Effect of a synbiotic containing Lactobacillus rhamnosus GG and fructooligosaccharides on the dynamics of the level of fecal calprotectin in children of first year of life

Rationale: As clinical efficacy of probiotics and prebiotics is determined by their joint effects both on the mechanism of immune tolerance, gut inflammation and intestinal wall permeability, one of the objective methods to assess efficacy of probiotic strain-containing agents could be based on measurement of fecal calprotectin levels. Aim: To evaluate changes in fecal calprotectin as an efficacy parameter of treatment with the Lactobacillus rhamnosus GG – fructooligosacсharide complex for prevention of atopic dermatitis in infants. Materials and methods: Sixty healthy newborns from the risk group for allergic disorders were randomized (envelope randomization) into two groups: the infants from the control group (n = 31) were given widely used recommendations to prevent atopic dermatitis, whereas the infants from the study group (n = 29) were additionally administered a synbiotic containing Lactobacillus rhamnosus GG with fructooligosaccharides. The efficacy of the synbiotic therapy was assessed by measurement of fecal calprotectin levels at 3 and 6 months of the follow-up. Results: The first measurement of fecal calprotectin levels at 3 months showed its significant increase in all infants (mean 276.9 ± 128.8 mcg/G), compared to the normal range (below 50 mcg/G). The second measurement at 6 months demonstrated a decrease in fecal calprotectin in infants from both groups (mean 75.8 ± 55.3 mcg/G). However, mean levels of fecal calprotectin in the infants from the study group who had been administered the synbiotic, was significantly lower than that in the control group (48.6 ± 38.5 and 99.7 ± 57.4 mcg/G, respectively; р < 0.05). Conclusion: The observed changes in fecal calprotectin levels support the positive role of synbiotics and lyophilized complex of Lactobacillus rhamnosus GG with fructooligosaccharides in the growth of gut microbiota in infants and in the reduction of inflammation, all of this being an important prerequisite for development of the oral tolerance mechanisms.