AANP Call for Abstracts 2009- Designer probiotics for the prevention of allergic diseases

Contact Information:

Barry W. Ritz, PhD

4 Hillman Drive, Suite 190
Chadds Ford, PA 19317
(610) 361-2800 x15
Fax (610) 361-6168
britz@atrium-innov.com

Presenter’s Information:

Dr. Ger Rijkers

Department of Surgery
University Medical Center Utrecht
Laboratory for Medical Microbiology and Immunology
St. Antonius Hospital, Nieuwegein
The Netherlands
UMC Phone: +31 30 2505188
SAH Phone: +31 30 6093742
grijkers@umcutrecht.nl
g.rijkers@antonius.net
ger@rijkers.nl
www.gtrijkers.nl

The abstract below is being submitted for an oral presentation. A 60-minute presentation is preferred, but
90 minutes would be acceptable. This abstract is most suitable for the pediatrics category, although other
categories, such as immunity or gastrointestinal health, would also be appropriate.

Short Description:

This presentation will include an overview of the topic of probiotics and allergic diseases, including an
illustration of the concept of the Allergic March and the results from a recently completed clinical trial.
This presentation will be directed to a general audience that includes students, practitioners, and
scientists.

Designer probiotics for the prevention of allergic diseases

Ger T. Rijkers, Titia Niers Harro Timmerman and Maarten Hoekstra

Departments of Pediatrics and Surgery, University Medical Center, Utrecht, The Netherlands

Learning objectives: 1) Discuss the importance of probiotic bacteria for balancing intestinal microbiota;
2) Explore disturbances in immunoregulation as the underlying cause of allergic diseases; 3) Illustrate the
concept of the “Allergic March”; and 4) Examine the immunomodulating effects of designer probiotic
therapy.

Outline of presentation: After a thorough introduction on intestinal bacteria and probiotics, the
immunopathology of allergic diseases will be presented. Next, the rationale and design of the PANDA
(Probiotics and Allergy) study will be discussed, followed by a presentation of the main findings: clinical,
immunological and microbiologal (gut microbiota). At the end, conclusions from this study and propects
for the use of probiotics in the prevention and treatment of other immune-mediated diseases will be
presented.

Background: There are indications that the composition of the microbiota of allergic children differs
from that of normal, healthy children. Therefore, modification of the intestinal microbiota by the
administration of probiotic bacteria may be a potential approach to prevent allergic disease. We aimed to
study the primary prevention of allergic disease in high-risk children by pre- and postnatal
supplementation of selected probiotic bacteria.

Methods: A mixture of 3 probiotics (B. bifidum, B. lactis and Lc. lactis; Ecologic® Panda) was selected
for use in a clinical trial based on their capacity to modulate the production of Th2 cytokines and
regulatory cytokines in vitro. In a double-blind, randomized, placebo-controlled trial, Ecologic PANDA
was prenatally administered to mothers of high-risk children (i.e. positive family history of allergic
disease) during the last 6 weeks of pregnancy and to their offspring for the first 12 months of life.

Results: Parental-reported eczema during the first three months of life was significantly lower in the
intervention group compared to placebo, 6/50 vs. 15/52 (p = 0.035). Cumulative incidence of parental-
reported eczema at 1 and 2 years was 23/50 (intervention) vs. 31/48 (placebo) and 27 (intervention) vs. 34
(placebo) respectively. The number needed to treat was 5.9 at age 3 and 12 months and 6.7 at age 2 years.
The intervention group was significantly more frequently colonized with higher numbers of Lc. lactis,
indicative of good compliance . Furthermore, at age 3 months in vitro production of IL-5 (146 pg/ml vs.
72 pg/ml; p= 0.04) was decreased in the probiotic-group compared to the placebo-group.

Conclusions: Probiotic therapy shows a preventive effect on the incidence of eczema in high-risk
children, which seems to be sustained during the first two years of life. In agreement with previous
studies, the preventive effect appears to be established within the first three months of life. Follow-up at 5
years of age will show whether the intervention would also reduce the incidence of asthma.

Biography:

Ger Rijkers is a medical immunologist, associate professor and senior scientist in the Department of
Surgery at the University Medical Center in Utrecht, The Netherlands, and at the Laboratory of Medical
Microbiology and Immunology of the St. Antonius Hospital in Nieuwegein. Dr. Rijkers has spent 2
sabbatical periods in the US: in 1983 in the Lab of Don Mosier at Fox Chase Cancer Center in
Philadelphia and in 1989 in the Lab of John Cambier at National Jewish Medical Center in Denver. Dr.
Rijkers’ research includes immunoregulation by probiotics, especially as related to autoimmune diseases,
allergic diseases and infections. Dr. Rijkers and colleagues at the Laboratory of Pediatric Immunology of
the Wilhelmina Children’s Hospital recently completed the PANDA study investigating the prevention of
allergic diseases with probiotics. He has >200 publications (PubMed), is an invited international speaker
and chairs the Expert Group on Functionality of Probiotics for ILSI Europe.

Word Count:

Description: 46 words
Abstract: 459 words
Bio: 149 words