Hydrolysed protein plus prebiotic formula could aid infants with allergy risk: Danone Nutricia study

The study, published in the Journal of Allergy and Clinical Immunology, ​investigated the effect of early life nutrition on the assembly of intestinal microbiome in infants at high risk of allergy – testing prebiotic combination could modulate the development of gut microbiota to a make-up that was closer to breast-fed infants.

Furthermore, the team aimed to identify patterns in the developing gut microbiota that might be implicated in the onset of eczema.

Led by researchers  from the Danone Nutricia Research labs in the Netherlands, in partnership with scientists at Wageningen University and Imperial College London the team found that infants receiving the partially hydrolysed protein plus prebiotic infant formula showed increased relative abundances of the genus Bifidobacterium​, alongside decreases of Clostridium​ species and an unassigned genus of Lachnospiraceae, when compared with infants receiving standard cow's milk formula.

“In this study we found that a partially hydrolysed protein formula supplemented with a specific oligosaccharide mixture (pHF-OS) modulates the developing gut microbiota of infants toward a pattern closer to that of breast-fed infants both in bacterial taxonomic composition and in metabolite composition,”​ wrote the team.

“The findings in this study confirm the major influence of early-life nutrition on assembly of the gut microbiota and provide new insights into how deviations in this assembly are associated with eczema development,” ​they added.

PATCH study​

The new findings are from a sub-study of the company’s larger PATCH clinical study investigating the effects of the same pHF-OS formula on the prevention of eczema in infants at increased risk of allergy. The first publication from the PATCH study found that pHF-OS resulted in hypo-antigenic and immunomodulatory effects, including increased regulatory T-cell numbers – but did not reduce eczema incidence by 12 or 18 months when compared with that in infants receiving standard cow's milk formula.

Now the team have followed up that result with a further analysis which uses 16S rRNA genetic sequencing to obtain an in-depth characterization of the microbiota composition of faeces collected at 4 and 26 weeks of age in a sub-group of vaginally born infants, including breast-fed infants (n = 30) and infants randomized to receive pHF-OS (n = 51) or standard cow's milk formula (control subjects, n = 57).

They team also measured faecal pH and levels of lactate and short-chain fatty acids (SCFAs) from stool samples collected at 4, 12, and 26 weeks of age.

“Faecal microbial composition, metabolites, and pH of infants receiving partially hydrolysed protein formula supplemented with non-digestible oligosaccharides was closer to that of breast-fed infants than that of infants receiving standard cow's milk formula,” ​reported the Danone Nutricea- led team.

Compared to infants fed cow’s milk, the formula resulted in a relative increase in the abundance of bacteria from the Bifidobacterium ​genus, while decreases were seen in the Clostridium​ species and in a genus of Lachnospiraceae.

“These modulations were reflected in marked differences in gut physiology characterized by lower stool pH, increased proportions of lactate, and decreased proportions of propionate, butyrate, isobutyrate, and isovalerate,” they said.

Eczema markers​

Furthermore, the team reported that infants with eczema by 18 months showed differences that were marked by decreased relative abundances of Parabacteroides​ and Enterobacteriaceae​ at 4 weeks, plus  a lower relative abundances of lactate-utilising bacteria producing butyrate at 26 weeks (Eubacterium​ and Anaerostipes​ species).

“It indicates a potential link between the activity of the microbiota and the expression of eczema in early life,”​ the authors concluded. “It emphasizes the importance of the microbial succession of species and metabolite cross-feeding to develop a gut physiology that supports gut development and also supports development of normal immune responses to environmental triggers.”​

“These observations could aid in the development of optimal nutritional strategies to support the timely gut colonization of keystone species in the gradually diversifying infant gut,”​ they added.

Source: Journal of Allergy and Clinical Immunology​
Published online ahead of print, doi: 10.1016/j.jaci.2017.05.054​
“Intestinal microbiota in infants at high risk for allergy: Effects of prebiotics and role in eczema development”​
Authors: Harm Wopereis, et al​