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Probiotics in the management of atopic eczema
E Isolauri1, T Arvola, Y Sütas
1Department of Paediatrics, University of Turku, Finland.
Insights
Specific probiotic strains, Bifidobacterium lactis Bb-12 and Lactobacillus GG, significantly improved atopic eczema in infants. These probiotics may offer a new strategy for allergy prevention and treatment by modulating inflammatory responses.
Area of Science:
- Pediatric Allergy and Immunology
- Microbiome Research
- Nutritional Immunology
Background:
- Rising incidence of allergic diseases in industrialized nations necessitates novel therapeutic approaches.
- Early-life interventions are crucial for managing and preventing allergic conditions.
Purpose of the Study:
- To evaluate the efficacy of specific probiotic strains in controlling allergic inflammation in infants.
- To assess the impact of Bifidobacterium lactis Bb-12 and Lactobacillus GG on atopic eczema.
Main Methods:
- A randomized double-blind placebo-controlled study involving 27 infants with atopic eczema.
- Infants were weaned onto extensively hydrolyzed whey formulas supplemented with either Bifidobacterium lactis Bb-12 or Lactobacillus GG, or unsupplemented formulas.
- Key outcome measures included SCORAD scores, growth parameters, and specific biomarkers of inflammation.
Main Results:
- Probiotic-supplemented formulas led to a significant improvement in atopic eczema severity (SCORAD scores).
- SCORAD scores decreased substantially in infants receiving Bifidobacterium lactis Bb-12 and Lactobacillus GG compared to the unsupplemented group.
- Reductions in soluble CD4 and eosinophilic protein X were observed, indicating modulation of inflammatory pathways.
Conclusions:
- This study provides the first clinical evidence that specific probiotic strains can modify allergic inflammation.
- Probiotics may exert anti-inflammatory effects beyond the gut, influencing systemic immune responses.
- These findings suggest probiotics as a promising strategy for allergy prevention and treatment during the critical weaning period.
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.