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Probiotic bacteria in the management of atopic disease: underscoring the importance of viability.

Abstract

OBJECTIVES

The aim of this study was to assess the efficacy of oral supplementation of viable and heat-inactivated probiotic bacteria in the management of atopic disease and to observe their effects on the composition of the gut microbiota.

METHODS

The study population included 35 infants with atopic eczema and allergy to cow's milk. At a mean age of 5.5 months, they were assigned in a randomized double-blind manner to receive either extensively hydrolyzed whey formula (placebo group) or the same formula supplemented with viable (viable LGG group) or heat-inactivated Lactobacillus GG (heat-inactivated LGG group), respectively. The changes in symptoms were assessed by the SCORAD method and the presence of some predominant bacterial genera in the feces detected with 16S rRNA-specific probes.

RESULTS

The treatment with heat-inactivated LGG was associated with adverse gastrointestinal symptoms and diarrhea. Consequently, the recruitment of patients was stopped after the pilot phase. Within the study population, atopic eczema and subjective symptoms were significantly alleviated in all the groups; the SCORAD scores (interquartile range) decreased from 13 (range, 4-29) to 8 (range, 0-29) units in the placebo group, from 19 (range, 4-47) to 5 (range, 0-18) units in the viable LGG group, and from 15 (range, 0-29) to 7 (range, 0-26) units in the heat-inactivated LGG group. The decrease in the SCORAD scores within the viable LGG group tended to be greater than within the placebo group. The treatments did not appear to affect the bacterial numbers within the genera enumerated.

CONCLUSIONS

Supplementation of infant formulas with viable but not heat-inactivated LGG is a potential approach for the management of atopic eczema and cow's milk allergy.

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  • Authors+Show Affiliations

    ,

    Department of Biochemistry and Food Chemistry, University of Turku, FIN-20014 Turku, Finland. pirkka.kirjavainen@utu.fi

    ,

    Source

    MeSH

    Administration, Oral
    Cohort Studies
    Dermatitis, Atopic
    Dietary Supplements
    Digestive System
    Double-Blind Method
    Feces
    Female
    Hot Temperature
    Humans
    Infant
    Infant Food
    Lactobacillus
    Male
    Milk Hypersensitivity
    Probiotics
    Severity of Illness Index
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12548058

    Citation

    Kirjavainen, Pirkka V., et al. "Probiotic Bacteria in the Management of Atopic Disease: Underscoring the Importance of Viability." Journal of Pediatric Gastroenterology and Nutrition, vol. 36, no. 2, 2003, pp. 223-7.
    Kirjavainen PV, Salminen SJ, Isolauri E. Probiotic bacteria in the management of atopic disease: underscoring the importance of viability. J Pediatr Gastroenterol Nutr. 2003;36(2):223-7.
    Kirjavainen, P. V., Salminen, S. J., & Isolauri, E. (2003). Probiotic bacteria in the management of atopic disease: underscoring the importance of viability. Journal of Pediatric Gastroenterology and Nutrition, 36(2), pp. 223-7.
    Kirjavainen PV, Salminen SJ, Isolauri E. Probiotic Bacteria in the Management of Atopic Disease: Underscoring the Importance of Viability. J Pediatr Gastroenterol Nutr. 2003;36(2):223-7. PubMed PMID: 12548058.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Probiotic bacteria in the management of atopic disease: underscoring the importance of viability. AU - Kirjavainen,Pirkka V, AU - Salminen,Seppo J, AU - Isolauri,Erika, PY - 2003/1/28/pubmed PY - 2003/6/21/medline PY - 2003/1/28/entrez SP - 223 EP - 7 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 36 IS - 2 N2 - OBJECTIVES: The aim of this study was to assess the efficacy of oral supplementation of viable and heat-inactivated probiotic bacteria in the management of atopic disease and to observe their effects on the composition of the gut microbiota. METHODS: The study population included 35 infants with atopic eczema and allergy to cow's milk. At a mean age of 5.5 months, they were assigned in a randomized double-blind manner to receive either extensively hydrolyzed whey formula (placebo group) or the same formula supplemented with viable (viable LGG group) or heat-inactivated Lactobacillus GG (heat-inactivated LGG group), respectively. The changes in symptoms were assessed by the SCORAD method and the presence of some predominant bacterial genera in the feces detected with 16S rRNA-specific probes. RESULTS: The treatment with heat-inactivated LGG was associated with adverse gastrointestinal symptoms and diarrhea. Consequently, the recruitment of patients was stopped after the pilot phase. Within the study population, atopic eczema and subjective symptoms were significantly alleviated in all the groups; the SCORAD scores (interquartile range) decreased from 13 (range, 4-29) to 8 (range, 0-29) units in the placebo group, from 19 (range, 4-47) to 5 (range, 0-18) units in the viable LGG group, and from 15 (range, 0-29) to 7 (range, 0-26) units in the heat-inactivated LGG group. The decrease in the SCORAD scores within the viable LGG group tended to be greater than within the placebo group. The treatments did not appear to affect the bacterial numbers within the genera enumerated. CONCLUSIONS: Supplementation of infant formulas with viable but not heat-inactivated LGG is a potential approach for the management of atopic eczema and cow's milk allergy. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/12548058/Probiotic_bacteria_in_the_management_of_atopic_disease:_underscoring_the_importance_of_viability_ L2 - http://Insights.ovid.com/pubmed?pmid=12548058 DB - PRIME DP - Unbound Medicine ER -