Antigen exposure is one of the major exogenous factors modulating human immunocompetence acquisition. Decline in family size and improvements in public health and hygiene in developed countries, may deprive the immune system of appropriate antigen input by diminishing infectious stimuli. Probiotics are a large group of microorganisms defined by their beneficial effects on human health and with stimulating effects on different functions of the immune system.
Aim of the study
We conducted a double-blind, placebo-controlled trial to determine if probiotics maintain their immune-stimulating effects in a population of 162 children with a high index of natural exposure to microorganisms. Children were to ingest for at least 4 months one of two products, low-fat milk fermented by Streptococcus thermophilus (control product) or low-fat milk fermented by S. thermophilus and Lactobacillus casei, with Lactobacillus acidophilus, oligofructose and inulin added after the fermentation process (test product). According to their age, children were vaccinated with DTP-Hib vaccine or a 23-valent anti-pneumococcal vaccine.
Final analysis of results was done in 70 children in each group, showing that the rate of immunoglobulin and isoagglutinin acquisition was similar in both groups. There was no difference between groups in antibody levels neither before nor after vaccination. Days of fever and number of episodes of infection were not statistically different in either group.
Supplementation of standard fermented milk with additional probiotics was not of benefit. The high natural rate of early microbial exposure in infants and children from a population of low socio-economic status living in a “less hygienic environment” may account for the absence of an additional immune-stimulating effect by supplementary probiotics.
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The work was supported by Sancor CUL Argentina, IDIP and CICPBA. NP formulated the hypothesis that the high index of microbial exposure in low socioeconomic environments may reduce or eliminate the immune-stimulating effects of probiotics. He participated in the design of the study, the analysis of results and the final writing of the manuscript. JCI conducted field work with patients and families, participated in the design of the study, the analysis of results and the final writing of the manuscript. CG-B, AV and LD coordinated sample taking, performed immunological laboratory determinations and participated in the analysis of results. MA participated in the design of the study and the statistical analysis of data. SG participated in the design of the study, the analysis of results and performed determinations in faecal flora. JCP, DV and RC participated in the design of the study, the preparation of products and the analysis of data.
Conflict of interest statement
Pernas J, Vicentin D, and Cravero R are members of the staff of Sancor CUL Argentina. The participation of Iannicelli J. and Girard-Bosch C. was partially supported by Sancor.
This work was performed at the Hospital de Niños S.M. Ludovica, 14 y 65, La Plata, Argentina.
Juan Pernas: Deceased.
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Pérez, N., Iannicelli, J.C., Girard-Bosch, C. et al. Effect of probiotic supplementation on immunoglobulins, isoagglutinins and antibody response in children of low socio-economic status. Eur J Nutr 49, 173–179 (2010). https://doi.org/10.1007/s00394-009-0063-5
- Immune system stimulation
- Antibody response
- Hygiene hypothesis