Filaggrin Mutation Status and Prevention of Atopic Dermatitis with Maternal Probiotic Supplementation

Acta Derm Venereol. 2024 Apr 24:104:adv24360. doi: 10.2340/actadv.v104.24360.

Abstract

The World Allergy Organization recommends probiotics in the prevention of atopic dermatitis in high-risk populations. Mutations in the filaggrin gene (FLG) result in an increased risk of atopic dermatitis through disruption of the skin keratin layer. This exploratory study investigated whether the preventive effect of maternal probiotics was evident in children with and without FLG mutations. DNA was collected from children (n = 228) from the Probiotic in the Prevention of Allergy among Children in Trondheim (ProPACT) study. Samples were analysed for 3 common FLG mutations (R501X, R2447X, and 2282del4). Overall, 7% of children had heterozygous FLG mutations; each child had only one of the 3 mutations. Mutation status had no association with atopic dermatitis (RR = 1.1; 95% CI 0.5 to 2.3). The risk ratio (RR) for having atopic dermatitis following maternal probiotics was 0.6 (95% CI 0.4 to 0.9) and RR was similar if the child expressed an FLG mutation (RR = 0.6; 95% CI 0.1 to 4.1) or wildtype FLG (RR = 0.6; 95% CI 0.4 to 0.9). The preventive effect of probiotics for atopic dermatitis was also evident in children without FLG mutation. Larger confirmatory studies are needed.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Child
  • Child, Preschool
  • DNA Mutational Analysis
  • Dermatitis, Atopic* / diagnosis
  • Dermatitis, Atopic* / genetics
  • Dermatitis, Atopic* / prevention & control
  • Dietary Supplements
  • Female
  • Filaggrin Proteins*
  • Genetic Predisposition to Disease
  • Heterozygote
  • Humans
  • Infant
  • Intermediate Filament Proteins* / genetics
  • Male
  • Maternal Nutritional Physiological Phenomena
  • Mutation*
  • Phenotype
  • Probiotics* / administration & dosage
  • Probiotics* / therapeutic use
  • Risk Factors
  • Treatment Outcome

Substances

  • Filaggrin Proteins
  • FLG protein, human
  • Intermediate Filament Proteins

Grants and funding

Funding sources: The Liaison Committee between the Central Norway Regional Health Authority and NTNU – Norwegian University of Science and Technology, and the Norwegian Research Council (grant reference number 2019/38881). Tine BA sponsored the study through supply and distribution of the study milk. The funding sources had no role in the study design, data collection, analysis, interpretation of the results, or writing of the manuscript.