Probiotics to young children with atopic dermatitis: a randomized placebo-controlled trial.

2007). The physical signs of the disease like itching eczema and pruritus can cause emotional stress and skin damage and thereby reduce the quality of life for the child, but also for the family (Levy, 2007). Local and anti-inflammatory treatment with corticosteroids is the current recommended treatment for infants with AD. Parents often fear side effects of the treatment and this may lead to non-compliance (Gustafsson et al., 2000). Therefore innovative treatment strategies with probiotics are of interest. Individuals with AD show elevated mucosal immunological responses and gastrointestinal inflammation which varies over time and impairment of the intestinal mucosal barrier appears to be strongly involved in the pathogenesis of AD. Studies suggest that probiotic supplementation stabilize the intestinal barrier function and decrease the gastrointestinal symptoms in children with AD (Rosenfeldt et al., 2003;Rosenfeldt et al., 2004). This means that the tendency to increased permeability of the intestinal mucosa which is observed in children with AD (Rokaite and Labanauskas, 2005), and possible leading to intestinal inflammation (Baumgart and Dignass, 2002), may be reduced by probiotic supplementation. The atopic march, referring to the increase in allergic diseases observed in high income societies, suggests that the change in lifestyle is a possible environmental cause that leads to the increasing number in incidence of AD (Kalliomaki et al., 2001). According to the ‘hygiene hypothesis’ the Western lifestyle has decreased the incidence of infections in early life and thereby lead to an undesirable effect on later development of allergies (Schaub et al., 2006). Influence of nutrition, use of antibiotics and maturation of the gut microbiota is included in the newest variety of the hygiene hypothesis (Noverr and Huffnagle, 2004;Schaub et al., 2006). Atopic dermatitis in infancy is believed to be associated with IgE-mediated food allergy, and studies have found a more pronounced beneficial effect of probiotics in the management of AD among children with a positive skin prick test and increased IgE levels (Rosenfeldt et al., 2003). ABSTRACT: Impairment of the intestinal mucosal barrier is involved in the pathogenesis of atopic dermatitis (AD), and studies suggest that probiotics stabilize the intestinal barrier function and decrease gastrointestinal symptoms in children with AD. The purpose of this study was to evaluate the clinical and immunological changes of AD after consumption of the probiotic strains Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07. Double-blind, randomized placebo-controlled intervention study. Fifty children (mean age 18 months) with AD received NCFM (1010 CFU/day), Bi-07 (1010 CFU/day) or placebo for 8 weeks. The immunological activity and clinical effect was evaluated by IgE, ECP, IL-10, IFN, IL-31, faecal calprotectin and SCORAD index. There were no overall beneficial effects of the probiotic strains on the degree of AD measured by SCORAD index. However, a post hoc analysis showed a significant reduction in severity of AD in the Bi-07 group and together with the decreasing levels of IFN-γ and IL-10 possible beneficial effects of this probiotic strain could be of interest. There was no effect on inflammatory markers or faecal calprotectin. The significant correlation between ECP and SCORAD index suggest the use of ECP as a measure of the degree of AD in children.