ProVen:
Probiotics for Childhood Allergies, Coughs & Colds
Webinar 12
ProVen
Antibiotics In Early Life And Risk Of Childhood AllergyEczemaPostnatal ( 2 week post birth) antibiotic exposure was associated with a 40% increased risk of eczema, with further 7% increasedrisk for each additional antibiotic course received during the first year of life (OR= 1.41, 95%CI: 1.30, 1.53)
Asthma Meta-analysis of 20 studies found that exposure to antibiotic in the first year of life increases the risk of developing childhood asthma by 50% (OR= 1.52, 95%CI: 1.30, 1.77) 22% children born to mothers who took antibiotics during pregnancy were diagnosed with asthma by age 3 compared to 11% children born to mothers who didn’t take antibiotics (P<0.01).
Rhinitis Antibiotics in the first week of life increased the risk of allergic rhinitis at 8 years old school children by 75% (aOR= 1.75, 95%CI: 1.03, 2.97)
(Tsakok T et al, Br J Dermatol 2013; Alm B et al, Pediatr Allergy Immunol 2014) (Murk W et al, Pediatrics 2011) (Lapin B et al, Ann Allergy Asth Immunol 2015)
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( Vangay P et al, Cell Host & Microbe 2015, Pelucchi C et al, Epidemiology 2012)
Probiotics in the Prevention of Childhood Allergy
• Type 1 hypersensitivity effects approximately 20% of children
• Almost all allergy established in first 2 years of life
• First expression is atopic eczema, followed by asthma, and rhinitis – the ‘allergic march’
• Meta analyses of 11 infant studies shows average of 20% reduction of IgE related eczema
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Swansea Baby Study - Allergy Prevention Trial
AIM
Investigate the effect of probiotics on prevention of allergic sensitization and allergic eczema in infants
STUDY DESIGN:
DBPC study with 454 mother-infant pairs
ProVen Pregnancy provided to mothers in 3rd trimester and
ProVen Baby provided to babies daily from birth for 6 months
Follow up: 6 months and 2 years Allen SJ et al Arch Dis Child 2014, 99: 1014-1019
Allen SJ et al J Nutr 2010, 140: 483-88
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Atopic eczema in infant
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PROBAT STUDY: PROBIOTICS IN PREVENTION OF ALLERGY
Allen SJ et al. Archives of Disease in Childhood 2014 Jun 19; doi:10.1136/archdischild-2013-305799
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Swansea Study Demonstrated Safety Of ProVen Probiotics in Mothers and in Newborns
ProVen Pregnancy and ProVen Baby administration was not associated with adverse events in either mothers or their infants.
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Swansea Baby Trial – Clinical OutcomesSignificant Reduction in Atopic Sensitisation in Children of 6 and 24 Months
Atopic sensitisation measured by skin prick test reaction to one or more of following allergens:cows milk, egg, grass pollen, tree pollen, house dust mite, nuts, fish.
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Result: The Effect of Lab4b Probiotics on Incidence of Atopic Eczema at 6 and 24
Months From Birth Atopic eczema defined as SCORAD measurement of skin rash co presented with SPT positivity for at least one allergen.
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Result: 57% reduction of risk of atopic eczema in ProVen Baby group!!
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Coughs and Colds – we all get ‘em! Coughs and colds – or upper respiratory tract infections ( UTRI) – are the most common infections we experience –adults 2-3 episodes per year: children 3-8 episodes per year.
No really effective treatment:No consistent evidence of prevention – until now!!Recent meta- analysis 20 trials concluded that ‘…probiotics reduce duration of infection by average of 30%’ King et al 2014
Symptoms:• sore throat• runny or blocked nose• cough• sneezing
Most common cause of:• days off work• absenteeism from school• visits to doctor• antibiotic use ( despite no
effect)
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Are Probiotics More Effective Than Vitamin C and Zinc in Prevention of Coughs and Colds
Recent Cochrane meta-analysis concluded that vitamin C at doses above 200mg/day:- reduced duration of coughs and colds in adults by average of 8% - reduced duration of coughs and colds in children by 14% ( 18% when 1-2g/day taken)
Hermila 2013 Cochrane ReportRecent meta-analysis for zinc concluded:
- no effect in prevention of coughs and colds- some effect in reduction of duration when taken within 24 hours of symptom onset.
Singh 2013 Cochrane Report
King 2014 in meta-analysis of 20 trials in adults and children concluded that probiotics reduce the duration of cough and cold symptoms by 30%!
ProVen
AIM:
To assess the impact of the combination of LAB4 probiotics with vitamin C on upper respiratory tract infections in children attending preschool facilities.
STUDY DESIGN:
Randomised double blind placebo controlled study : 57 children aged between 4-6 years provided with ProVen Fit for School daily for 6 months during the autumn and winter.
PROCHILD Study
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PROCHILD STUDY: Probiotics in the prevention of coughs and colds
Garaiova I et al. European Journal of Clinical Nutrition 2014 Sept 10; doi:10.1038/ejcn.2014.174
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PROCHILD Study – Main Results
• Total number of days with URTI symptoms (sneezing, sore throat, cough, runny/blocked nose
51% reduction in active group (p= 0.0059)
• Frequency of occurrence of URTI symptoms
33% reduction in active group (p= 0.0019)
• Absence from preschool
30% reduction in active group (p= 0.0069)
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Sneezing Runny nose Blocked nose Sore throat Cough Total URTIsymptoms
Total Number of Days with URTI Symptoms
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P = 0.07
Reduces Duration of UTRI Symptoms by 50%
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Reduces Incidence of URTI Symptoms by 33%
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Due to URTI Any Illness
Total Number of Days Absent from Preschool Facilities
Placebo Lab4+Vitamin C
P = 0.007 P=0.0069
Reduces Absenteeism from School by 30%
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Cough medicine Antihistamins Nasal spray/drops Painkillers Total
Total Number of Days of Medication Usage
Placebo Lab4+Vitamin C
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Total Medication Reduced by 50%
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Due to URTI Any Illness
Total Number of Physician Visits
Placebo Lab4+Vitamin C
P = 0.08
Visits to Physician Reduced by 50%
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Number of children (%)
24.114.3
NUMBER OF CHILDREN WITH A LEAST ONE DAY OF ORAL
ANTIBIOTIC USEPlacebo Lab4+Vitamin C
Reduce Antibiotic Use by 40%
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The Gut-Brain Axis