Reduced Th22 cell proportion and prevention of atopic dermatitis in infants following maternal probiotic supplementation

Abstract

Summary Background In the randomized, controlled study Probiotics in the Prevention of Allergy among Children in Trondheim (ProPACT), maternal probiotic supplementation reduced the incidence of atopic dermatitis (AD) in the offspring. In the current study, we hypothesized that the effect was mediated by a shift in the T helper (Th) cells in the children. Objective To examine whether Th cell proportions were affected by maternal probiotic supplementation and thus could mediate the preventive effect of probiotics on AD. Methods A total of 415 pregnant women were randomized to ingest a combination of Lactobacillus rhamnosus GG (LGG), Bifidobacterium animalis subsp. lactis Bb‐12 (Bb‐12) and Lactobacillus acidophilus La‐5 (La‐5) or placebo, and their offspring were assessed for AD during the first 2 years of life. Peripheral blood collected at 3 months of age was analysed for regulatory T cells (n=140) and Th subsets (n=77) including Th1, Th2, Th9, Th17 and Th22. Results The proportion of Th22 cells was reduced in children in the probiotic group compared to the placebo group (median 0.038% vs 0.064%, P=.009). The difference between the probiotic and placebo groups was also observed in the children who did not develop AD during the 2‐year follow‐up. The proportion of Th22 cells was increased in children who developed AD compared to the children who did not develop AD (0.090% vs 0.044%, P<.001). Mediation analysis indicated that the preventive effect of probiotics was partially mediated through the reduction in Th22 cells. Conclusion Perinatal maternal probiotic supplementation with a combination of LGG, Bb‐12 and La‐5 reduced the proportion of Th22 cells in 3‐month‐old children. This may partially explain the preventive effect of probiotics on AD.

The Key Role of TNF-TNFR2 Interactions in the Modulation of Allergic Inflammation: A Review

“…On the other hand, Th22 cells are increased in children with asthma and atopic dermatitis. These cells act by increasing the recruitment of leukocytes and disrupting the epithelial integrity on the skin and in the lungs ( 18 , 19 ).…”

Rationale of Probiotic Supplementation during Pregnancy and Neonatal Period

“…A recent randomized, controlled study (Probiotics in the Prevention of Allergy among Children in Trondheim, ProPACT) in part explains how perinatal maternal probiotics supplementation can play a protective role in the development of atopic dermatitis. In this study T-regs, Th-1, Th-2, and Th-17 lymphocyte or the Th-1/Th-2 ratio seem not to be influenced by a mixture of LGG, La-5, and Bb-12, but this reduces the proportion of Th-22 number [ 72 ].…”

Maternal Consumption of Lactobacillus GG During Pregnancy Prevents Infant Eczema at 1 Year of Age

“…However, according to the review by West et al, only a few reports have examined the benefits of probiotic administration administered only in the prenatal or postnatal period [20]. Specifically, Rø et al [28] speculated that the effect of perinatal probiotic administration was mediated via a reduction in the proportion of Th22 cells, which is likely to be the same mechanism mediating the beneficial effects that we identified in our study. This pathway could explain the effectiveness of probiotics in lowering an infant's risk of developing an allergy.…”