Non‐digestible oligosaccharides reduce immunoglobulin free light‐chain concentrations in infants at risk for allergy

Abstract

Prebiotic oligosaccharides influence the intestinal microbiota and can positively modulate the infant's immune system. It was demonstrated that a special prebiotic mixture (Immunofortis(®)) of short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lcFOS) can reduce the cumulative incidence of atopic dermatitis (AD) in infants at risk for allergy as determined using the AD symptom score (SCORAD). Additionally, it was shown very recently that immunoglobulin free light-chain (Ig-fLC) might be involved in the pathophysiology of allergic disease. Increased Ig-fLC concentrations were found in patients suffering from AD, cow's milk allergy, allergic rhinitis, or asthma. In this study, the effect of supplementation of scGOS/lcFOS on the Ig-fLC plasma concentrations in infants at risk for allergy was assessed. The plasma kappa and lambda Ig-fLC concentrations were measured in a double-blind, placebo-controlled, randomized trial, in which infants at risk for developing allergic disease received a hypoallergenic whey formula containing 8 g/l of the scGOS/lcFOS mixture (n = 34) or maltodextrin as a placebo (n=40) for 6 months. After intervention, plasma samples were collected, and total plasma concentrations of lambda and kappa Ig-fLC were analyzed using ELISA. Total kappa and lambda Ig-fLC plasma concentrations were higher in infants suffering from AD when compared to infants without any sign of AD. In infants receiving the prebiotic mixture, the Ig-fLC levels were significantly lower compared to the placebo-fed infants (p<0.001). Interestingly, lambda Ig-fLC concentrations were positively correlated with total IgE (p<0.05). These data demonstrate for the first time that the specific scGOS/lcFOS mixture lowered kappa and lambda Ig-fLC plasma concentrations in infants at high risk for allergies when compared to infants receiving placebo formula. Because Ig-fLC concentrations were increased in infants suffering from AD, this may have contributed, at least in part, to the reduced incidence in AD as described previously. This suggests a possible role for Ig-fLC in the pathophysiology of AD in infants at risk for allergy development.

Prebiotics in infant formula

“…56 Prebiotics were shown to reduce immunoglobulin free lightchain concentrations in infants at risk for allergy. 57 Although a reduction of eczema was reported in infants, this effect was not consistent between studies and caution was advised in view of methodological concerns regarding included studies. 58 Shortterm enteral supplementation of non-human neutral and acidic OS during the neonatal period in preterm infants dids not decrease the incidence of allergic and infectious diseases during the first year of life.…”

“…65 There were no significant differences between the synbiotic and the placebo group. 57 The same group showed that synbiotics prevented asthma-like symptoms in infants with atopic dermatitis. 66 At the same time, another group reported that a synbiotic combination of Lacto salivarius plus FOS is superior to the prebiotic alone for treating moderate to severe childhood atopic dermatitis.…”

Role of Cellular Immunity in Cow’s Milk Allergy: Pathogenesis, Tolerance Induction, and Beyond

“…Mechanistically, IgG4 serves as a blocking antibody via competition with allergens for binding to IgE on the Fc ε receptors [62] and as an anti-inflammatory factor due to its dynamic Fab arm exchange resulting as a bispecific antibody with a substantially decreased capacity for cross-linking [63]. In addition, infants who received nondigestible carbohydrates (prebiotics) during the first six months of age had lower incidence of atopic dermatitis, which was linearly associated with lower levels of Ig-fLCs [64]. Taken together, the decreasing levels of allergen-specific specific IgE and/or Ig-fLCs as well as the increasing levels of allergen-specific IgG4 partly contribute to the development of tolerance.…”

Prebiotics and Probiotics in Allergy: Potential Mechanisms of Prebiotics’ and Probiotics’ Actions in Allergy - (Part 1)

“…They also can stimulate IFN-γ and IL-10 production [18]. The particular scGOS/lcFOS preparation decreased kappa and lambda immunoglobulin levels in plasma of infants at high risk for allergy development in contrast to infants receiving placebo formula [19].…”