No statistically significant subgroup differences were found according to infant risk of allergy or type of infant feed .
There is some evidence that a prebiotic supplement added to infant feeds may prevent eczema .
It is unclear whether the use of prebiotic should be restricted to infants at high risk of allergy or may have an effect in low risk population s ; or whether it may have an effect on other allergic diseases including asthma
BACKGROUND Prebiotics ( commonly oligosaccharides ) added to infant feeds have the potential to prevent sensitisation of infants to dietary allergens .
OBJECTIVES To determine the effect of prebiotic given to infants for the prevention of allergy .
High intestinal IgA associates with reduced risk of IgE-associated allergic diseases.
Development of oral tolerance and its stimulation by probiotics are still incomprehensible . Microbial stimulation of the gut may induce a subtle inflammation and induce secretion of mucosal IgA , which participates in antigen elimination . In a cohort of allergy-prone infants receiving probiotics and prebiotics or placebo  we studied intestinal IgA and inflammation in the development of eczema , food allergy , asthma , and rhinitis ( allergic diseases ) . We performed a nested unmatched case-control study of 237 infants participating in a r and omized double-blind placebo-controlled allergy-prevention trial using a combination of four probiotic strains pre-natally and during 6 months form birth . We measured faecal IgA , alpha1-antitrypsin ( alpha1-AT ) , tumour necrosis factor-alpha ( TNF-alpha ) , and calprotectin  at the age of 3 and 6 months . By age 2 yr , 124 infants had developed allergic disease or IgE-sensitization  ( cases ) and 113 had not ( controls ) . In infants with high faecal IgA concentration at the age of 6 months , the risk of having any allergic disease before the age of 2 yr tended to reduce [ odds ratio ( OR : 0.52 ) ] and the risk for any IgE-associated ( atopic ) disease reduced significantly ( OR : 0.49 ) . High faecal calprotectin at the age of 6 months associated also with lower risk for IgE-associated diseases up to age 2 yr ( OR : 0.49 ) . All faecal inflammation markers ( alpha1-AT , TNF-alpha , and calprotectin ) correlated positively with faecal IgA ( p < 0.001 ) . Probiotics tended to augment faecal IgA ( p = 0.085 ) and significantly increased faecal alpha1-AT ( p = 0.001 ) . High intestinal IgA in early life associates with minimal intestinal inflammation and indicates reduced risk for IgE-associated allergic diseases
No statistically significant subgroup differences were found according to infant risk of allergy or type of infant feed .
There is some evidence that a prebiotic supplement added to infant feeds may prevent eczema .
It is unclear whether the use of prebiotic should be restricted to infants at high risk of allergy or may have an effect in low risk population s ; or whether it may have an effect on other allergic diseases including asthma
BACKGROUND Prebiotics ( commonly oligosaccharides ) added to infant feeds have the potential to prevent sensitisation of infants to dietary allergens .
OBJECTIVES To determine the effect of prebiotic given to infants for the prevention of allergy .