Atopic Dermatitis (AD) is the earliest and the most common manifestation of allergies. Recent studies have shown that allergies were associated with a disruption of the gut microbial ‘balance’ suggesting that the use of nutritional intervention very early in life may restore an optimal pattern of microflora aiming at improving the host’s health. So far, most human intervention studies have focused on improving postnatal infant colonization.
Our clinical trial PREGRALL will be the first to test the hypothesis that a maternal antenatal prebiotics (GOS/inulin) supplementation will prevent AD in high-risk children. The PREGRALL study will recruit 376 allergic pregnant women. Participants will be randomized to be given prebiotics supplementation or placebo, from 20 weeks of pregnancy to delivery. Primary outcome is AD prevalence at one year old. PREGRALL will lead a translational study based on biological samples from 60 infant-mother dyads. Samples will be collected at different times: blood and stools; cord blood; colostrum; breastmilk and placenta.
We hypothezise that prebiotics could modify favourably the placental microbiota which could impact then on fœtus immune system orientation to protect against allergies. Microbiota composition and diversity will be assessed by sequencing the variable V3-V4 region of the 16S rRNA gene.
PREMIPLA will result in a detailed and dynamic cartography of the placental microbiota. We expect to observe substantial differences between communities depending on (i) exposure to prebiotics during antenatal period and (ii) development of AD in infancy.