CN104039175A - Allergy treatment with non- digestible oligosaccharide - Google Patents

Allergy treatment with non- digestible oligosaccharide Download PDF

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Publication number
CN104039175A
CN104039175A CN201180075877.1A CN201180075877A CN104039175A CN 104039175 A CN104039175 A CN 104039175A CN 201180075877 A CN201180075877 A CN 201180075877A CN 104039175 A CN104039175 A CN 104039175A
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composition
treatment
purposes
baby
aforementioned
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G·贝姆
G·莫偌
F·威斯
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Nutricia NV
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Nutricia NV
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    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23LFOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/125Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives containing carbohydrate syrups; containing sugars; containing sugar alcohols; containing starch hydrolysates
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23LFOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L29/00Foods or foodstuffs containing additives; Preparation or treatment thereof
    • A23L29/30Foods or foodstuffs containing additives; Preparation or treatment thereof containing carbohydrate syrups; containing sugars; containing sugar alcohols, e.g. xylitol; containing starch hydrolysates, e.g. dextrin
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23LFOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/702Oligosaccharides, i.e. having three to five saccharide radicals attached to each other by glycosidic linkages
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/733Fructosans, e.g. inulin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00Drugs for immunological or allergic disorders
    • A61P37/08Antiallergic agents
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23VINDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2002/00Food compositions, function of food ingredients or processes for food or foodstuffs

Abstract

The present invention relates to the treatment of subjects in order to reduce the incidence and or severity of allergic disease and/or manifestations in subjects during (early) childhood. The present inventors have found that the administration of certain non-digestible oligosaccharides, especially lc-FOS and/or sc-GOS, during infancy, as secondary intervention in subjects who develop allergy, especially atopic dermatitis, produces a reduction in the incidence and/or severity of allergic disease and/or manifestations later in life, i.e. far beyond the intervention period. Hence, one aspect of the present invention concerns a the treatment of an infant that develops allergy or atopic dermatitis before the age of 6 months, for reducing the incidence of allergic diseases and/or manifestation in said individual during (early) childhood, said treatment comprising administering a composition comprising non-digestible oligosaccharides to said infant.

Description

Use the allergy therapy of non-digestible oligosaccharide
Technical field
The present invention relates to reduce the allergic disease of experimenter (in early days) childhood and/or the incidence of disease and/or the seriousness of performance.More specifically, the present invention relates to non-digestible oligosaccharide (especially lc-FOS and/or sc-GOS) for during infancy, infancy suffer from allergy especially in the experimenter of atopic dermatitis as secondary intervention, to reduce allergic disease and/or the incidence of disease of performance and/or the purposes of seriousness of experimenter (in early days) childhood.
Background technology
In the past few decades, atopic diseases---comprises atopic dermatitis (also referred to as eczema), allergic rhinitis and asthma---and become frequent all the more in Western society, and this phenomenon is also referred to as " allergic popular ".In developed country, atopic diseases has affected about 20% population at present.Atopic diseases is generally divided into 3 continuous stages: infancy, childhood and the manhood, each stage has distinctive physical examination performance (physical finding).Atopic diseases can have tremendous influence to patient's quality of life.It is also for family and society have brought huge financial burden.
Atopic dermatitis is the most general chronic dermatosis in initial several years of life.Atopic dermatitis is usually the initial performance of allergic disease.Data in literature has shown the process that develops into other atopic diseaseses in later stage of life atopic dermatitis.The process that develops into atopic diseases (for example atopic dermatitis, allergic rhinoconjunctivitis (rhinoconjunctivitis), wheezing and final asthma) from baby's allergy is defined as " allergia process (allergic march) " or " idiocrasy process (atopic march) " in the art.The cutaneous manifestations of idiocrasy (atopy) usually represents the beginning of idiocrasy process.On the basis of some longitudinal researches, only about half of atopic dermatitis patients will be suffered from asthma, and 2/3rds will suffer from allergic rhinitis.Think that epidermis (epicutaneous) sensitization is arch-criminal.Now confirmable, the risks and assumptions of the sensitization of aeroallergen when the atopic dermatitis in initial 3 middle of the month is 5 years old.This risk can increase in the time having the Positive family history of atopic diseases.A research shows, parents suffer from that children that spy answers disease and self suffer from early stage atopic dermatitis have 77% can be by aeroallergen sensitization in the time of 5 years old.Although these risks and assumptions are also obviously relevant with the performance of allergia breathing problem, during to 5 years old, the positive predictive value of this result not yet reaches so high, 50%.
In the treatment of atopic diseases and research, be intended to the intervention of the beginning of avoiding idiocrasy process (" primary prevention/intervention ") and attempting usually to have difference between the intervention (" secondary prevention/intervention ") of the progress that regulates idiocrasy process.
Up to the present, research has mainly concentrated on primary prevention, forms and optimizes early immune and grow, and in the process of doing these things, ignore otherwise risk.This class intervention is for still healthy but have the colony of the risk of suffering from described disease.Unfortunately, up to the present all predictive factor (predictor) of investigation are all responsive to not special.Therefore, only have and be applicable to whole crowd, there is no risk and cost when low when possible preventive measure, just should be recommended.
Kukkonen et al. (" Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases:a randomized; double-blind; placebo-controlled trial ", J Allergy Clin Immunol2007; 119 (1): 192-195) described one 1223 researchs of carrying out in nourishing excessive risk child's pregnant woman, described pregnant woman uses probiotics preparation or placebo 2-4 week before childbirth.Their baby accepts identical probio and adds galactooligosaccharide (n5461) or placebo (n5464) 6 months.Before 2 years old, probiotic therapy does not all demonstrate any impact to the incidence of disease of all allergic diseases.But in the time of 2 years old, demonstrate the preventative effect of probio to AE.
Kuitunen et al. (" Airway inflammation in probiotic-treated children at 5 years ", Pediatric allergy and immunology2011; 22 (2): 249-51) described the research of an effect about probio of carrying out in 1223 pregnant woman, the child that described pregnant woman nourishes suffers from allergic risk to be increased.In the baby of 1018 Intentionality treatments, their FENO (Exhaled nitric oxide, Fractional exhaled nitric oxide) was measured in 160 of random selections in the time of 5 years old.In probiotic group, from gravidic the 36th week, mother took in rhamnose lactic acid bacteria (Lactobacillus rhamnosus) GG, rhamnose lactic acid bacteria LC705, short Bifidobacterium Bifidum (Bifidobacterium breve) Bb99 and propionibacterium freudenreichii Xie Shi subspecies (Propionibacterium freudenreichiissp.shermanii) JS of capsule form every day for twice.Their ewborn infant was accepted identical probio at postnatal 6 months and adds the galactooligosaccharide of 0.8g once a day.The airway inflammation that treatment in initial 6 months of life is measured by FENO during to 5 years old does not act on.In these identical babies, demonstrate the prophylactic effect of probio to AE in the time of 2 years old.But, when described effect to 5 year old, disappear.
Kukkonen et al. (" Probiotics prevent IgE-associated allergy until age 5years in cesarean-delivered children but not in the total cohort ", J Allergy Clin Immunol2009; 123:335-41) research of a placebo control is described, this research is carried out in 1223 are nourished the mother who suffers from the child that allergic risk is high, and described mother accepts probiotic composition (2 kinds of lactic acid bacterias (lactobacilli), Bifidobacterium (bifidobacteria) and Propionibacterium (propionibacteria)) or placebo in gravidic last moon.Their baby is from being born until 6 monthly ages were accepted described probiotic composition.Baby also accepts prebiotics galactooligosaccharide or placebo.In the time of 5 years old, evaluate CIR and the IgE sensitization of allergic disease (eczema, food allergy, allergic rhinitis and asthma).The allergic disease that described probiotic group is relevant with IgE with allergic disease in placebo and the frequency of sensitization are similar: be respectively 52.6% contrast 54.9% and 29.5% contrast 26.6%, and the two is all 41.3%.The frequency of eczema (39.3%vs43.3%), AE (24.0%vs25.1%), allergic rhinitis (20.7%vs19.1%) or the asthma (13.0%vs14.1%) of two groups does not have significant difference.Conclusion is to carry out perinatal period to high risk mother and children and supplement, the preventative effect of allergy that realization can not extend to 5 years old.
ETAC (idiocrasy children are carried out to early treatment) is a promising research, and it is to be that the baby in 1-2 year studies to 817 ages, and described baby suffers from AE and has atopic family history.Use cetirizine (cetirizine, 0.25mg/kg, twice of every day) or placebo to treat these babies.In the subgroup of the children with pollen sensitization or dirt mite sensitization, compared with placebo, SOA be formed with 50% minimizing.But whole analysis fails to reach significance,statistical.
It will be understood by those skilled in the art that therefore secondary intervention is especially useful because before the initial performance of atopic diseases becomes significantly, very difficult qualification has the experimenter of risk.Previously described secondary intervention should be intended to (in early days) of allergia phenotype in sensitization experimenter to reverse, to prevent or to regulate the further progress of idiocrasy process.
The baby who the object of the invention is in the initial some months of life the performance for developing atopic diseases provides this class treatment, and this treatment is also for a long time effective after intervention period.Particularly, the object of this invention is to provide effective treatment, described treatment is applicable to whole colony, devoid of risk and the low cost of suffering from idiocrasy baby.
Summary of the invention
The present inventor had been found that before 6 monthly ages some non-digestible oligosaccharide is suffered to atopic dermatitis or allergic baby, the incidence of disease of allergic disease and/or allergia performance can reduce by 5 years old time.
Do not wish to be limited to theory, it is to produce by the effect of the intestinal flora to baby that many people think to the positive effect of atopic dermatitis.Need to change to these microbiotas (for example increasing Bifidobacterium and Bacillus acidi lactici) causes allergic positive effect.
The present inventor has been found that at present in baby's group of suffering from atopic dermatitis at life and gives non-digestible oligosaccharide in initial 6 months, and the allergic disease to later stage of life and/or performance produce positive effect.Due to several reasons, this is very surprising.Surprisingly, observe, say accurately in suffering from the crowd of atopic dermatitis infancy and observe, giving non-digestible oligosaccharide at life in initial 6 months can also have impact in the several years in later stage of life.Have been found that even and suffer from the experimenter of atopic dermatitis (although being given non-digestible oligosaccharide) in infancy, still can obtain positive findings.
Appended embodiment has described the result of 5 years follow-up investigations, described research is about following aspect: (i) CIR of allergia performance during 5 years, and (ii) allergia performance and continue the incidence of allergia performance the 5th year time.Embodiment shows, can realize positive effect, and described positive effect continues to grow to 5 years old most in suffering from the experimenter of atopic dermatitis infancy.Described effect is not to be caused by the direct effect of compound sugar, because the experimenter for the treatment of group and control group, only the initial some months of life or initial 1 year or accepted in two years different treatments, uses non-digestible oligosaccharide composition treatment of the present invention.More specifically, in the time of 5 years old, the children in treatment group had at least 2 years or time that more may at least 3 years no longer with non-digestible oligosaccharide composition treatment of the present invention.
Therefore, one aspect of the present invention relates to the baby that allergy or atopic dermatitis are suffered from treatment before 6 monthly ages, the incidence of disease of the allergic disease for reducing described individuality (in early days) childhood and/or allergia performance, described treatment comprises and gives described baby by the composition that comprises non-digestible oligosaccharide.
Another aspect of the present invention relates to the purposes of non-digestible oligosaccharide for the manufacture of composition, described composition for treating the baby who suffers from allergy or atopic dermatitis before 6 monthly ages, allergic disease for reducing described individuality (in early days) childhood and/or the incidence of disease of performance, described treatment comprises and gives described baby by described composition.
Another aspect of the present invention relates to the composition that comprises non-digestible oligosaccharide, described composition for treating the baby who suffers from allergy or atopic dermatitis before 6 monthly ages, allergic disease for reducing described individuality (in early days) childhood and/or the incidence of disease of performance, described treatment comprises and gives described baby by described composition.
Detailed description of the invention
Defined invention above and some preferred aspect of the present invention thereof and embodiment describe in detail in following part.
In order to understand rightly this description and claims thereof, should be understood that verb " comprises " and morphology conversion is used with its unrestricted implication, mean to comprise this word project afterwards, but do not get rid of the project of specifically not mentioning.In addition, while mentioning a key element by indefinite article " " or " one ", do not get rid of the possibility that has more than one described key element, unless context has specified clearly and only had a described key element.Therefore, indefinite article " " or " one " mean " at least one " conventionally.
treat the experimenter of the treatment according to the present invention
The present invention relates to treat baby.When for this paper, except as otherwise noted, term " baby ", refers to that the age is the people experimenter at 0-36 monthly age.In a preferred embodiment of the invention, described experimenter to be treated is the age about baby of 1 years old at the most.Specific embodiment of the invention scheme relates to treating and is less than the experimenter that 12 monthly ages were preferably less than for 6 monthly ages.
In one embodiment of the invention, described baby to be treated suffers from initial 1 year at life or has suffered from allergy or atopic dermatitis.In another embodiment of the present invention, described baby to be treated suffered from or has suffered from allergy or atopic dermatitis in postnatal initial 6 months.In another embodiment, described baby to be treated suffered from or has suffered from allergy or atopic dermatitis in postnatal 3 months.
As mentioned before, completely beyond thoughtly be, before bringing into use non-digestible oligosaccharide treatment, suffers from the baby of allergy or atopic dermatitis, although or used before non-digestible oligosaccharide to carry out treatment but still the baby that suffers from atopic dermatitis, all from (further) treatment of use Non Digestible Oligosaccharides, be benefited,, reduce particularly seriousness and/or the incidence of disease of the performance of the allergia 5 years old time of later stage of life.Therefore, in one embodiment of the invention, described baby to be treated has suffered from allergy or the particularly baby of atopic dermatitis of atopic dermatitis in treatment.In addition, in one embodiment of the invention, described baby to be treated is the baby who still suffers from allergy or atopic dermatitis after using before non-digestible oligosaccharide to treat.
medical indication
As mentioned before, the present invention relates to treat the defined experimenter of previous section, object be reduce early stage childhood and childhood allergic disease and/or the incidence of disease and/or the seriousness of performance.
Term " allergic disorder " typically refers to so a kind of morbid state or syndrome, and wherein body produces and is exposed to the strong relevant immune response of environmental antigens, and described immune response generally includes and produces IgE antibody.This immune response causes that allergic symptoms is for example itched, sneezed, cough, unsmooth breath (respiratory congestion), rhinorrhea, skin rash etc., and such as asthma attack of serious reaction.Term " allergia performance " more broadly refers to symptom, effect and illness that caused by allergic disease or relevant to allergic disease.
The allergic disease that can treat by method of the present invention and the example of allergic disorder include but not limited to drug hypersensitivity, allergic rhinitis, bronchial astehma, ragweed pollen Hay Fever, anaphylaxis syndrome, nettle rash, angioedema, atopic dermatitis, erythema nodosum, erythema multiforme, the strong gloomy syndrome of Shi Difen (Stevens Johnson Syndrome), cutaneous necrosis induced phlebitis (cutaneous necrotizing venulitis), bullous skin disease, wheezing, the allergy that food hypersenstivity and insect venom are brought out, and any other allergic disease or allergic disorder.
In an especially preferred embodiment of the present invention, described treatment for reducing early stage childhood or childhood the incidence of disease and/or the seriousness of atopic dermatitis.The childhood that term being early stage, preferably refer to that the age is the 4-6 people in year.Atopic dermatitis is considered to a kind of concrete form of eczema.
In an especially preferred embodiment of the present invention, described treatment for reducing early stage childhood or childhood wheezing the incidence of disease and/or seriousness.When for this paper, term " wheezing " refers to and in the time that small airway is narrow, sends high-pitched whistle.This is narrow may be because many reasons occurs, conventionally relevant to atopic diseases or allergic disease, although can there is such as virus infections of other reasons.There is the performance of two kinds of principal modes according to morbidity and age, the acute onset of wheezing and recurrent or delay property wheezing (persistent wheeze) in baby.The present invention is specifically related to for reducing the incidence of disease of wheezing and/or the treatment of seriousness, especially recurrent or delay property wheezing, the especially wheezing relevant to atopic diseases.
In an especially preferred embodiment of the present invention, described treatment for reducing early stage childhood or childhood allergic rhinoconjunctivitis the incidence of disease and/or seriousness.
Atopic dermatitis, wheezing and allergic rhinoconjunctivitis in some experimenter may be the key element being associated in same illness.Be not to have each key element, but experimenter can be easy to suffer from all these three kinds of associated conditions simultaneously.Therefore, in one embodiment of the invention, treatment of the present invention for reducing early stage childhood or childhood in seriousness and the incidence of disease of atopic dermatitis, wheezing and allergic rhinoconjunctivitis.
It will be understood by those skilled in the art that simply, term " reduce ... the incidence of disease and/or seriousness " object that means described treatment is compared with untreated experimenter, make in some way early stage childhood and/or childhood quality of life significantly improve.This improvement can be to reduce because experimenter suffers the number of times in the period of inconvenience that allergic disease brings or burden, because the duration in this period shortens, and/or because the inconvenient or burden suffering within this period alleviates, or due to two in these effects or whole combinations.Therefore, described expression be also included in early stage childhood and/or childhood do not exist any described experimenter to experience period of allergic disease performance completely, and in early days childhood and/or childhood there is not allergic disease completely.
From being expressly understood above, the object of described treatment be the childhood of described experimenter early stage or childhood in realization effect.In one embodiment, the present invention relates to treat experimenter be greater than at the age 3,4,5,6 or realize 7 years old time in effect mentioned above any or all.In addition, the present invention relates generally to treatment experimenter be less than at the age 10,9,8 or realize 7 years old time in effect mentioned above any or all.In the time of this age, described experimenter no longer accepts described treatment conventionally.Preferably, in the time of this age, described experimenter has continued time of at least 1,2 or 3 year and has no longer accepted the particular treatment that the non-digestible oligosaccharide of any use is carried out.
Therefore, therapeutic purposes of the present invention are to realize long-term effect particularly, but this does not imply generation or acute effect or short-term effect do not occur.
The generation of supposing this long-term effect is relevant to the process that is called as ' idiocrasy process ' or ' allergia process ', this means infancy, early stage childhood, childhood and even allergia performance or the allergic disease of manhood may be associated in such a way: the generation that determines at least in part later stage of life allergic disease and/or performance is grown in infantile immunity.Therefore,, in atopic diseases treatment, being intended to avoid can be variant between the intervention that this idiocrasy process starts and the intervention of attempting the progress that regulates described allergia process or idiocrasy process.Conventionally, the object of the invention is to realize the latter.Especially preferred embodiment relates to the treatment of the progress for regulating the defined experimenter of previous section (especially suffer from or suffered from the patient of atopic dermatitis in initial 6 months at life) idiocrasy process.
The present invention can cause the instant alleviation of atopic dermatitis in baby or short-term to be alleviated, and described baby had suffered from atopic dermatitis before treatment, but the present invention is not specifically limited to this aspect.In any case the present invention comprises such embodiment, wherein said treatment can be (for example in two years not initial afterwards in birth in infancy, in birth afterwards in initial 1 year, or in birth afterwards in initial 6 months) prevention, cure, suppress or eliminate atopic dermatitis.
non-digestible oligosaccharide
Composition of the present invention comprises non-digestibility or non-digestible oligosaccharide, and it preferably promotes enteron aisle lactic acid to generate growth, especially Bifidobacterium and/or the Bacillus acidi lactici of bacterium.
The term " compound sugar " using in the present invention refers to that the degree of polymerization (DP) is for 2-250, and preferably DP is 2-100, more preferably 2-60, the even more preferably sugar of 2-10.If it is the compound sugar of 2-100 that composition of the present invention comprises DP, the present invention includes so the composition that contains such compound sugar: the DP of described compound sugar is that 2-5, DP are that 50-70 and DP are 7-60.
" degree of polymerization " or " DP " refers to the sum of the sugar unit in oligomeric sugar chain or polysaccharide chain." average DP " refers to compound sugar in composition or the average DP of polysaccharide chain, do not need possible monose or disaccharides to take into account (if there is monose or disaccharides, being preferably removed).The average DP of composition is for carrying out the differentiation between composition.In addition the % sugar unit in composition,---for example % glucose unit and % fructose units---is distinguishing.
The term " non-digestible oligosaccharide " using in the present invention refers to that the acid that is not present in intestines in people's UGI (small intestine and stomach) or the effect of digestive ferment digest or only digested by its part, but the compound sugar being fermented by people's intestinal flora.For example, sucrose, lactose, maltose and maltodextrin are considered to digestible.Preferably, the neutral compound sugar that described non-digestible oligosaccharide is non-digestibility.The term " neutral compound sugar " using in the present invention refers to such compound sugar, wherein more than 75% (preferably more than 85%, more preferably more than 95%, even more preferably more than 99%) sugar unit be selected from glucose, fructose, galactolipin, mannose, ribose, rhamnose, arabinose and wood sugar.Preferred neutral compound sugar is transgalactooligosac,harides and FOS.
Preferably, non-digestible oligosaccharide of the present invention is prebiotic oligosaccharide.Term " prebiotic oligosaccharide " refers to a kind of non-digestible oligosaccharide, its growth by the prebiotic bacterial classification of a kind of or limited quantity in selective stimulating colon and/or active and advantageously affect host.
Preferably, non-digestible oligosaccharide of the present invention is soluble.Term used herein " soluble ", when relevant with polysaccharide, fiber or compound sugar, mean described material at least according to L.Prosky et al., J.Assoc.Off.Anal.Chem.71, the described method of 1017-1023 (1988) is soluble.
Preferably, composition of the present invention comprises at least one and is selected from following non-digestible oligosaccharide: galactooligosaccharide, non-digestibility dextrin, xylo-oligosaccharide, low araban, glucose oligosaccharide (comprising oligomeric dragon gallbladder sugar and cyclodextrin), oligomeric chitose, oligomeric fucose, Oligomeric manna sugar, oligoisomaltose, FOS (comprising inulin), oligomeric galactomannan sugar, oligomeric grape mannose and oligomeric Arabic galactolipin; More preferably at least galactooligosaccharide and/or FOS, most preferably galactooligosaccharide at least.
Preferably, composition of the present invention comprises at least one and is selected from the non-digestible oligosaccharide of galactooligosaccharide, fucosido lactose (fucosylactose), saliva lactose (sialyllactose), FOS.
Term used herein " FOS " refers to a kind of polysaccharide carbohydrate of non-digestibility, the chain that it comprises the fructose units with at least 2 β-connections, and DP is 2-250, preferably 7-100, more preferably 20-60.Preferably use inulin.Inulin can be with trade name " Raftilin " (Orafti) obtain.The average DP of FOS of the present invention is preferably at least 7, and more preferably at least 10, preferably lower than 100.The FOS using preferably has (majority) fructose units connecting with β (2 → 1) key.Other terms of FOS comprise inulin, fruit polysaccharide (fructopolysaccharide), polyfructosan, levulan and FOS (oligofructose).Composition of the present invention preferably comprises the FOS that DP is 2-100.
Non-digestibility dextrin refers to the DP preferably with 10-50, preferably (maltose) dextrin of digestion resistant or the poly dextrose of digestion resistant of the DP of 10-20.Described non-digestibility dextrin preferably comprises α (1 → 4), α (1 → 6) glycosidic bond and 1 → 2 and 1 → 3 key.For example non-digestibility dextrin can be with trade name " Fibersol " (from Matsutami Industries) or (from Danisco) obtains.
The present inventor's discovery, galactooligosaccharide can be advantageously used in composition of the present invention, and this is because these compound sugar are especially effective aspect stimulation of bifidobacteria growth.Therefore, in preferred embodiments, composition of the present invention comprises galactooligosaccharide.Term used herein " galactooligosaccharide " refers to a kind of non-digestible oligosaccharide, wherein at least 30%, preferably at least 50%, and more preferably at least 60% sugar unit is galactose units.It is 2-100 that composition of the present invention preferably comprises DP, the galactooligosaccharide that more preferably DP is 2-10.Preferably, the sugar of described galactooligosaccharide is β-connection, just as the situation in human milk oligosaccharides.
Preferably, composition of the present invention comprises the galactooligosaccharide that is selected from transgalactooligosac,harides, lactose-N-tetrose (LNT) and lacto-N-neotetraose (neo-LNT).In especially preferred embodiment, method of the present invention comprises and gives transgalactooligosac,harides ([galactolipin] n-glucose; 2,3,4,5,6 wherein n is the integer between 1-60, ...., 59,60; Preferably n is 2,3,4,5,6,7,8,9 and/or 10).For example transgalactooligosac,harides (TOS) is with trade name Vivinal tMthe transgalactooligosac,harides that (Borculo Domo Ingredients, Netherlands) sells.
Composition of the present invention preferably comprises 0.5-75 gram, preferably the described non-digestible oligosaccharide/100 gram dry weight of 0.5-50 gram.Composition of the present invention preferably comprises 0.1-75 gram, preferably the described galactooligosaccharide/100 gram dry weight of 0.1-50 gram.
Method of the present invention preferably includes and comprises 0.05-25 gram, preferably part of 0.1-5 gram of non-digestible oligosaccharide.Method of the present invention preferably includes and comprises 0.05-25 gram of galactooligosaccharide, preferably part of 0.1-5 gram of galactooligosaccharide.
The present inventor also finds, the growth that the mixture of the non-digestibility of long-chain (neutrality) compound sugar and short chain non-digestible (neutrality) compound sugar stimulates healthy intestinal flora (especially Bifidobacterium) synergistically, and reduce the appearance of the Escherichia coli (E.coli) in the baby that gives a birth by caesarean birth otomy.
Therefore, composition of the present invention preferably comprises at least two kinds of non-digestibility (neutrality) compound sugar with different averages degree of polymerization (DP).Preferred weight ratio:
A. (non-digestibility (neutrality) compound sugar that DP is 2-5): (DP is 6,7,8 and/or 9 non-digestibility (neutrality) compound sugar) >1; And/or
B. (non-digestibility (neutrality) compound sugar that DP is 10-60): (DP is 6,7,8 and/or 9 non-digestibility (neutrality) compound sugar) >1
Preferably, two weight ratios are all greater than 2, even more preferably greater than 5.
Because short chain compound sugar promotes the growth of Bifidobacterium consumingly, therefore in order further to improve, non-digestible oligosaccharide of the present invention preferably has the short chain compound sugar of relative high-load.Therefore, preferably, in composition of the present invention at least the described non-digestible oligosaccharide of 10wt.% have the DP of 2-5 (2,3,4 and/or 5) and at least the described non-digestible oligosaccharide of 5wt.% there is the DP of 10-60.Preferably 50wt.% at least, more preferably at least the neutral compound sugar of the described non-digestibility of 75wt.% has the DP of 2-9 (2,3,4,5,6,7,8 and/or 9).
In order to improve bio-diversity and to stimulate the organic growth of multiple enteron aisle, composition of the present invention preferably comprises two kinds of non-digestible oligosaccharide with different structure.Composition of the present invention preferably comprises at least two kinds of different non-digestibility (neutrality) compound sugar, and the sugar unit homology of wherein said compound sugar is lower than approximately 90%, preferably lower than 50%, even more preferably less than 25%, even more preferably less than 5%.The term " homology " using in the present invention is the cumulative percentage of the identical sugar unit in different compound sugar.For example, compound sugar 1 (OL1) has the structure of fruc-fruc-glu-gal, therefore comprises 50% fruc (fructose), 25% gal (galactolipin) and 25% glu (glucose).Compound sugar 2 (OL2) has the structure of fruc-fruc-glu, therefore comprises 66% fruc, 33% glu.Therefore described different compound sugar has the homology of 75% (50%fruc+25%glu).
Composition of the present invention preferably comprises galactooligosaccharide and FOS, the FOS that the transgalactooligosac,harides that more preferably DP is 2-7 and DP are 10-100.
Preferably, the non-digestible oligosaccharide that is used as active component in treatment of the present invention is not human milk oligosaccharides.
composition
Preferably in intestines, give, more preferably orally give composition of the present invention.Therefore, composition of the present invention is preferably Orally administered composition, more preferably infant formula thing.Composition of the present invention is preferably the synthesizing formula thing of preparing by mixing heterogeneity.Composition of the present invention can be advantageously used for baby's complete nutrition thing.
Not human milk or breast milk according to composition of the present invention.In addition, composition of the present invention is not naturally occurring mammalian milk.In addition, if described composition comprises animal breast or based on animal breast, so described composition generally comprises at least one conventionally in the non-existent non-digestible oligosaccharide in naturally occurring animal Ruzhong.
Composition of the present invention preferably comprises lipid, protein and carbohydrate, and gives preferably as liquid food.The term " liquid food " using in the present invention comprises dry food (for example powder), and described food is accompanied with description to described dry foodstuff mixture for example, is mixed mutually with suitable liquid (water).
Composition of the present invention is preferably baby nutrition is provided, and comprises lipid composition, protein component and carbohydrate ingredient.Described lipid composition preferably provides the 5-50% of total amount of heat, and described protein component preferably provides the 5-50% of total amount of heat, and described carbohydrate ingredient preferably provides the 15-90% of total amount of heat.Composition of the present invention is preferably used as infant formula thing, and wherein said lipid composition provides the 35-50% of total amount of heat, and described protein component provides the 7.5-12.5% of total amount of heat, and described carbohydrate ingredient provides the 40-55% of total amount of heat.In order to calculate the total amount of heat percentage of described protein component, need to consider the gross energy that described protein, peptide and amino acid provide.
Preferably, described lipid composition comprises at least one lipid that is selected from vegetable lipid and animal lipid and at least one and is selected from the oily bond of fish oil, animal oil, vegetable oil, algae oil, fungal oil and bacterium oil.Preferably, described lipid comprises at least alpha linolenic acid of 12mg/100kcal (ALA).Preferably, the linoleic acid of described lipid composition (LA) is 5-15, more preferably 5-10 with the wt/wt ratio of ALA.Preferably, the amount of trans-fatty acid is lower than 4wt.% in TL.The trans-fatty acid harm intestines barrier of high-load.
The protein component using in composition of the present invention preferably comprises at least one being for example selected from, for example, in inhuman animal protein (lactoprotein, meat albumen and egg protein), phytoprotein (soybean protein, wheat gluten, rice protein, potato protein and pea protein), free amino acid and composition thereof.Especially preferably nitrogenous source, the especially cow's milk protein in cow's milk source, for example casein and lactalbumin.Preferably, described protein component comprises complete protein, more preferably complete milk albumin and/or complete ox casein.Due to composition of the present invention by suitably for reducing baby's allergy, therefore the protein of infant formula thing is preferably selected from lactoprotein (for example casein of hydrolysis and/or the lactalbumin of hydrolysis), vegetable protein and/or the amino acid of hydrolysis.Use the protein of these hydrolysis can further reduce baby's allergy.Use the absorption to dietary protein component of baby's immature intestines that the protein of these hydrolysis advantageously improves cesarean section delivery.
Preferably, described composition comprises digestible carbohydrates.The digestible carbohydrates using in composition of the present invention is preferably selected from sucrose, lactose, glucose, fructose, corn-syrup solids, starch and maltodextrin, and composition thereof, more preferably lactose.
Can comprise in addition other active components according to composition of the present invention, such as vitamin (A, B1, B2, B3, B5, B12, C, D, E, K etc.), probio (such as Bifidobacterium, Bacillus acidi lactici etc.), other prebioticses, fiber, lactoferrin, immunoglobulin (Ig), nucleotides etc.Nutrient for example protein, lipid and other carbohydrate (for example digestible carbohydrates, non-digestible carbohydrates, soluble or insoluble carbohydrate) can exist with different amounts.The typical insoluble non-digestible carbohydrates being present in human infant nutrition is soybean polyoses, resistant starch, cellulose and hemicellulose.The digestible carbohydrates that is used for the typical soluble of human infant nutrition is for example maltodextrin, lactose, maltose, glucose, fructose, sucrose and other monose or disaccharides or its mixture.Described composition also can comprise other non-active ingredients and carrier, such as glucose, lactose, sucrose, sweet mellow wine, starch, cellulose or cellulose derivative, dolomol, stearic acid, saccharin sodium, talcum, magnesium carbonate etc.Described composition also can comprise water, electrolyte, essential amino acid and nonessential amino acid, trace element, mineral matter, fiber, sweetener, flavor enhancement, colouring agent, emulsifying agent and stabilizing agent (such as soybean lecithin, citric acid, monoglyceride or diglyceride), anticorrisive agent, adhesive, spices etc.
In another embodiment, the invention provides a kind of method, wherein the composition that contains compound sugar (preferably containing the concentrate composition of a large amount of compound sugar) is mixed with baby's to be given nutrients.Provide concentrated form to make it possible to non-digestible oligosaccharide of the present invention to be added in synthetic baby milk formulation and breast milk.
The described composition that comprises non-digestible oligosaccharide that is applicable to this method---is preferably concentrated composition---and preferably comprises at least 5wt.% of dry weight basis with described composition, preferably 10wt.% at least, more preferably the non-digestible oligosaccharide of 25wt.% at least, wherein said non-digestible oligosaccharide is preferably selected from galactooligosaccharide, non-digestibility dextrin, xylo-oligosaccharide, low araban, glucose oligosaccharide (comprising oligomeric dragon gallbladder sugar and cyclodextrin), oligomeric chitose, oligomeric fucose, Oligomeric manna sugar, oligoisomaltose and FOS (comprising inulin).Can improve in the following manner described composition: above-disclosed to said composition and one or more component is mixed mutually, be preferably selected from one or more or whole components in uronic acid oligosaccharides, LC-PUFA (long-chain polyunsaturated fatty acid), nucleotides and probio.
Preferably described concentrated composition is designed to can be added in single part of human infant nutrition.The accumulating weight of the non-digestible oligosaccharide in this based composition is preferably every part of 0.1-10 gram, preferably 0.2-5 gram.Described composition is preferably by packaged, i.e. a UD form of wafer (preferably with).A described composition preferably has 0.5-25 gram, preferably the dry weight of 1-10 gram.
treatment
It will be understood by those skilled in the art that in a preferred embodiment of the invention, described treatment comprises and in intestines, gives described composition." intestines in " in this article refer in the intestines and stomach that are directly delivered to experimenter (for example oral or by pipe, conduit or valve (stoma)).Especially preferred oral gives.
In one embodiment of the invention, described treatment is included in a certain treatment phase and repeats to give described composition.In a preferred embodiment of the invention, within the described treatment phase, give a described composition for monthly at least 1 time, at least 2 times, at least 3 times or at least 4 times.In another preferred embodiment of the present invention, within the described treatment phase, give a described composition at least 1 time weekly, at least 2 times, at least 3 times, at least 4 times, at least 5 times, at least 6 times or at least 7 times.More preferably, within the described treatment phase, at least every 3 days 1 time, at least every 2 days 1 time or at least give a described composition every day for 1 time.In the most preferred embodiment of the present invention, described treatment comprises and gives 1,2 or 3 part of composition that comprises described non-digestible oligosaccharide every day.
Preferably, the amount that is suitable for the accumulating weight of the non-digestible oligosaccharide that every portion of these dosage regimens comprises is 0.1-10 gram, preferably 0.2-5 gram.Therefore, in a preferred embodiment of the invention, treatment of the present invention comprises with said frequencies with 0.1-10 gram, preferably the dosage of 0.2-5 gram gives non-digestible oligosaccharide, preferably, described treatment comprises and gives 0.1-10 gram every day, preferably 0.2-5 gram of compound sugar.
Preferably, the described treatment phase continued at least 1 week, at least 2 weeks, at least one month, at least 2 months, at least 3 months, at least 4 months, at least 5 months or at least 6 months.In addition, preferably in postnatal 6 months, start described treatment in postnatal 5 months, in postnatal 4 months or in postnatal 3 months.
Preferably, described experimenter, before 2 years old, preferably, before 1 years old, more preferably, before 6 monthly ages, most preferably accepted described treatment before 3 monthly ages.
In especially preferred embodiment of the present invention, before 2 years old or before 1 years old or before 6 monthly ages, stop described treatment.In the time of 2 years old, stop giving described composition, continue at least 1 year, preferably the time of at least 2 years.
Mention hereinbefore, the baby that one embodiment of the invention relate to accepting lacto treats.Therefore, the invention provides as the method for defined treatment in any above-mentioned part, said method comprising the steps of:
A) composition that comprises non-digestible oligosaccharide is mixed mutually with the nutrients (preferably lacto) of waiting to give described baby; With
B) by step a) in obtain mixture give described baby.
Therefore, by some embodiments mentioned above, the present invention has been described.It should be understood that these embodiments allow various change well-known to those skilled in the art and alternative form.Therefore,, although described specific embodiment, these are that example does not limit the scope of the invention.
All patents of quoting in present specification and bibliography are all included in herein by reference in full.
Following examples are used for illustrating the present invention as described above.
Embodiment
introduce
Whether the object of research of the present invention is to evaluate in really suffering from baby's group of atopic dermatitis infancy to continue exceed between intervention period and continue to 5 years old for allergic protectiveness effect.
method
Research and design
Initial research is the test of random, double blinding, placebo, as described in other places (1,2).Briefly, there is full-term newborn infant that spy answers disease father and mother medical history and accepts in initial 6 months at life the hypoallergenic formulation (1) of prebiotic-supplemented (8g/L scGOS/lcFOS) or supplementary placebo (8g/L maltodextrin).In order to evaluate described prebiotics intervention to allergic possible long-term protectiveness effect, seminar was followed up a case by regular visits to until 5 years old.Follow up a case by regular visits to is that researcher by not knowing formulation distribution condition carries out.
Described research approach is ratified by the Ethics Committee of Milan, ITA Macedonio Melloni hospital.Obtain written Informed Consent Form from father and mother there.
Nutritional intervention
Nutritional intervention was for initial 6 months of described research, and detailed description in Moro et al (1).
Within 5 years, follow up a case by regular visits to scheme
Contact image data by the diary that (i) follows up a case by regular visits to, (ii) write by father and mother and the phone (iii) being undertaken by trained personnel.
Terminal and definition
Interested main terminal is:
The CIR of allergia performance in 5 years, and
The incidence that 5 years old time, allergia performance and lasting allergia show.
The inventor has also evaluated
To AD in initial 6 months of life there is relevant 5 years old of situation time allergia performance illness rate, taking the generation of assessing early stage AD whether as the predictor of continuation allergia performance.
The allergia of monitoring shows as AD, recurrent wheezing, allergic rhinoconjunctivitis and nettle rash.
According to Harrigan and Rabinowitz (3) and the described standard diagnostics atopic dermatitis of Muraro et al (4) (AD).After 2 years, continue the itch skin disorder at least 4 weeks in the case of existing, if there is following characteristics, be diagnosed as AD: have general dry skin at upper 1 year cheek or forehead and exopodite.Recurrent wheezing is defined as to be had 3 times or more times outbreak of wheezing through doctor diagnosed (4) in each follow-up period.Allergic urticaria is defined as (5) 2 times or more times itch eruption with typical outward appearance that observed by doctor and that caused by identical allergen or the outbreak of swelling.Allergic rhinoconjunctivitis be considered to repeatedly through doctor diagnosed and common cold or infect irrelevant nose and eyes symptom (itch, sneeze, secretion increase and nasal obstruction) (6,7).
Compared with 16.7% in intervention group, in placebo, suffer from when 6 monthly age in the case of AD, have 50% in the time of 5 years old, continue to there is AD, the allergy (p<0.05) of the wheezing of delay property and nose conjunctivitis form.The children that suffer from AD in described whole group in initial 6 months suffer from more delay allergic performance and allergic rhinoconjunctivitis (table 1) during at 5 years old.In described whole group, during with regard to 5 years old, with regard to the illness rate of the performance of any delay allergic, AD and allergic rhinoconjunctivitis, AD-6mo (+) children (are respectively 40,30,25%) (be respectively 9,7,1.4 apparently higher than AD-6mo (-) children, 4.2%) (p<0.01, p<0.0001, p=0.01, odds ratio is respectively 6.2,30.4,7.7).AD-6mo (+) children also tend in the time of 5 years old, to have more delay wheezing (20% contrast 5.6%, p=0.065, odds ratio is 4.3).
Table 1. during to 6 months AD there is relevant 5 years old of situation time delay the illness rate (in conjunction with placebo intervention group) of allergic performance and nose conjunctivitis
Bibliography
1.Moro?G,Arslanoglu?S,Stahl?B,Jelinek?J,Wahn?U,Boehm?G.A?mixture?of?prebiotic?oligosaccharides?reduces?the?incidence?of?atopic?dermatitis?durig?the?first?six?months?of?age.Arch?Dis?Child.2006;91:814–9.
2. Arslanoglu?S, Moro?GE, Schmitt?J, Tandoi?L, Rizzardi?S, Boehm?G.Early?dietary?intervention?with?a?mixture?of?prebiotic?oligosaccharides?reduces?the?incidence?of?allergic?manifestations?and?infections?during?the?first?two?years?of?life. J?Nutr2008;138(6):1091-5.
3.Harrigan?E,Rabinowitz?LG.Atopic?dermatitis.Pediatr?Allergy?Immunol.1999;19:383–9.
4.Muraro?A,Dreborg?S,Halken?S, ?et?al.Dietary?prevention?of?allergic?diseases?in?infants?and?small?children.Part?II:Evaluation?of?methods?in?allergy?prevention?studies?and?sensitization?markers.Definitions?and?diagnostic?criteria?for?allergic?diseases.Pediatr?Allergy?Immunol.2004;14:196–205.
5.von?Berg?A,Koletzko?S,Grübl?A,Filipiak-Pittroff?B,Wichmann?HE,Bauer?CP,Reinhardt?D,Berdel?D;German?Infant?Nutritional?Intervention?Study?Group.The?effect?of?hydrolyzed?cwow's?milk?formula?for?allergy?prevention?in?the?first?year?of?life:the?German?Infant?Nutritional?Intervention?Study,a?randomized?double-blind?trial.J?Allergy?Clin?Immunol.2003Mar;111(3):533-40.
6.Johansson?SG,Bieber?T,Dahl?R,Friedmann?PS,Lanier?BQ,Lockey?RF,Motala?C,Ortega?Martell?JA,Platts-Mills?TA,et?al.Revised?nomenclature?for?allergy?for?global?use:report?of?the?Nomenclature?Review?Committee?of?the?World?Allergy?Organization,October2003.J?Allergy?Clin?Immunol.2004;113:832–6.
7.Kulig?M,Klettke?U,Wahn?V,Forster?J,Bauer?CP,Wahn?U.Development?of?seasonal?allergic?rhinitis?during?the?first7years?of?life.J?Allergy?Clin?Immunol.2000Nov;106(5):832-9.

Claims (18)

1. the composition that comprises non-digestible oligosaccharide suffers from allergy or atopic dermatitis baby for the preparation for the treatment of before 6 monthly ages to be to reduce the purposes of composition of the incidence of disease of the allergic disease of described individuality (in early days) childhood and/or performance, and described treatment comprises and gives described baby by described composition.
2. the purposes of claim 1, the incidence of disease of delay atopic dermatitis, allergic rhinoconjunctivitis and/or the wheezing of wherein said treatment for reducing (in early days) childhood.
3. the purposes of claim 1 or 2, wherein said treatment is the allergic disease when the >4 year and/or the incidence of disease of performance for reducing described individuality.
4. the purposes of claim 1-3 any one, wherein said treatment is for reducing the incidence of disease of described individuality allergic disease and/or performance 5 years old time.
5. the purposes of aforementioned claim any one, wherein said treatment is included in postnatal 2 years and gives described baby by described composition.
6. the purposes of aforementioned claim any one, wherein said treatment is included in postnatal 1 year and gives described baby by described composition.
7. the purposes of aforementioned claim any one, wherein said treatment is included in postnatal 6 months and gives described baby by described composition.
8. the purposes of aforementioned claim any one, wherein said treatment comprises administration every day, continues the time of at least 1 month.
9. the purposes of aforementioned claim any one, the administration of wherein said composition stopped in the time of 2 years old, and continued at least 1 year, preferably the time of at least 2 years.
10. the purposes of aforementioned claim any one, wherein said composition comprises galactooligosaccharide.
The purposes of 11. aforementioned claim any one, wherein said composition comprises FOS.
The purposes of 12. aforementioned claim any one, wherein said composition is infant formula thing.
The purposes of 13. aforementioned claim any one, wherein said non-digestible oligosaccharide is not human milk oligosaccharides.
The purposes of 14. aforementioned claim any one, wherein said composition is not human milk.
The purposes of 15. aforementioned claim any one, wherein said baby acceptor breast milk, and described treatment is included in and gives before described composition described composition to mix with lacto.
16. the purposes of aforementioned claim any one, wherein said baby has suffered from atopic dermatitis or allergy in the time of 3 monthly age.
The purposes of 17. aforementioned claims, wherein gives described composition to suffer from atopic dermatitis or allergic baby at life in initial 1 year.
18. the composition that comprises non-digestible oligosaccharide suffers from the baby of allergy or atopic dermatitis for treatment before 6 monthly ages, the incidence of disease of the allergic disease for reducing described individuality (in early days) childhood and/or allergia performance, described treatment comprises and gives described baby by described composition.
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