Effects of a specific synbiotic blend on fecal short-chain fatty acids and gut inflammation in cow's milk-allergic children receiving amino acid–based formula during early life: results of a randomized controlled trial (PRESTO study)

Consumption of an amino acid-based formula (AAF) with added synbiotics [short-chain oligofructose and long-chain inulin (scFOS/lcFOS, 9:1 ratio) and <i>Bifidobacterium breve</i> M-16V] (AAF-S) beneficially impacts the gut microbiome of infants with cow's milk allergy (CMA). We assessed the effect of consuming AAF with or without synbiotics by children with CMA for 12 months on their fecal (branched) short-chain fatty acids (SCFA/BCFA) concentrations, and on gut barrier and inflammation markers (Netherlands Trial Register NTR3725). Feces and saliva were collected from 161 children (≤13 months) with IgE-mediated CMA at baseline, 6 and 12 months after enrollment, and at 24 and 36 months follow-up. Fecal SCFA and BCFA were analyzed by gas chromatography, and gut barrier and inflammation markers were measured in saliva/feces by ELISA or ImmunoCAP. At 6 months, children receiving AAF-S had significantly lower fecal propionate, valerate and BCFA concentrations compared to children consuming AAF. The percentage of propionate from the total 6 SCFA/BCFA (acetate + butyrate + propionate + valerate + isobutyrate + isovalerate) was significantly lower, while the percentage of acetate from the total 6 SCFA/BCFA was significantly higher in the AAF-S group. There were no significant differences between groups in fecal concentrations of butyrate at 6 months, nor in SCFA or BCFA at baseline and after 12, 24 or 36 months. Intestinal inflammation and barrier markers did not differ between groups. Addition of synbiotics to AAF brings concentrations of key fecal microbial metabolites more in line with patterns observed in healthy breastfed infants. The effects on SCFA and BCFA concentrations were transient and only seen at 6 months.

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Journal
Frontiers in Allergy
Published
2025-11-27
DOI
https://doi.org/10.3389/falgy.2025.1667162
Primary Topic
Probiotics and Fermented Foods
Type
article
Field-Weighted Citation Impact
0.00

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article

Effects of a specific synbiotic blend on fecal short-chain fatty acids and gut inflammation in cow's milk-allergic children receiving amino acid–based formula during early life: results of a randomized controlled trial (PRESTO study)

Harm Wopereis, Suwat Benjaponpitak, Michel Erlewyn‐Lajeunesse, Pasuree Sangsupawanich et al.
Frontiers in Allergy
Probiotics and Fermented Foods
article

Effects of a specific synbiotic blend on fecal short-chain fatty acids and gut inflammation in cow's milk-allergic children receiving amino acid–based formula during early life: results of a randomized controlled trial (PRESTO study)

Harm Wopereis, Suwat Benjaponpitak, Michel Erlewyn‐Lajeunesse, Pasuree Sangsupawanich, Louise J. Michaelis, Valérie Trendelenburg, Simone Eussen, Kok Wee Chong, Annelot C. Breedveld, Pantipa Chatchatee, Anna Nowak‐Węgrzyn, Carla M. Davis, Lars Lange, Antonella Muraro, Atanaska I. Kostadinova, Manon M. Oude Nijhuis, Adam Fox, Jane E. Langford, Kirsten Beyer, Robert D. Pesek
article en

Abstract

Consumption of an amino acid-based formula (AAF) with added synbiotics [short-chain oligofructose and long-chain inulin (scFOS/lcFOS, 9:1 ratio) and <i>Bifidobacterium breve</i> M-16V] (AAF-S) beneficially impacts the gut microbiome of infants with cow's milk allergy (CMA). We assessed the effect of consuming AAF with or without synbiotics by children with CMA for 12 months on their fecal (branched) short-chain fatty acids (SCFA/BCFA) concentrations, and on gut barrier and inflammation markers (Netherlands Trial Register NTR3725). Feces and saliva were collected from 161 children (≤13 months) with IgE-mediated CMA at baseline, 6 and 12 months after enrollment, and at 24 and 36 months follow-up. Fecal SCFA and BCFA were analyzed by gas chromatography, and gut barrier and inflammation markers were measured in saliva/feces by ELISA or ImmunoCAP. At 6 months, children receiving AAF-S had significantly lower fecal propionate, valerate and BCFA concentrations compared to children consuming AAF. The percentage of propionate from the total 6 SCFA/BCFA (acetate + butyrate + propionate + valerate + isobutyrate + isovalerate) was significantly lower, while the percentage of acetate from the total 6 SCFA/BCFA was significantly higher in the AAF-S group. There were no significant differences between groups in fecal concentrations of butyrate at 6 months, nor in SCFA or BCFA at baseline and after 12, 24 or 36 months. Intestinal inflammation and barrier markers did not differ between groups. Addition of synbiotics to AAF brings concentrations of key fecal microbial metabolites more in line with patterns observed in healthy breastfed infants. The effects on SCFA and BCFA concentrations were transient and only seen at 6 months.

Frontiers in AllergyVol. 6
Arkansas Children's Hospital (US), Prince of Songkla University (TH), University of Padua (IT), Chulalongkorn University (TH), Baylor College of Medicine (US), Guy's and St Thomas' NHS Foundation Trust (GB), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), University Hospital Southampton NHS Foundation Trust (GB), NYU Langone Health (US), St. Marien-Hospital Bonn (DE), Danone (Netherlands) (NL), KK Women's and Children's Hospital (SG), Great North Children's Hospital (GB), Ramathibodi Hospital (TH), Texas Children's Hospital (US), Charité - Universitätsmedizin Berlin (DE)
Scurlock Foundation, Food Allergy Research and Education, Mead Johnson Nutrition, Danone, Regeneron Pharmaceuticals, Aimmune Therapeutics, Mylan, Astellas Pharma, European Academy of Allergy and Clinical Immunology, National Institutes of Health, Allergopharma, National Institute of Allergy and Infectious Diseases, Precursory Research for Embryonic Science and Technology
Openalex Percentile: Top 58%
Probiotics and Fermented Foods
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