THE ROLE OF PROBIOTIC SUPPLEMENTS IN THE TREATMENT OF ATOPIC DERMATITIS

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。食物过敏反应的一个基础是通过高通透性的肠粘膜摄取过敏原。据推测，乳酸杆菌GG通过封闭肠道桥粒，可以防止过敏原渗漏，从而改善食物过敏患者的特应性皮炎。将招募1-8岁的患有严重湿疹和多种食物过敏的儿童患者(总共24名可评估的患者进行研究)。特应性皮炎的严重程度将使用SCORAD指数进行测量。肠道通透性将通过高效液体蔗糖、乳果糖和甘露醇排泄量的测定来分析。患者将进行禁食，并按体重摄入甘露醇/乳果糖/蔗糖，随后进行5小时尿液采集，以确定各自的尿液排泄量。然后，患者将被随机分配到根据体重每天摄入GG乳杆菌或安慰剂六周，之后他们将在隔夜禁食后返回进行蔗糖/乳果糖/甘露醇重复摄入和尿液排泄评估。预计乳酸杆菌GG通过定植肠道菌群和促进内源性屏障机制，将被证明是治疗特应性皮炎的有效工具，该特应性皮炎具有食物过敏病因，肠道通透性的变化与临床特应性改善之间存在相关性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A basis of the allergic response to a food is uptake of allergens across hyperpermeable intestinal mucosa. It is hypothesized that lactobacillus GG, by sealing the desmosomes of bowel, will prevent allergen leakage, resulting in improvement of atopic dermatitis in patients with food allergies. Pediatric patients ages 1-8 (a total of 24 evaluable patients to be studied) with severe eczema and multiple food allergies will be recruited. Severity of atopic dermatitis will be measured using the SCORAD Index. Intestinal permeability will be analyzed by high performance liquid measurement of sucrose, lactulose and mannitol excretion. Patients will present fasting and consume a weight based volume of mannitol/lactulose/sucrose with a subsequent five hour urine collection for determination of urinary excretion of each. Patients will then be randomly assigned to either a weight based daily ingestion of lactobacillus GG or placebo for six weeks, afterwards they will return after overnight fasting for a repeat sucrose/lactulose/mannitol ingestion and urinary excretion evaluation. It is anticipated that lactobacillus GG, by colonizing bowel flora and promoting endogenous barrier mechanisms will prove to be a useful tool in treating atopic dermatitis that has a food allergy etiology and that a correlation will exist between changes in intestinal permeability and clinical improvement of atopy.