Abstract
BackgroundThe Probiotics in Prevention of Allergy among Children in Trondheim (ProPACT) study, a randomised, placebo controlled trial, demonstrated that maternal supplementation with probiotic milk reduced the incidence of atopic dermatitis (AD) in infancy. The mechanisms behind this effect are incompletely understood and breast milk cytokines have been postulated as possible mediating factors. In this study we aimed to assess whether breast milk TLSP and TGF-β are affected by a maternal probiotic supplementation regime, and their contribution to the preventive effect of this regime on AD in the offspring.MethodsTSLP and TGF-β isoforms (TGF-β1, TGF-β2 and TGF-β3) were measured using ELISA and multiplex assays, respectively, in breast milk samples collected at 10 days and 3 months postpartum from women participating in the ProPACT trial (n = 259). The natural indirect and direct effects of maternal probiotics on AD, due to changes in breast milk cytokines, were estimated using causal mediation techniques.ResultsProbiotic supplementation tend to lead to high levels of breast milk TSLP at 10 days postpartum (p = 0.062), but this change did not contribute to the prevention of AD according to the mediation analysis. Probiotics had no apparent effect on TSLP at 3 months or TGF-βs at either time points. Thus, these are unlikely to be mediators of the effect of maternal probiotics on AD in offspring.ConclusionsWhilst maternal probiotic supplementation resulted in higher breast milk concentrations of TLSP at 10 days postpartum, this does not appear to be a mechanism for prevention of AD by maternal probiotics.Trial registration The original trial protocol is registered in ClinicalTrials.gov (identifier NCT00159523)
Highlights
The Probiotics in Prevention of Allergy among Children in Trondheim (ProPACT) study, a randomised, placebo controlled trial, demonstrated that maternal supplementation with probiotic milk reduced the incidence of atopic dermatitis (AD) in infancy
Using samples taken during the ProPACT trial, we have previously reported that the maternal intestinal microbiota is modified by probiotic supplementation, and that children born to mothers who received the probiotics have a higher abundance of Lactobacillus rhamnosus GG (LGG) which persists up until 3 months of age [4]
The aims of the current study were to: (a) determine if perinatal maternal probiotic supplementation alters the concentration of TLSP, TGF-β1, TGF-β2 or TGF-β3 in breast milk at 10 days and 3 months postpartum and (b) investigate if these breast milk cytokines contribute to the preventative effect of maternal probiotic supplementation on the development of AD at 2 years of age through causal mediation analysis
Summary
The Probiotics in Prevention of Allergy among Children in Trondheim (ProPACT) study, a randomised, placebo controlled trial, demonstrated that maternal supplementation with probiotic milk reduced the incidence of atopic dermatitis (AD) in infancy. The mechanisms behind this effect are incompletely understood and breast milk cytokines have been postulated as possible mediating factors. Studies investigating the effect of probiotic supplementation on breast milk TGF-β concentrations and or their association with later allergy related disease in offspring, have produced conflicting results [13,14,15,16,17,18]
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