associated with later development of eczema but not atopy in high‐risk infants

Background:  Alterations in intestinal microflora have been linked to the development of allergic disease. Recent studies suggest that healthy infant immune development may depend on the establishment of a diverse gut microbiota rather than the presence or absence of specific microbial strains.

Prenatal administration of Lactobacillus rhamnosus has no effect on the diversity of the early infant gut microbiota

To cite this article: Ismail IH, Oppedisano F, Joseph SJ, Boyle RJ, Robins‐Browne RM, Tang MLK. Prenatal administration of Lactobacillus rhamnosus has no effect on the diversity of the early infant gut microbiota. Pediatric Allergy Immunology 2012: 23: 255–258.

Probiotic effects in allergic disease

The increasing prevalence of allergic disease has been linked to reduced microbial exposure in early life. Probiotics have recently been advocated for the prevention and treatment of allergic disease. This article summarises recent publications on probiotics in allergic disease, focusing on clinical studies of prevention or treatment of allergic disease. Studies employing the combined administration of pre‐natal and post‐natal probiotics suggest a role for certain probiotics (alone or with prebiotics) in the prevention of eczema in early childhood, with the pre‐natal component of treatment appearing to be important for beneficial effects. On the other hand, current data are insufficient to support the use of probiotics for the treatment of established allergic disease, although recent studies have highlighted new hope in this area. Probiotic bacteria continue to represent the most promising intervention for primary prevention of allergic disease, and well‐designed definitive intervention studies should now be a research priority.

Relationship between breast milk sCD14, TGF‐β1 and total IgA in the first month and development of eczema during infancy

The overall beneficial effects of breastfeeding for infants have been well documented, but its role in allergy prevention is controversial.

Prebiotic‐supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high‐risk infants: a randomized controlled trial

Prevention guidelines for infants at high risk of allergic disease recommend hydrolysed formula if formula is introduced before 6 months, but evidence is mixed. Adding specific oligosaccharides may improve outcomes.

Reduced neonatal regulatory T cell response to microbial stimuli associates with subsequent eczema in high-risk infants.

Regulatory T cells (Treg) play an essential role in early immune programming and shaping the immune response towards a pro‐allergic or tolerant state. We evaluated cord blood Treg and cytokine responses to microbial and non‐microbial stimuli in infants at high risk of allergic disease and their associations with development of allergic disease in the first year.

Maternal Supplementation with LGG Reduces Vaccine-Specific Immune Responses in Infants at High-Risk of Developing Allergic Disease.

Probiotics are defined as live micro-organisms that when administered in adequate amounts confer a health benefit on the host. Among their pleiotropic effects, inhibition of pathogen colonization at the mucosal surface as well as modulation of immune responses are widely recognized as the principal biological activities of probiotic bacteria. In recent times, the immune effects of probiotics have led to their application as vaccine adjuvants, offering a novel strategy for enhancing the efficacy of current vaccines. Such an approach is particularly relevant in regions where infectious disease burden is greatest and where access to complete vaccination programs is limited. In this study, we report the effects of the probiotic, Lactobacillus rhamnosus GG (LGG) on immune responses to tetanus, Haemophilus influenzae type b (Hib) and pneumococcal conjugate (PCV7) vaccines in infants. This study was conducted as part of a larger clinical trial assessing the impact of maternal LGG supplementation in preventing the development of atopic eczema in infants at high-risk for developing allergic disease. Maternal LGG supplementation was associated with reduced antibody responses against tetanus, Hib, and pneumococcal serotypes contained in PCV7 (N = 31) compared to placebo treatment (N = 30) but not total IgG levels. Maternal LGG supplementation was also associated with a trend to increased number of tetanus toxoid-specific T regulatory in the peripheral blood compared to placebo-treated infants. These findings suggest that maternal LGG supplementation may not be beneficial in terms of improving vaccine-specific immunity in infants. Further clinical studies are needed to confirm these findings. As probiotic immune effects can be species/strain specific, our findings do not exclude the potential use of other probiotic bacteria to modulate infant immune responses to vaccines.

Early gut colonisation by Bifidobacterium breve and B. catenulatum differentially modulates eczema risk in children at high‐risk of developing allergic disease

An altered compositional signature and reduced diversity of early gut microbiota are linked to development of allergic disease. We investigated the relationship between dominant Bifidobacterium species during the early post‐natal period and subsequent development of allergic disease in the first year of life.

Pneumococcal glomerulonephritis in a healthy child: a case report and literature review.

Pneumococcal glomerulonephritis is rarely described in the literature. We report a four-year-old boy who developed acute glomerulonephritis following pneumococcal bacteraemia and submandibular lymphadenitis, and review the published literature. Two weeks after developing acute glomerulonephritis, the patient developed bronchopneumonia with left pleural effusion. However, by the fourth week of admission, his renal function had normalised and lung involvement resolved.