-Linolenic acid supplementation for prophylaxis of atopic dermatitis—a randomized controlled trial in infants at high familial risk1–3

Background: Studies suggest that low concentrations of n–6 long-chain polyenes in early life are correlated to atopic disease in later life. Objective: The purpose of the study was to investigate the possible preventive effect of -linolenic acid (GLA) supplementation on the development of atopic dermatitis in infants at risk. Design: In a double-blind, randomized, placebo-controlled trial, formula-fed infants (n = 118) with a maternal history of atopic disease received borage oil supplement (containing 100 mg GLA) or sunflower oil supplement as a placebo daily for the first 6 mo of life. Main outcome measures were the incidence of atopic dermatitis in the first year of life (by UK Working Party criteria), the severity of atopic dermatitis (SCORing Atopic Dermatitis; SCORAD), and the total serum immunoglobulin E (IgE) concentration at the age of 1 y. Results: The intention-to-treat analysis showed a favorable trend for severity of atopic dermatitis associated with GLA supplementation (x– ± SD SCORAD: 6.32 ± 5.32) in the GLA-supplemented group as compared with 8.28 ± 6.54 in the placebo group (P = 0.09; P = 0.06 after adjustment for total serum IgE at baseline, age 1 wk), but no significant effects on the other atopic outcomes. The increase in GLA concentrations in plasma phospholipids between baseline and 3 mo was negatively associated with the severity of atopic dermatitis at 1 y (Spearman’s correlation coefficient = 0.233, P = 0.013). There was no significant effect on total serum IgE concentration. Conclusion: Early supplementation with GLA in children at high familial risk does not prevent the expression of atopy as reflected by total serum IgE, but it tends to alleviate the severity of atopic dermatitis in later infancy in these children. Am J Clin Nutr 2003;77:943–51.