liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Björkstén, Bengt
Publications (10 of 31) Show all publications
Abrahamsson, T. R., Sinkiewicz, G., Jakobsson, T., Fredrikson, M. & Björkstén, B. (2009). Probiotic lactobacilli in breast milk and infant stool in relation to oral intake during the first year of life. Journal of pediatric gastroenterology and nutrition, 49(3), 349-354
Open this publication in new window or tab >>Probiotic lactobacilli in breast milk and infant stool in relation to oral intake during the first year of life
Show others...
2009 (English)In: Journal of pediatric gastroenterology and nutrition, ISSN 1536-4801, Vol. 49, no 3, p. 349-354Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This is to identify factors affecting the prevalence of Lactobacillus reuteri in maternal faeces and breast milk and infant faeces after oral supplementation with L reuteri and to assess the influence on microbial ecology, particularly Clostridium difficile and Bifidobacterium colonization.

MATERIALS AND METHODS: In this double-blind trial, 232 mothers with a family history of atopic disease were randomized to a daily intake of either L reuteri American-type culture collection (ATCC) 55730 (1 x 10 colony-forming units [CFU]) or placebo for the last 4 weeks of pregnancy. Their babies then continued with the same study product daily from birth until 12 months of age. Bacterial counts and prevalence were assessed in maternal breast milk and faeces and infant faeces, using conventional cultivation methods.

RESULTS: The prevalence of L reuteri was higher during the first year of life in the stool samples from infants in the active as compared with the placebo-treated group. The highest prevalence was recorded at 5 to 6 days of age (82% in the treated vs 20% in the placebo group, P < 0.001). Lactobacillus reuteri was isolated from 12% and 2%, respectively, in the colostrum samples (P < 0.05). Breast-feeding seemed to reduce faecal L reuteri counts, although antibiotics did not influence the levels of L reuteri. The administration of L reuteri did not affect bifidobacteria or C difficile colonization.

CONCLUSION: Lactobacillus reuteri may be detected in breast milk after oral supplementation to the mother and in almost all infants after oral supplementation during the first year of life, as well as occasionally in many untreated infants.

Keywords
Bifidobacteria, Clostridium, Faeces, Probiotics, Lactobacillus reuteri
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20622 (URN)10.1097/MPG.0b013e31818f091b (DOI)19525871 (PubMedID)
Available from: 2009-09-15 Created: 2009-09-15 Last updated: 2009-09-27Bibliographically approved
Fagerås Böttcher, M., Abrahamsson, T. R., Fredriksson, M., Jakobsson, T. & Björkstén, B. (2008). Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 19(6), 497-504
Open this publication in new window or tab >>Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy
Show others...
2008 (English)In: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, ISSN 1399-3038, Vol. 19, no 6, p. 497-504Article in journal (Refereed) Published
Abstract [en]

The immunological composition of breast milk differs between mothers. The reasons for these differences and the consequences for the breast-fed infants are poorly understood. The aim of this study was to evaluate the effect of probiotic Lactobacillus reuteri supplementation on the immunological composition of breast milk in relation to sensitization and eczema in the babies. Total IgA, secretory IgA (SIgA), TGF-beta1, TGF-beta2, IL-10, TNF, soluble CD14 (sCD14), and Na/K ratios were analyzed in colostrum and mature milk obtained from women treated with L. reuteri (n = 54) or placebo (n = 55) from gestational week 36 until delivery. Bacteriological analyses of L. reuteri were performed in faecal samples of the mothers. The infants were followed prospectively for 2 yr regarding development of eczema and sensitization as defined by a positive skin prick test and/or circulating allergen-specific IgE antibodies at 6, 12, and 24 months of age. Supplementation of L. reuteri during pregnancy was associated with low levels of TGF-beta2 and slightly increased levels of IL-10 in colostrum. For TGF-beta2, this association was most pronounced in mothers with detectable L. reuteri in faeces. Infants receiving breast milk with low levels of TGF-beta2 were less likely to become sensitized during their first 2 yr of life. A similar trend was observed for development of IgE-associated eczema. The levels of total IgA, SIgA, TGF-beta1, TNF, sCD14, and Na/K ratios in breast milk were not affected by the intake of L. reuteri. None of these parameters correlated with sensitization or development of eczema in the infant, except for high Na/K ratios that associated with increased risk of sensitization. Supplementation with L. reuteri during late pregnancy reduces breast milk levels of TGF-beta2, and low levels of this cytokine are associated with less sensitization and possibly less IgE-associated eczema in breast-fed infants.

Keywords
Lactobacilli, breast milk, TGF-b, sensitization, infancy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20623 (URN)10.1111/j.1399-3038.2007.00687.x (DOI)18221472 (PubMedID)
Available from: 2009-09-15 Created: 2009-09-15 Last updated: 2009-09-27Bibliographically approved
Abrahamsson, T. R., Jakobsson, T., Böttcher, M. F., Fredrikson, M., Jenmalm, M. C., Björkstén, B. & Oldaeus, G. (2007). Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 119(5), 1174-1180
Open this publication in new window or tab >>Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial
Show others...
2007 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 119, no 5, p. 1174-1180Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: An altered microbial exposure may underlie the increase of allergic diseases in affluent societies. Probiotics may alleviate and even prevent eczema in infants.

OBJECTIVE: To prevent eczema and sensitization in infants with a family history of allergic disease by oral supplementation with the probiotic Lactobacillus reuteri.

METHODS: Double-blind, randomized, placebo-controlled trial, which comprised 232 families with allergic disease, of whom 188 completed the study. The mothers received L reuteri ATCC 55730 (1 x 10(8) colony forming units) daily from gestational week 36 until delivery. Their babies then continued with the same product from birth until 12 months of age and were followed up for another year. Primary outcome was allergic disease, with or without positive skin prick test or circulating IgE to food allergens.

RESULTS: The cumulative incidence of eczema was similar, 36% in the treated versus 34% in the placebo group. The L reuteri group had less IgE-associated eczema during the second year, 8% versus 20% (P = .02), however. Skin prick test reactivity was also less common in the treated than in the placebo group, significantly so for infants with mothers with allergies, 14% versus 31% (P = .02). Wheeze and other potentially allergic diseases were not affected.

CONCLUSION: Although a preventive effect of probiotics on infant eczema was not confirmed, the treated infants had less IgE-associated eczema at 2 years of age and therefore possibly run a reduced risk to develop later respiratory allergic disease. CLINICAL IMPLICATION: Probiotics may reduce the incidence of IgE-associated eczema in infancy.

Keywords
Children, eczema, IgE, Lactobacillus, prevention, probiotics, sensitization, skin prick test
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20580 (URN)10.1016/j.jaci.2007.01.007 (DOI)17349686 (PubMedID)
Available from: 2009-09-15 Created: 2009-09-15 Last updated: 2017-12-13Bibliographically approved
Rytkonen, J., Karttunen, T., Karttunen, R., Valkonen, K., Björkstén, B. & Kokkonen, J. (2004). BCG vaccine modulates intestinal and systemic response to ß-lactoglobulin. Pediatric Allergy and Immunology, 15(5), 408-414
Open this publication in new window or tab >>BCG vaccine modulates intestinal and systemic response to ß-lactoglobulin
Show others...
2004 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 15, no 5, p. 408-414Article in journal (Refereed) Published
Abstract [en]

ß-Lactoglobulin (BLG) is a clinically important antigen in cow's milk and one of the major allergens causing cow's milk allergy. Bacillus Calmette-Guérin (BCG) vaccination has been suggested to modify immune response possibly decreasing the risk of allergy to some antigens in both human and experimental animals. In the present study, we have analyzed whether the early BCG vaccination has any effect on the markers of systemic and gastrointestinal (GI) sensitization to BLG. We immunized two groups of Hooded-Lister rat puppets with intraperitoneal injections of native BLG at 43 and 62 days with pertussis vaccine as adjuvant, one group receiving additionally BCG. The animals were then fed native and denatured milk products twice weekly from 73 to 131 days of age, when they were killed. Control group was not vaccinated and received normal rat forage. Total immunoglobulin E (IgE) levels and BLG-specific IgG1 and IgG2a concentrations were determined in serum samples. Spontaneous interleukin (IL)-4 and interferon (IFN)-? production from duodenal specimens were measured, and the inflammatory cells were quantitated in specimens from different sections of the GI tract. Administration of BCG simultaneously with BLG resulted in reduced IgE concentration in serum, while the specific IgG1 and IgG2a antibody responses and the spontaneous secretion of IL-4 and IFN-? were not affected. Furthermore, BCG-induced eosinophilic infiltration and increase of intraepithelial lymphocytes (IEL) in the GI mucosa, and a trend toward increased number of lamina propria mononuclear inflammatory cells in the colon (BCG compared with BLG, p = 0.09, BCG compared with controls, p = 0.02). Controls showed increment of IgG1 response in comparison with the BLG group (p = 0.04) and increase of mucosal eosinophilic infiltration. The BCG modified the response to BLG both at the systemic level as shown by decrease of total IgE and at GI mucosa where increase of eosinophilic infiltration and increased number of IEL were seen. Increment of IgG1 level and eosinophils in the controls might be related with the lack of modulatory effect of pertussis vaccination. A shift of response toward the lower GI tract after BCG immunization as shown by a trend for increase of mononuclear inflammatory cells in colon lamina propria mimics disease development in some cases of clinical food allergy, and emphasizes the need for evaluation of the changes in the whole GI tract in food allergy models.

Keywords
ß-lactoglobulin, Bacillus Calmette-Guérin, Gastrointestinal inflammation, Immunoglobulin E, Milk
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-45619 (URN)10.1111/j.1399-3038.2004.00177.x (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Casas, R., Jenmalm, M. & Björkstén, B. (2004). Cat allergen-induced cytokine secretion and Fel d 1–immunoglobulin G immune complexes in cord blood. Clinical and Experimental Allergy, 34(4), 591-596
Open this publication in new window or tab >>Cat allergen-induced cytokine secretion and Fel d 1–immunoglobulin G immune complexes in cord blood
2004 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 34, no 4, p. 591-596Article in journal (Refereed) Published
Abstract [en]

Background We have recently obtained evidence for the presence of immune complexes (IC) in cord blood from allergic and non-allergic mothers. Such complexes could conceivably provide the fetus with the initial trigger for the priming of the T cell system already in utero.

Objective To relate the presence of Fel d 1–IgG IC to T cell cytokine production in cord blood mononuclear cells (CBMCs) after stimulation with cat allergen.

Methods CBMC obtained from babies of 15 allergic and 22 non-allergic mothers were cultured in the presence of cat allergen. The production of IFN-γ, IL-5, IL-10 and IL-13 was determined by ELISA. Furthermore, IgG1 and IgG4 antibodies to cat allergen in cord blood samples were measured by ELISA. A more sensitive ELISA was used to measure Fel d 1–IgG IC.

Results The prevalence and levels of IC were similar in cord blood from children of allergic and non-allergic mothers. The production of IL-5, IL-10. IL-13 and IFN-γ by CBMC was not influenced by maternal atopy, but IFN-γ was less commonly detected in samples with IC. There was no association between the presence of IC and any other cytokines. The levels of IgG1 and IgG4 antibodies were similar in both groups, and tended to be associated with the presence of IC.

Conclusion Immune complexes in cord blood may represent a normal mechanism for inducing primary immune responses, as the responses in babies from allergic and non-allergic mothers were largely similar. Low levels of IFN-γ seems to be related with the presence of IC in cord blood.

Keywords
allergen, cord blood, cytokine, Fel d 1, IgG, immune complex
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22341 (URN)10.1111/j.1365-2222.2004.1924.x (DOI)1542 (Local ID)1542 (Archive number)1542 (OAI)
Note
On the day of the defence day the status of this article was submitted.Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
Mai, X., Gäddlin, P.-O., Nilsson, L., Finnström, O., Björkstén, B., Jenmalm, M. C. & Leijon, I. (2003). Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study. Pediatric Allergy and Immunology, 14(3), 184-192
Open this publication in new window or tab >>Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study
Show others...
2003 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 14, no 3, p. 184-192Article in journal (Refereed) Published
Abstract [en]

We assessed the relationship between very low birth weight (VLBW) (≤1500 g) and the development of asthma, lung function and atopy. The study groups comprised 74 of all 86 (86%) VLBW and 64 of all 86 (74%) matched term children who were prospectively followed for 12 years. A questionnaire on asthmatic and allergic symptoms was completed and skin prick tests, spirometry and hypertonic saline provocation tests were performed at 12 years of age. Cytokine secretion was analysed in stimulated blood leukocyte cultures in 28 VLBW and 23 term children. A history of asthma was more frequent among the VLBW children, as compared with the term children at age 12 (22% vs. 9%, p = 0.046). Among the VLBW children, very preterm birth (gestational age: week 25 to 29) (RR 2.5, 95%CI 1.1–5.8), neonatal mechanical ventilation (RR 2.8, 95%CI 1.2–6.4) and neonatal oxygen supplementation (RR 4.3, 95%CI 1.3–14.0) were significantly associated with a history of asthma by the age of 12 years in univariate analyses. In multivariate logistic regression, neonatal oxygen supplementation ≥ 9 days was the only remaining significant risk factor for a history of asthma (adjusted OR 6.7, 95%CI 1.0–44). The VLBW children who required mechanical ventilation during the neonatal period were more likely to have bronchial hyperresponsiveness than those not requiring mechanical ventilation (60% vs. 28%, p = 0.050). The spirometric values were similar among the VLBW and the term children at 12 years. Very low birth weight was not significantly related to allergic rhinoconjunctivitis, eczema or positive skin prick tests. Furthermore, the levels of IL-4, IL-5 and IFN-γ in stimulated cell cultures were similar in the VLBW and the term children. A history of asthma by 12 years of age was twice as common among the VLBW as the term children, and neonatal oxygen supplementation seemed to be associated with the increased risk. Furthermore, mechanical ventilation during the neonatal period was associated with bronchial hyperresponsiveness at age 12. Very low birth weight per se was not, however, related to atopy.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26442 (URN)10.1034/j.1399-3038.2003.00045.x (DOI)10985 (Local ID)10985 (Archive number)10985 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Böttcher (Fagerås), M., Björkstén, B., Gustafson, S., Voor, T. & Jenmalm, M. C. (2003). Endotoxin levels in Estonian and Swedish house dust and atopy in infancy. Clinical and Experimental Allergy, 33(3), 295-300
Open this publication in new window or tab >>Endotoxin levels in Estonian and Swedish house dust and atopy in infancy
Show others...
2003 (English)In: Clinical and Experimental Allergy, ISSN 1365-2222, Vol. 33, no 3, p. 295-300Article in journal (Refereed) Published
Abstract [en]

Background Immune responses, including those to allergens, may be T helper (Th)2 skewed in newborns. In order to redress the fetal Th1/Th2 imbalance, Th1-stimulating factors, such as bacterial endotoxin, may be required. The increasing prevalence and severity of atopic diseases in industrialized countries, which are in marked contrast with the low prevalence of allergy among children in the formerly socialist countries of Europe, have been suggested to be caused by a reduced microbial stimulation.

Aim To relate the endotoxin levels in house dust from two countries with a low (Estonia) and a high (Sweden) prevalence of allergy to the development of atopic disease and sensitization in the children during the first 2 years of life.

Methods The study included 108 children from Tartu, Estonia and 111 children from Linköping, Sweden. Skin prick tests were performed at 3, 6, 12 and 24 months of age, and questionnaires were distributed to the families. At 24 months, a paediatrician examined the children. Dust samples were collected from mattresses and carpets and the endotoxin concentration was determined by a chromogenic Limulus assay.

Results The endotoxin levels were higher in Estonian than in Swedish house dust (median levels 29 (range 0.25–280) and 14 (range 0.25–99) EU/mg dust, respectively, P < 0.001). Furthermore, the levels were inversely related to the development of atopic disease and sensitization in the Swedish, but not in the Estonian, children.

Conclusions The low prevalence of atopic disease in Estonia may, at least in part, be related to the high endotoxin levels in this country. The findings support that high levels of endotoxin, or other bacterial products with Th1-stimulating properties, might protect children from developing atopic disease.

Keywords
atopy, childhood, endotoxin
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13204 (URN)10.1046/j.1365-2222.2003.01562.x (DOI)000181330600006 ()12614441 (PubMedID)
Available from: 2008-04-17 Created: 2008-04-17 Last updated: 2013-05-14
Mai, X., Nilsson, L., Axelson, O., Bråbäck, L., Sandin, A., Kjellman, M. & Björkstén, B. (2003). High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: phase II. Acta Paediatrica, 92(10), 1144-1148
Open this publication in new window or tab >>High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: phase II
Show others...
2003 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, no 10, p. 1144-1148Article in journal (Refereed) Published
Abstract [en]

Aim: To assess the relationship between high body mass index (BMI) and asthma and atopic manifestations in 12-y-old children.

Methods: The relationship between high BMI and asthma symptoms was studied in 457 sixth-grade children, with (n= 161) and without (n= 296) current wheeze. High BMI was defined as ±75th percentile of gender-specific BMI reference values for Swedish children at 12 y of age; overweight as a subgroup of high BMI was defined as ±95th percentile. Children with a BMI >75th percentile served as controls. Questionnaires were used to assess asthmatic and allergic symptoms, and bronchial hyperresponsiveness was assessed by hypertonic saline provocation tests.

Results: Current wheeze was associated with high BMI after adjustment for confounding factors (adjusted OR 1.7, 95% CI 1.0–2.5) and overweight had an even more pronounced effect (adjusted OR 1.9, 95% CI 1.0–3.6). In addition, asthma severity was associated with high BMI, as evaluated by the number of wheezing episodes during the previous 12 mo among the wheezing children (adjusted OR 2.0, 95% CI 1.0–4.0). There was also an association between high BMI and the presence of eczema in wheezing children (adjusted OR 2.2, 95% CI 1.0–4.6). However, high BMI was not significantly associated with hay fever, positive skin prick tests or bronchial hyperresponsiveness.

Conclusion: The study confirms and extends a previously observed relationship between BMI and the presence of wheezing and asthma.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26373 (URN)10.1080/08035250310005666 (DOI)10907 (Local ID)10907 (Archive number)10907 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Casas, R., Björkstén, B. & Jenmalm, M. (2002). Cat allergen induced cytokine secretion and Fel d 1-IgG immune complexes in cord blood. Journal of Allergy and Clinical Immunology, 109(1)
Open this publication in new window or tab >>Cat allergen induced cytokine secretion and Fel d 1-IgG immune complexes in cord blood
2002 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 109, no 1, p. 529-Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-48971 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Casas, R., Jenmalm, M. & Björkstén, B. (2002). Cat allergen induced cytokine secretion in relation with the detection of Fel d 1-IgG immune complexes in cord blood. Allergy. European Journal of Allergy and Clinical Immunology, 57
Open this publication in new window or tab >>Cat allergen induced cytokine secretion in relation with the detection of Fel d 1-IgG immune complexes in cord blood
2002 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 57, p. 135-135Conference paper, Published paper (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-48489 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Organisations

Search in DiVA

Show all publications