A specific synbiotic-containing amino acid-based formula restores gut microbiota in non-IgE mediated cow's milk allergic infants [Elektronisk resurs] a randomized controlled trial

• Background: Altered gut microbiota is implicated in cow’s milk allergy (CMA) and differs markedly from healthy, breastfed infants. Infants who suffer from severe CMA often rely on cow’s milk protein avoidance and, when breastfeeding is not possible, on specialised infant formulas such as amino-acid based formulas (AAF). Herein, we report the effects of an AAF including specific synbiotics on oral and gastrointestinal microbiota of infants with non-IgE mediated CMA with reference to healthy, breastfed infants. Methods: In this prospective, randomized, double-blind controlled study, infants with suspected non-IgE mediated CMA received test or control formula. Test formula was AAF with synbiotics (prebiotic fructo-oligosaccharides and probiotic  Bifidobacterium breve  M-16V). Control formula was AAF without synbiotics. Healthy, breastfed infants were used as a separate reference group (HBR). Bacterial compositions of faecal and salivary samples were analysed by 16S rRNA-gene sequencing. Faecal analysis was complemented with the analysis of pH, short-chain fatty acids (SCFAs) and lactic acids. Results: The trial included 35 test subjects, 36 controls, and 51 HBR. The 16S rRNA-gene sequencing revealed moderate effects of test formula on oral microbiota. In contrast, the gut microbiota was substantially affected across time comparing test with control. In both groups bacterial diversity increased over time but was characterised by a more gradual increment in test compared to control. Compositionally this reflected an enhancement of  Bifidobacterium  spp. and  Veillonella  sp. in the test group. In contrast, the control-fed infants showed increased abundance of adult-like species, mainly within the  Lachnospiraceae family, as well as within the  Ruminococcus  and  Alistipes  genus. The effects on  Bifidobacterium  spp. and  Lachnospiraceae  spp. were previously confirmed through enumeration by fluorescent in situ hybridization and were shown for test to approximate the proportions observed in the HBR. Additionally, microbial activity was affected as evidenced by an increase of l-lactate, a decrease of valerate, and reduced concentrations of branched-chain SCFAs in test versus control. Conclusions: The AAF including specific synbiotics effectively modulates the gut microbiota and its metabolic activity in non-IgE mediated CMA infants bringing it close to a healthy breastfed profile. 

Ämnesord

Medical and Health Sciences  (hsv)

Health Sciences  (hsv)

Nutrition and Dietetics  (hsv)

Medicin och hälsovetenskap  (hsv)

Hälsovetenskaper  (hsv)

Näringslära  (hsv)

Genre

government publication  (marcgt)

Indexterm och SAB-rubrik

Cow's milk allergy

Pediatrics

Gut microbiota

Prebiotics

Probiotics