Premium
Intestinal defensin secretion in infancy is associated with the emergence of sensitization and atopic dermatitis
Author(s) -
Savilahti E. M.,
Kukkonen A. K.,
Haahtela T.,
Tuure T.,
Kuitunen M.,
Savilahti E.
Publication year - 2012
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2011.03904.x
Subject(s) - placebo , atopic dermatitis , medicine , atopy , synbiotics , feces , sensitization , allergy , immunology , gastroenterology , confidence interval , probiotic , biology , microbiology and biotechnology , alternative medicine , pathology , bacteria , genetics
Background Intestinal flora and innate immunity, and their interactions impact adaptive immunity. Objective To study the association of fecal defensin levels in infancy with synbiotic treatment and with the emergence of atopy. Methods The randomly selected group of 102 infants belonged to a randomized, double‐blind placebo‐controlled trial where 1223 infants in high risk for allergy received, from birth to 6 months, a mixture of synbiotics, or placebo. Clinical trials registration number for the clinical trial is NCT00298337. In the subgroup, 45 received active treatment and 56 received placebo treatment. Follow‐up for the emergence of sensitization and allergic diseases lasted 5 years. At the age of 3 ( n = 96) and 6 ( n = 87) months, we measured fecal levels of human neutrophil peptide ( HNP ) 1–3 and of β‐defensin 2 ( HBD 2) using enzyme linked immunosorbent assays and concentrations of lactic acid bacteria on MRS agar. We used multifactorial regression in data analysis. Results Fecal levels of HNP 1–3 and HBD 2 decreased from the age of 3–6 months ( P < 0.0001). HBD 2 levels decreased less in the synbiotics group compared with placebo ( P < 0.02). High fecal HBD 2 levels at 6 months were associated with an increased risk for sensitization by the age of 5 years ( OR 2.5, 95% confidence interval 1.1–5.8, P < 0.03). High fecal HNP 1–3 levels at 6 months were associated with a decreased risk for atopic dermatitis ( OR 0.4, 95% CI 0.1–1.0, P < 0.05). Samples with very low or high HBD 2 levels at 6 months had low concentrations of lactic acid bacteria ( P < 0.02). Conclusions and clinical relevance Early innate immunity responses in the gut are associated with the emergence of sensitization and atopic dermatitis later in childhood.