Norsk forening for dermatologi og venerologi

St. Olavs hospital

Atopisk eksem

7. mai 2016

Prevention of Allergy Among Children in Trondheim (PACT) study and Probiotics in the Prevention of Allergy Among Children in Trondheim (ProPACT) study (klinisk forskning, epidemiologisk, RCT, basalforskning) Tilhørighet (f.eks heseforetak, sykehus) Torbjørn Øien, ISM, DMF, NTNU.

The primary objective of the PACT study was to study the efficacy of an intervention in primary health care on three assumed risk factors for atopic disease as AD, asthma, and allergic rhinoconjunctivitis (ARC) in an unselected population of pregnant women and small children. Further to study the effectiveness on the incidence of atopic disease from intervening on these risk factors. It is also possible to study risk factors and the natural history of atopic diseases. Until two years of age, nearly 14000 children were recruited in the control group, and 2860 children were included in the intervention group. A paper on the impact of the intervention on parental smoking is published, and in another paper we found a considerable impact on dietary behaviour, while changes in indoor dampness exposure were neglectable. A paper on the effectiveness on incidence of disease showed a reduction in both asthma and the use of asthma medicines. In the ProPACT study, the objective was to investigate the relationship between supplement of probiotics to pregnant and breast-feeding women, and the incidence of atopic sensitisation and atopic disease at two years of age. Stool samples, cord blood and venous blood were collected from the children at the ages of 10 days, 3 months and 1 and 2 years. In addition, maternal breast milk and bacterial samples from the vaginal mucosa of the mother and from the oral mucosa of the child were collected. Four hundred and fifteen pregnant women were computer randomized. At 2 years, 138 and 140 children in the probiotic and the placebo groups, respectively, were assessed. In conclusion, the cumulative incidence of AD at 2 years of age was almost halved, and probiotics may be sufficient for long term reduction in the cumulative incidence of AD until 6 years of age. We investigated the intestinal microbiota of mothers and children, and found that different probiotic bacteria seem to have different ability to transfer from the mother to the child. We found no evidence that the probiotics altered the microbial composition or alpha and beta diversity of the children.