Probiotics: A novel approach in the management of food allergy
Probiotics: A novel approach in the management of food allergy
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DOI：
10.1016/s0091-6749(97)70093-9
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发表时间：
1997-02-01
影响因子：
14.2
通讯作者：
Isolauri, E
中科院分区：
文献类型：
--
作者：
Majamaa, H;Isolauri, E
背景：胃肠道微生物区系是肠道黏膜防御屏障的重要组成部分。我们先前已经证明，人类肠道中的一株乳杆菌GG(Atcc 53103)能促进局部抗原特异性免疫反应(特别是在免疫球蛋白A类)，防止通透性缺陷，并提供受控的抗原吸收。目的：本研究的目的是评估在特应性湿疹和牛奶过敏的婴儿中不添加乳杆菌GG(5×10(8)个菌落形成单位/克配方)和(n=13)添加乳杆菌GG(5×10(8)个菌落形成单位/克配方)消除牛奶的临床和免疫学效果。研究的第二部分涉及10名患有特应性湿疹和牛奶过敏的母乳喂养婴儿。其中乳酸菌GG用于哺乳母亲。方法：通过临床评分评估特应性湿疹的严重程度。在饮食干预前后测定粪便α(1)-抗胰蛋白酶、肿瘤坏死因子-α和嗜酸性粒细胞阳离子蛋白的浓度作为肠道炎症的标志。结果：在1个月的研究期间，特应性皮炎的临床评分显著改善，用乳杆菌GG强化的广谱乳清配方治疗。α(1)-抗胰蛋白酶浓度在这组中显著降低(p=0.03)，但在接受不含乳杆菌GG的乳清配方组中没有显著降低(p=0.68)。同时，这组患者的粪便肿瘤坏死因子-α浓度中位数(从下四分位到上四分位)显著降低，从709pg/gm(91至1131pg/gm)降至34pg/gm(19至103pg/gm)(p=0.003)，但只接受广泛水解乳清配方的患者没有下降(p=0.38)。结论：益生菌可能促进特应性皮炎和食物过敏患者的内源性屏障机制，并通过减轻肠道炎症，可能成为治疗食物过敏的有用工具。
Background: The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier. We have previously shown that a human intestinal floral strain Lactobacillus GG (ATCC 53103), promotes local antigen-specific immune responses (particularly in the IgA class), prevents permeability defects, and confers controlled antigen absorption.Objective: The aim of this study was to evaluate the clinical and immunologic effects of cow's milk elimination without (n = 14) and with (n = 13) the addition of Lactobacillus GG (5 X 10(8) colony-forming units/gm formula) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow's milk allergy. The second part of the study involved 10 breast-fed infants who had atopic eczema and cow's milk allergy. In this group Lactobacillus GG was given to nursing mothers.Methods: The severity of atopic eczema was assessed by clinical scoring. The concentrations of fecal alpha(1)-antitrypsin, tumor necrosis factor-alpha, and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention.Results: The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG. The concentration of alpha(1)-antitrypsin decreased significantly in this group (p = 0.03) but not in the group receiving the whey formula without Lactobacillus GG (p = 0.68). In parallel, the median (lower quartile to upper quartile) concentration of fecal tumor necrosis factor-alpha decreased significantly in this group, from 709 pg/gm (91 to 1131 pg/gm) to 34 pg/gm (19 to 103 pg/gm) (p = 0.003), but not in those receiving the extensively hydrolyzed whey formula only (p = 0.38). The concentration of fecal eosinophil cationic protein remained unaltered during therapy.Conclusion: These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy, and by alleviating intestinal inflammation, may act as a useful tool in the treatment of food allergy.