Hypo-antigenic and immune modulatory properties of a partially hydrolyzed cow's milk formula supplemented with prebiotic oligosaccharides

Background: Prevention guidelines for infants at high risk for allergy, who are not breastfed, recommend use of hydrolyzed formula in the first 4-6 months, but evidence for efficacy is limited and conflicting. Specific mixtures of oligosaccharides may offer an additional strategy for allergy prevention. Objective: To determine the hypo-antigenic and immunological effects of early intervention with a partially hydrolyzed whey formula (pHF) containing oligosaccharides in infants with increased risk of allergic disease. Method: Infants at increased risk of allergic disease were randomly assigned to receive pHF supplemented with a specific mixture (0.8 g/100 ml) of oligosaccharides including short chain galacto-oligosaccharides and long chain fructo-oligosaccharides (9:1), or standard cow's milk formula for the first 6 months of life if parents decided to stop or supplement breastfeeding (n = 1047) (trial registration number: ISRCTN65195597). Serum (n = 562) and peripheral blood mononuclear cells (n = 85) were obtained from a subgroup of infants at 6 months. Allergen-specific immunoglobulins were measured by CAP FEIA. Regulatory T cell (Treg) and plasmatocytoid dendritic cell (pDC) populations were analyzed by flow cytometry, and cytokine responses by multiplex assay. Results: pHF supplemented with prebiotic oligosaccharides intake was associated with reduced serum cow's milk-specific IgG1 (P <0.0001, Mann-Whitney test) and increased percentages of Treg (P = 0.0176 Two-Sample T-test) and pDC (P = 0.0251 Two-Sample T-test) as compared to conventional formula. Cytokine responses were similar in both groups. Conclusion: These findings support the hypo-antigenic and immune-modulatory capacity of this pHF containing prebiotic oligosaccharides and demonstrate a capacity to influence regulatory immune parameters that may contribute to anti-allergic effects in later life.