4919
document
Probiotics in the management of atopic eczema . BACKGROUND Over the last two decades the incidence of allergic diseases has increased in industrialized countries , and consequently new approaches have to be explored . OBJECTIVE The potential of probiotics to control allergic inflammation at an early age was assessed in a randomized double-blind placebo-controlled study . METHODS A total of 27 infants , mean age 4.6 months , who manifested atopic eczema during exclusive breast-feeding and who have had no exposure to any infant or substitute formula were weaned to probiotic-supplemented , Bifidobacterium lactis Bb-12 or Lactobacillus strain GG ( ATCC 53103 ) , extensively hydrolysed whey formulas or to the same formula without probiotics . The extent and severity of atopic eczema , the growth and nutrition of infants , and concentrations of circulating cytokines/chemokines and soluble cell surface adhesion molecules in serum and methyl-histamine and eosinophilic protein X in urine were determined . RESULTS The SCORAD score reflecting the extent and severity of atopic eczema was 16 ( 7-25 ) during breast-feeding , median ( interquartile range ) . After 2 months , a significant improvement in skin condition occurred in patients given probiotic-supplemented formulas , as compared to the unsupplemented group ; chi ( 2 ) = 12.27 , P = 0.002 . SCORAD decreased in the Bifidobacterium lactis Bb-12 group to 0 ( 0-3.8 ) , and in the Lactobacillus GG group to 1 ( 0.1-8.7 ) , vs unsupplemented 13.4 ( 4.5-18.2 ) , median ( interquartile range ) , in parallel with a reduction in the concentration of soluble CD4 in serum and eosinophilic protein X in urine . CONCLUSION The results provide the first clinical demonstration of specific probiotic strains modifying the changes related to allergic inflammation . The data further indicate that probiotics may counteract inflammatory responses beyond the intestinal milieu . The combined effects of these probiotic strains will guide infants through the weaning period , when sensitization to newly encountered antigens is initiated . The probiotic approach may thus offer a new direction in the search for future foods for allergy treatment and prevention strategies .
4920
Intervention_Pharmacological
Probiotics
4921
Intervention_Pharmacological
probiotic-supplemented
4922
Intervention_Pharmacological
Bifidobacterium lactis Bb-12
4923
Intervention_Pharmacological
Lactobacillus strain GG ( ATCC 53103 ) , extensively hydrolysed whey formulas
4924
Intervention_Control
same formula without probiotics
4925
Outcome_Physical
allergic inflammation
4926
Outcome_Physical
SCORAD score
4927
Outcome_Physical
extent and severity of atopic eczema
4928
Outcome_Physical
skin condition
4929
Outcome_Physical
SCORAD
4930
Outcome_Physical
CD4
4931
Outcome_Physical
allergic inflammation
4932
Outcome_Physical
inflammatory responses
4933
Participant_Condition
atopic eczema .
4934
Participant_Condition
allergic inflammation at an early age