Yonago Acta medica 2010;53:37–45

Clinical Effects of Probiotic Bifidobacterium breve
Supplementation in Adult Patients with Atopic Dermatitis
Yuichi Yoshida, Taizo Seki*, Hiroshi Matsunaka*, Tessin Watanabe, Masahisa Shindo,
Nanako Yamada and Osamu Yamamoto
Division of Dermatology, Department of Medicine of Sensory and Motor Organs, School of Medicine,
Tottori University Faculty of Medicine, Yonago 683-8504 and *Research and Development, Tokiwa
Pharmaceutical, Kobe 650-8521, Japan

Probiotics (live microbial food supplements) have been shown to be effective in allergic
diseases, but the potential of probiotics for treatment of adult atopic dermatitis is not clear.
The effect of probiotic Bifidobacterium breve (B. breve) for atopic dermatitis was assessedin this study. A total of 24 patients were given either B. breve strain YY or a placebo for
8 weeks. Clinical severity was evaluated by using the severity scoring of atopic dermatitis
and quality of life was assessed by Skindex-29-J. In addition, blood and fecal samples weretaken before and after the study. The objective severity scoring for atopic dermatitis significantly improved in the probiotic group compared with the placebo group. In the qualityof life assessment, the total score showed significant improvement in the probiotic group.
The proportion of B. breve in intestinal microflora was increased in the probiotic group.
However, no significant change in thymus and activation-regulated chemokine (TARC/
CCL17), immunoglobulin E or the number of eosinophils was found. Our results suggestthat B. breve may be beneficial for the treatment of atopic dermatitis. However, since theseverity of disease symptoms in the placebo group at the beginning of the study was milder
than those in the probiotic group because the number of patients in the present pilot study
was relatively small, further study is needed to determine the clinical value of B. breve in
adult patients with atopic dermatitis.
Key words: allergy; Bifidobacterium; intestinal; probiotics; quality of life

self-control against causal and aggravating factors(Furue et al., 2009). In 80% of patients, symptoms
appear by the age of 5 and involve a genetic factor
known as “atopic disposition.” Recently, filaggrin
deficiency is thought to be the major risk factor for
AD sufferers (O’Regan et al., 2009). In addition todiminished barrier function, environmental factors
such as mites and house dust, perspiration, bacteria or fungi, contact antigens, stress and food havebeen indicated as causal and aggravating factors.
Physicians provide guidance regarding schemes

Atopic dermatitis (AD) is characterized by an itchyrash that often appears on the face and neck, in the
cubital fossa, and in the popliteal fossa, tending toflare up and spread throughout the body. Patientswith AD are also predisposed to other allergic
diseases, including bronchial asthma and allergic
rhinitis. The basic treatment regimen consists ofanti-inflammatory therapy focusing mainly on theuse of topical steroids appropriate to disease severity and prevention of relapse or recrudescence after
remission by placing an emphasis on skin care andAbbreviations: AD, atopic dermatitis; IgE, immunoglobulin E; LAB, lactic acid bacteria; QOL, quality of life; SCORAD,
severity scoring of atopic dermatitis; TARC, thymus and activation-regulated chemokine

37

Y. Yoshida et al.

and efforts to alleviate those factors in daily life.
Treatment does not aim at providing a complete
cure but rather at controlling the disease on a levelthat causes less of a hindrance to the patient indaily life.
From an epidemiological survey conducted
in 1989, Strachan proposed the so-called “hygiene
hypothesis” according to which “exposure to infections or unhygienic environments up to infancy
reduces the subsequent onset of allergic diseases”(Strachan, 1989). In fact, AD has been increasing
in developed countries. If, during infancy, someone is too clean and has too few opportunities tohave contact with bacteria and viruses, helper T
cells (Th cells) are not stimulated and, consequently, allergies increase. That theory is easy to understand and has been relatively accepted (Flöistrup etal., 2006).
Probiotics are defined as “living microorganisms and products containing microbial metabolites
which, in vivo, affect the normal intestinal bacterial flora by improving its balance, and which areconsequently biologically beneficial” (Fuller, 1989;
Salminen et al., 1998). A large number of lactic
acid-producing bacteria (such as Lactobacillus,Enterococcus, Streptococcus and Bifidobacterium)
are used as probiotics. Owing to their bactericidal
and antiproliferative effects against pathogens, they
primarily help regulate intestinal functions. Secondly, they also have a stimulating effect on immunity.
In 2001, in a double-blind study, Kalliomäki
et al. administered the lactic acid bacterium (LAB)
Lactobacillus rhamnosus (L. rhamnosus) to 159
pregnant women with an atopic disposition andtheir infants aged up to 6 months (Kalliomäki etal., 2001). At the age of 2 years, the incidence ofAD was significantly lower in the Lactobacillustreated group than in the placebo-treated group. Ina follow-up study, the frequency of AD was also
low at 4 years of age in the Lactobacillus-treatedgroup (Kalliomäki et al., 2003). In a double-blind
study, Kukkonen et al. administered 4 types of
encapsulated probiotics (L. rhamnosus GG and
LC705, Bifidobacterium breve (B. breve) and Pro-

pionibacterium freudenreichii ssp. Shermanii) to1,223 pregnant women with an atopic disposition.
To the newborns of those women, 0.8 g of galactooligosaccharide (a saccharide that helps the intestinal growth of LAB) or a placebo was added asa prebiotic and administered in addition to Lactobacillus for 6 months after birth (Kukkonen et al.,2008). At 2 years of age, the incidence of AD wassignificantly lower in the probiotics-treated groupthan in the placebo-treated group. Hattori et al. reported an elevation of the percentage of Bifidobacterium of the intestines and an improvement of cutaneous symptoms after administration of B. breve
to AD infants with low amounts of intestinal Bifidobacterium (Hattori et al., 2003). Intestinal flora
have a great influence on whether Th cells becomeTh1 or Th2 type cells. In hygienic environments,
administration of probiotics to pregnant womenand newborns promotes a healthy differentiation ofnaive T cells into Th1 cells during infancy and isconsidered useful in preventing and treating AD (Heet al., 2001).
Meanwhile, in adults who have passed beyond
the period of body growth and who no longer show
any major changes in the balance between Th1 andTh2 cells, improvement of AD symptoms by probiotics has been hitherto considered difficult (Leeet al., 2008). However, it has been reported that
Bifidobacterium is present in a significantly low
number in the intestinal flora of AD patients after
infancy (Suzuki et al., 2008). Among probiotics,
Lactobacillus is often used as fermented milk for
its excellent flavor. In Japan, a fermented milk
food has been developed based on live B. longum,
which has a high fixation ratio in the intestines ofadults and is excellent for regulation of the intestinal functions; its antiallergic effect is being studied(Xiao et al., 2007; Iwabuchi et al., 2009).
In the present study, B. breve was selected on
the basis of a report that this organism develops
dominantly in the intestines of healthy breast-fed
infants but is present in low numbers in the intestines of infants with AD, and because in addition
to its regulatory effect on intestinal function, its
immunoregulatory effect is potentially useful in38

Probiotics in adult patients with AD

adult patients with AD. Viable B. breve or placebo
capsules were administered to 24 adult patientswith AD in a double-blind manner. Disease severity was assessed using the severity scoring of
AD (SCORAD) (Kunz et al., 1997); intestinal
flora were examined through feces sampling, serum markers such as serum immunoglobulin E(IgE) and plasma thymus and activation-regulated
chemokine (TARC) levels were measured (Kakinuma et al., 2001), and skin-disease-specific quality of life (QOL) was evaluated exhaustively.

was replaced with a placebo powder. Test samples
were provided by Tokiwa Pharmaceutical, Kobe,
Japan).
The administered dose of B. breve was morethan 20 billion per day (2.0 × 1010 colony formingunit). Test sample A was formulated to containmore than 10 billion B. breve (1.0 × 1010 colony
forming unit) per capsule. The test samples wereingested as one capsule after breakfast and one
after dinner. The study period was 8 weeks.
Dermatologists rapidly examined subjects’ symptoms before study initiation and 8 weeks after its
completion. Severity was assessed on the basis of
SCORAD.
Fecal sampling was performed and intraintestinal bacterial flora was searched before study initiation and 8 weeks after its completion. Naturally
excreted feces collected by the subjects were immediately chilled under anaerobic conditions andbacterial flora was searched for within 24 h (Calpis,
Tokyo, Japan).
Blood collection was performed before study
initiation and 8 weeks after its completion; blood
markers including serum IgE, eosinophils andplasma TARC were examined (Mitsubishi Chemical Medience, Tokyo).
Skindex-29 is a measure using 29 items that
can help determine health-related QOL associatedwith skin disease (Chren et al., 1997). Before study
initiation and after its completion, the skin diseasespecific QOL questionnaire Skindex-29-J (Japaneseversion) was completed (Fukuhara, 2004).
Statistical analyses were conducted using
SPSS software (SPSS 12.0J for Windows, SPSS,
Chicago, IL). For an intergroup comparison between the B. breve-administered group and thecontrol group, Student’s t-test was performed forage, the chi-square test was performed for gender,
Mann-Whitney’s U test was performed for the
SCORAD, and the chi-square test was performed
among disease-severity-based subgroups. The correlation between the objective SCORAD and each
end-point (QOL according to the Skindex-29-J,
Bifidobacterium in the intestinal flora and blood
markers) was examined using Spearman’s rank

Subjects and Methods
The present study has been reviewed by the Ethical
Review Board of Tottori University Hospital, andwas conducted from January 2008 through May
2009 after being approved on April 11, 2007 (Approval Number: 841). Written voluntary agreement
was obtained after a full explanation was provided
to the subjects regarding research purposes andmethods, prospective benefits and risks, and they
understood that a lack of participation would not
result in any disadvantage, that consent could be
withdrawn at any time, and that their personal information would be protected.
Twenty-four adult patients (8 men, 16 women;mean age: 30.2 ± 9.6 years), diagnosed according
to the Guideline for Management of AD by theJapanese Dermatological Association (Furue etal., 2009), were selected as test subjects. During
the study, as a general rule, we decided to continueeach participant’s pre-study treatment regimen.
Test meals for 24 subjects were randomly allocated by the controller as follows: 16 subjects were
given test sample A containing B. breve (B. breveadministered group), and 8 subjects were given
test sample B containing a placebo (control group).
After sample allocation, the key code was kept by
the controller. The test was terminated once theprescribed number of participants was reached.
(Test sample A: capsules filled with a lyophilized
powder of live B. breve strain YY. Test sample B:
capsules in which the Test sample A constituent
39

Y. Yoshida et al.

Table 1. Correlation coefficient between evaluation items at baseline

istered group. The average age of the test subjects
was 30.2 years (range, 20–65 years). However, theaverage placebo group SCORAD score was 25.7
and the average B. breve-administered group SCORAD score was 41.0. Patients with high disease
severity were present in significantly large numbersin the B. breve-administered group. This is attributable to the fact that the study was not randomized
according to disease severity. All SCORAD values
in the B. breve-administered group decreased after
the study, and a statistically significant difference
was found in the objective SCORAD and in B
value, which is indicative of the extent of the rash
(Table 3). Meanwhile, the placebo group showedno change (Table 4).
At the beginning of the study, no difference
was found between instestinal flora in the feces of
the B. breve-administered group and that of theplacebo group. Since fecal sampling could not
be performed in one B. breve-administered groupsubject (for personal reasons), the subject was excluded; post-study analysis of the intestinal flora
was conducted in only 15 B. breve-administeredObjective SCORAD
rs
P value
Skindex-29-J
Bifidobacterium (log number)
Bifidobacterium (%)
Eosinophil
IgE (RIST)
TARC

0.547
–0.066–0.249
0.465
0.585
0.569

0.006**
0.758
0.241
0.022*
0.003**
0.004**

IgE, immunoglobulin E; TARC, thymus and activationregulated chemokine; RIST, radio-immunosorbent test;
rs, Spearman rank correlation coefficient; SCORAD,
severity scoring of atopic dermatitis.
* P < 0.05, **P < 0.01.

correlation coefficient. For comparison within eachgroup before initiation and after completion, theWilcoxon ranked sum test was used for SCORAD,
Skindex-29-J and enterobacteria search. Student’s
t-test was performed for blood tests.

Results
Regarding treatment circumstances, 18 patientsused topical preparations (17 used steroids, 7 concomitantly received internal tacrolimus and 1 used
Vaseline only) and 15 used orally administered
medicines (anti-histamines). During the study
period, as a general rule, no pre-study treatment
methods were changed.
We examined the relationships between theobjective SCORAD of all patients at study initiation and at each end-point (Table 1). Skindex-29-J,
number of eosinophils, total IgE levels and plasma
TARC levels showed significantly positive correlations to the objective SCORAD. In contrast,
Bifidobacterium in the intestinal flora showed nocorrelation in terms of logarithmic number or rateof colonization.
We compared the demographic attributesof the placebo and B. breve-administered groupsubjects (Table 2). There were no differences forgender or age between the 8 subjects in the placebogroup and the 16 subjects in the B. breve-admin-

Table 2. Demographics and clinical characteristics of the subjects at the study initiation
VariableAge (year)
Mean
Range
GenderNumber of males (%)
Number of females (%)
Race
Asian (%)
SCORAD
Total score
Objective SCORAD
Severity of AD‡
Mild, < 15.0
Moderate, 15.0–40
Severe, > 40.0

Placebo[n = 8]

B. breve[n = 16]

P value†

29.3
22 – 65

30.7
20 – 46

0.738

3 (37)
5 (63)

5 (31)
11 (69)

0.759

100		

100

25.7
21.8

41.0
33.7

0.027*
0.016*

1
7
0

1 		
9
6

0.133

AD, atopic dermatitis; B. breve, Bifidobacterium breve;
SCORAD, severity scoring of atopic dermatitis.
† Student’s t-test, chi square or Mann-Whitney’s U test;*P < 0.05.
‡ Severity of AD based on objective SCORAD.

40

Probiotics in adult patients with AD

Table 3. Change from baseline in the Bifidobacterium breve-administered group [n = 16]
Variable

Baseline
Mean ±SD

SCORAD

Total score41.0 ± 18.0
Objective SCORAD
33.7 ± 13.6
A: Extent criteria
28.3 ± 20.6
B: Intensity criteria
8.0 ±
2.9
C: Subjective symptoms
7.3 ±
5.9
Fecal microflora (log number) Total bacteria
10.36 ±
0.40‡
Bifidobacterium
8.89 ±
2.57‡
Clostridium lecithinase (+)
1.90 ±
2.29‡
Enterobacteriaceae
7.31 ±
1.25‡
Fecal microflora (%)
Bifidobacterium
22.11 ± 20.2‡
Clostridium lecithinase (+)
0.00 ±
0.00‡
Enterobacteriaceae
1.38 ±
3.13‡
Diagnostic marker
Plasma TARC (pg/mL)
760.8 ± 1356.3
Serum IgE (RIST) (IU/mL) 5694.6 ± 8087.0
Eosinophil (/µL)
528.8 ± 503.6
QOL
Skindex-29-J
40.0 ± 21.2
Emotions
42.7 ± 23.9
Symptoms
57.8 ± 25.8
Functioning
27.5 ± 21.1

Mean

Final
±
SD

35.3 ± 16.9
28.9 ± 14.0
25.5 ± 23.4
6.8 ±
3.0
6.3 ±
5.0
10.43 ±
0.45‡
9.79 ±
0.68‡
1.49 ±
2.05‡
7.33 ±
1.01‡
36.39 ± 27.28‡
0.00 ±
0.00‡
0.46 ±
0.66‡
511.7 ± 1099.2
5463.2 ± 8164.4
475.6 ± 426.1
30.4 ± 14.1
32.3 ± 16.2
44.6 ± 13.5
20.6 ± 15.6

P value†
0.109
0.034*
0.437
0.018*
0.861
0.362
0.060
0.208
0.834
0.031*
0.180
0.400
0.133
0.444
0.418
0.019*
0.030*
0.016*
0.087

QOL, quality of life; RIST, radio-immunosorbent test; SCORAD, severity scoring of atopic dermatitis; TARC, thymus
and activation-regulated chemokine.
† Wilcoxon signed rank test or Student’s t-test; *P < 0.05.
‡ n = 15.
Table 4. Change from baseline in the placebo group [n = 8]
Variable
SCORAD

Total score
Objective SCORAD
A: Extent criteria
B: Intensity criteria
C: Subjective symptoms
Fecal microflora (log number) Total bacteria
Bifidobacterium
Clostridium lecithinase (+)
Enterobacteriaceae
Fecal microflora (%)
Bifidobacterium
Clostridium lecithinase (+)
Enterobacteriaceae
Diagnostic marker
Plasma TARC (pg/mL)
Serum IgE (RIST) (IU/mL)
Eosinophil (/µL)
QOL
Skindex-29-J
Emotions
Symptoms
Functioning

Baseline
Mean ±
SD

Final
±
SD

P value†Mean

25.7 ±
6.6
21.8 ±
6.8
14.9 ± 13.6
5.4 ±
1.4
3.9 ±
2.0
10.53 ±
0.33
9.88 ±
0.53
1.48 ±
2.08
6.78 ±
1.33
29.93 ± 17.57
0.00 ±
0.00
0.21 ±
0.36
179.3 ± 281.6
699.4 ± 742.2
332.5 ± 364.1
27.8 ± 14.8
32.5 ± 21.3
39.7 ± 11.5
16.8 ± 16.0

26.1 ± 12.1
21.1 ±
9.3
13.6 ± 12.0
5.3 ±
2.1
5.0 ±
3.5
10.61 ±
0.46
9.88 ±
0.71
2.06 ±
2.58
7.29 ±
0.98
21.83 ± 13.43
0.00 ±
0.00
0.61 ±
1.36
292.3 ± 577.4
629.6 ± 605.0
336.3 ± 245.0
24.9 ±
17.1
30.9 ± 19.2
34.2 ± 19.1
14.6 ±
17.7

0.866
0.440
0.292
0.888
0.323
0.389
0.866
0.500
0.834
0.123
1.000
1.000
0.332
0.250
0.973
0.401
0.574
0.527
0.600

QOL, quality of life; RIST, radio-immunosorbent test; SCORAD, severity scoring of atopic dermatitis; TARC, thymus
and activation-regulated chemokine.
† Wilcoxon signed rank test or Student’s t-test.

41

Y. Yoshida et al.

group subjects (Table 3). The logarithmic numberof Bifidobacterium increased, and a remarkableand statistically significant increase in colonization
rate was seen (Table 3). Meanwhile, no change
was observed in intestinal flora of the control group(Table 4). On the other hand, no significant difference was found in blood variables after the study ineither group.
At study initiation, the Skindex-29-J score was
40.0 in the B. breve-administered group and 27.8
in the placebo group; likewise, there was also a
difference in the Skindex-29-J score (Tables 3 and
4). Overall Skindex-29-J values decreased significantly as a result of Bifidobacterium administration (Table 3). Among the measured Skindex-29-J
items (emotions, symptoms and functions), emotions and symptoms also significantly decreased.
Meanwhile, the Skindex-29-J of the placebo group
showed no change (Table 4).

intestinal bacterial flora in low-weight children(Akiyama et al., 1994).
Although prevention of AD by administration of probiotics to mothers and infants has already been reported (Kalliomäki et al., 2003),
most reports on the treatment of patients with AD
by probiotics were based on studies in infants. A
randomized double-blind crossover study of a combination of L. rhamnosus and L. reuteri in patientswith childhood AD (average 5.2 years of age) was
also reported (Rosenfeldt et al., 2003). Cutaneous
eruption size according to the SCORAD (A values)
decreased significantly in probiotic-administeredgroups. Meanwhile, only a few studies have confirmed the efficacy of probiotic administration in
adult AD patients. Roessler et al. recently reported
that SCORAD scores tended to improve after administration of L. paracasei and B. lactis to adultAD patients (Roessler et al., 2008). In addition,
an epidemiologic study reported that the numberof Bifidobacterium was significantly lower in AD
patients than in healthy subjects (Watanabe et al.,2003).
Therefore, in this study, we examined the efficacy of administration of live encapsulated B. breveto adult AD patients. Throughout the study period,
we found no exacerbation of allergic symptoms oradverse reactions (digestive symptoms) caused by
the administration of test meals, suggesting thatlive B. breve is safe for adult AD patients. In addition to a significant decrease in objective SCORAD
after administration of live B. breve, a significant
decrease of the extent of cutaneous eruption (Bvalue) was found as well as elevated Bifidobacterium colonization rate in feces. This also indicatesthat B. breve administration improves skin diseasespecific QOL of adult patients with AD. However,blood tests showed no significant difference in
TARC level, an AD blood variable. Overall, thepresent study suggests that administration of live B.
breve is a safe and useful adjuvant therapy for adultAD patients.
There are 2 types of Th cells: those that inhibit allergy (Th1 cells) and those that promoteallergy (Th2 cells). Allergies do not occur when

Discussion
In 1899, Bifidobacterium was isolated from thefeces of breast-fed children and was used as a probiotic for the first time (Tissier, 1899). While in themother’s womb, human beings live in an aseptic
environment, but by the 6th or 7th day after birth,
Bifidobacterium accounts for as much as 95% of
the enteric bacteria in infants’ intestines. Fromthen on, under the influence of various factors suchas age, eating habits and stress, Bifidobacterium
decreases to 15% in adults and < 1% in the elderly.
Generally, LAB produce lactic acid by degrading
sugar, but Bifidobacterium has strong bactericidal
activity in addition to producing acetic acid. Bifidobacterium regulates intestinal function but,unlike LAB, it cannot grow in the presence of oxygen; for that reason, it must be carefully processed.
The predominant types of Bifidobacterium
present in human intestines vary from B. brevein infants, B. longum in adults and B. adlescentis
in the elderly (Mitsuoka, 2005). Previous reports
have also mentioned administration of B. breve via
bottle-feeding to ensure the formation of normal
42

Probiotics in adult patients with ADparative study of 6 different types of Lactobacillus
with potential antiallergic properties was conducted
on oval albumin-sensitized BALB/c mice. As aresult, it was concluded that B. breve was the mostpromising probiotic (Hougee et al., 2010).
In adult AD patients, whose Th cells are
already mature, the improving effect of B. brevemight be difficult to explain in terms of Th1/Th2
balance alone. Recently, other T-helper cell subsetsthat differentiate from naive T cells have attracted
attention as clues to immunostimulatory activity
phenomena that cannot be explained by Th1/Th2
balance. Typical examples include regulatory T
cells, which release the immunodepressive cytokine
IL-10 (Sakaguchi, 2000), and Th17 cells, which
release the inflammatory cytokine IL-17 (Weaver
et al., 2006). Recent probiotic research has also reported that the LAB L. casei increases IL-10 secretion from regulatory T cells (Hacini-Rachinel et al.,2009) and that B. infantis has an inhibitory effecton Th17 (Tanabe et al., 2008). It might have been
through this kind of immunoregulatory effect thatB. breve improved adult AD symptoms.
In conclusion, we conducted a study ofB. breve administration on adult AD patients.
Through exhaustive evaluation of cutaneous symptom severity, intestinal flora detected in the feces,
blood allergy indicators, and patients’ psychological status (QOL), we found that cutaneous symptoms improved, the share of Bifidobacteria in thefeces increased significantly, and skin diseasespecific patient QOL improved significantly. The
above results suggest that administration of B.
breve might be a useful adjuvant therapy for adultAD. However, the severity of disease symptom inthe placebo group was milder than that in the probiotic group because the number of patients in thepresent pilot study was relatively small. We plan toperform further large study in order to determine
the definite clinical value of B. breve in adult patients with AD.

the balance between Th1 and Th2 is preserved, butwhen Th2 dominates, allergies occur easily. Neonatal T cells are naive but during an individual’s
period of growth, they gradually differentiate into
Th1 and Th2 cells. Production of Th1 cells isfacilitated by gram-positive bacteria, whereas production of Th2 cells is facilitated by gram-negative
bacteria (Takeuchi et al., 1999). In the differentiation process, dendritic cells are stimulated throughToll-like receptors (TLR, membrane protein receptors that activate intracellular transcription factors
such as NF- B) when molecules derived fromviruses or bacteria are present. The probiotic LAB
is a gram-positive bacterium that stimulates TLR2,
which recognizes peptidoglycans in gram-positivebacteria and causes the differentiation of naive T
cells into Th1 cells. In sterile environments where
TLR are not stimulated, naive T cells differentiate
into Th2 cells. In a clean environment, B. breveis thought to promote differentiation of naive T
cells to Th1 during infancy. In addition, stimulation with B. breve causes maturation of dendritic
cells and an increase of immunosuppressive IL10 through TLR2 (Hoarau et al., 2006). It is fromB. breve (the major portion of intestinal flora) that
healthy infants receive the stimulation required for
immune cell maturation during early childhood.
In contrast, it can be hypothesized that B. breve isabsent in children with AD, resulting in insufficient
stimulation.
In a double-blind, placebo-controlled trial using yogurt containing B. longum on adult patientswith pollen allergy, the B. longum-administeredgroup showed significant improvement of symptoms and significant inhibition of increased TARC
levels (Xiao et al., 2007; Iwabuchi et al., 2009).
Even in adults, Bifidobacterium is suggested to
improve the balance between Th1/Th2 when dominated by the Th1 side. In experiments conductedon mice orally administered B. breve, allergyinduced increases in IgE levels were inhibited, IL-4
was significantly inhibited, and, consequently, Th2cell proliferation was suppressed, suggesting thatthe balance between Th1/Th2 might have shifted to
the Th1 side (Inoue et al., 2009). Recently, a com-

Acknowledgments: We thank Professor Hiroshi Haginoof the School of Health Science in the Faculty of Medicine, whose cooperation has led to the accomplishment of
this study.

43

Y. Yoshida et al.

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Received March 1, 2010; accepted March 25, 2010
Corresponding author: Yuichi Yoshida, MD45

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