The Editors' Choice

Abstract

Importance of allergen-specific serum IgE in studies of immunotherapyMaternal perinatal probiotics reduce eczema risk in the infantReports of well-conducted trials have suggested that specific probiotics might reduce the risk of eczema in infants and children. However, administering viable bacteria to newborn infants has raised safety concerns, and it is not clear which population is most likely to benefit from the intervention, nor do we know when or for how long probiotics should be administered. Rautava et al (p 1355) investigated whether maternal perinatal probiotic supplementation with either a combination of Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 or a combination of Lavtobacillus paracasei ST11 and Bifidobacterium longum BL999 is safe and effective in reducing the risk of eczema in high-risk infants objectively identified on the basis of having skin prick test response–positive allergic mothers. In a randomized controlled trial of 241 mother-infant pairs, maternal probiotic supplementation with either combination during the last 2 months of pregnancy and the first 2 months of breast-feeding significantly reduced the risk of eczema in the infants during the first 2 years of life in comparison with the risk seen in infants whose mothers received placebo. No adverse effects were related to the use of probiotics. These findings suggest that solely maternal perinatal probiotic supplementation is safe and effective in reducing eczema risk in infants at high hereditary risk.Acetaminophen exposure associates with early asthmatic symptoms independently of lower airway infectionsAcetaminophen/paracetamol exposure in early childhood has been suggested to be related to the development of asthma in large epidemiologic studies. However, asthma in children is also related to recurrent lower airway infections, which are a frequent indication for acetaminophen use in young children. This makes lower airway symptoms a potential confounder when one is analyzing the relationship between acetaminophen exposure and asthma. In this issue Kreiner-Møller et al (p 1434) investigated these relationships in the Copenhagen Study on Asthma in Childhood (COPSAC) birth cohort of children followed with deep clinical phenotyping from birth. As anticipated, the results showed that lower airway infections in the first 3 years of life were associated with asthmatic symptoms in the same time period. Lower airway infections were also associated with acetaminophen use. The association between acetaminophen use and asthmatic symptoms was independent of concurrent lower airway tract infections, suggesting an independent role of acetaminophen use in asthmatic symptoms. The association did not persist to asthma at the age of 7 years. Moreover, the authors were not able to find any relationship between maternal acetaminophen use during pregnancy and later development of asthmatic symptoms in the child. Further independent studies need to investigate the possible negative influence of early childhood exposure to acetaminophen use on the risk of asthmatic symptoms.Allergy recall: Decidedly CD28 dependentAirway inflammation without (left) and with (right) interruption of CD28 costimulation before intranasal challenge.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Administration of CCL18 prevents allergic airway inflammation in humanized miceInhibition of airway hyperresponsiveness by administration of CCL18.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Anaphylaxis to milk formula containing the prebiotic galacto-oligosaccharideDose-dependent effect of scGOS on basophil activation.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Importance of allergen-specific serum IgE in studies of immunotherapy Maternal perinatal probiotics reduce eczema risk in the infantReports of well-conducted trials have suggested that specific probiotics might reduce the risk of eczema in infants and children. However, administering viable bacteria to newborn infants has raised safety concerns, and it is not clear which population is most likely to benefit from the intervention, nor do we know when or for how long probiotics should be administered. Rautava et al (p 1355) investigated whether maternal perinatal probiotic supplementation with either a combination of Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 or a combination of Lavtobacillus paracasei ST11 and Bifidobacterium longum BL999 is safe and effective in reducing the risk of eczema in high-risk infants objectively identified on the basis of having skin prick test response–positive allergic mothers. In a randomized controlled trial of 241 mother-infant pairs, maternal probiotic supplementation with either combination during the last 2 months of pregnancy and the first 2 months of breast-feeding significantly reduced the risk of eczema in the infants during the first 2 years of life in comparison with the risk seen in infants whose mothers received placebo. No adverse effects were related to the use of probiotics. These findings suggest that solely maternal perinatal probiotic supplementation is safe and effective in reducing eczema risk in infants at high hereditary risk. Reports of well-conducted trials have suggested that specific probiotics might reduce the risk of eczema in infants and children. However, administering viable bacteria to newborn infants has raised safety concerns, and it is not clear which population is most likely to benefit from the intervention, nor do we know when or for how long probiotics should be administered. Rautava et al (p 1355) investigated whether maternal perinatal probiotic supplementation with either a combination of Lactobacillus rhamnosus LPR and Bifidobacterium longum BL999 or a combination of Lavtobacillus paracasei ST11 and Bifidobacterium longum BL999 is safe and effective in reducing the risk of eczema in high-risk infants objectively identified on the basis of having skin prick test response–positive allergic mothers. In a randomized controlled trial of 241 mother-infant pairs, maternal probiotic supplementation with either combination during the last 2 months of pregnancy and the first 2 months of breast-feeding significantly reduced the risk of eczema in the infants during the first 2 years of life in comparison with the risk seen in infants whose mothers received placebo. No adverse effects were related to the use of probiotics. These findings suggest that solely maternal perinatal probiotic supplementation is safe and effective in reducing eczema risk in infants at high hereditary risk. Acetaminophen exposure associates with early asthmatic symptoms independently of lower airway infectionsAcetaminophen/paracetamol exposure in early childhood has been suggested to be related to the development of asthma in large epidemiologic studies. However, asthma in children is also related to recurrent lower airway infections, which are a frequent indication for acetaminophen use in young children. This makes lower airway symptoms a potential confounder when one is analyzing the relationship between acetaminophen exposure and asthma. In this issue Kreiner-Møller et al (p 1434) investigated these relationships in the Copenhagen Study on Asthma in Childhood (COPSAC) birth cohort of children followed with deep clinical phenotyping from birth. As anticipated, the results showed that lower airway infections in the first 3 years of life were associated with asthmatic symptoms in the same time period. Lower airway infections were also associated with acetaminophen use. The association between acetaminophen use and asthmatic symptoms was independent of concurrent lower airway tract infections, suggesting an independent role of acetaminophen use in asthmatic symptoms. The association did not persist to asthma at the age of 7 years. Moreover, the authors were not able to find any relationship between maternal acetaminophen use during pregnancy and later development of asthmatic symptoms in the child. Further independent studies need to investigate the possible negative influence of early childhood exposure to acetaminophen use on the risk of asthmatic symptoms. Acetaminophen/paracetamol exposure in early childhood has been suggested to be related to the development of asthma in large epidemiologic studies. However, asthma in children is also related to recurrent lower airway infections, which are a frequent indication for acetaminophen use in young children. This makes lower airway symptoms a potential confounder when one is analyzing the relationship between acetaminophen exposure and asthma. In this issue Kreiner-Møller et al (p 1434) investigated these relationships in the Copenhagen Study on Asthma in Childhood (COPSAC) birth cohort of children followed with deep clinical phenotyping from birth. As anticipated, the results showed that lower airway infections in the first 3 years of life were associated with asthmatic symptoms in the same time period. Lower airway infections were also associated with acetaminophen use. The association between acetaminophen use and asthmatic symptoms was independent of concurrent lower airway tract infections, suggesting an independent role of acetaminophen use in asthmatic symptoms. The association did not persist to asthma at the age of 7 years. Moreover, the authors were not able to find any relationship between maternal acetaminophen use during pregnancy and later development of asthmatic symptoms in the child. Further independent studies need to investigate the possible negative influence of early childhood exposure to acetaminophen use on the risk of asthmatic symptoms. Allergy recall: Decidedly CD28 dependent Administration of CCL18 prevents allergic airway inflammation in humanized mice Anaphylaxis to milk formula containing the prebiotic galacto-oligosaccharide