Probiotics in prevention and treatment of atopic eczema

One hypothesis for why some people develop atopic diseases, such as allergic rhinitis, asthma and atopic eczema, is that there are alterations in their intestinal microflora not seen in those without such conditions. This theory underlies the proposal that probiotics (orally administered micro-organisms) containing, for example, Lactobacillus and Bifidobacterium species, might help to prevent and treat atopic disorders by altering intestinal microflora (1).

• there is trail evidence to suggest that the probiotic Lactobacillus rhamnosus GG, when taken by a women during pregnancy and then either continued during breast-feeding or given to the baby, may help to prevent atopic eczema in children with a family history of atopy (2,3)
  • double-blinded, placebo-controlled study of 62 mother-infant pairs (2)
    • shown that administering probiotics to the pregnant and lactating mother increased the immunoprotective potential of breast milk, as assessed by the amount of anti-inflammatory transforming growth factor beta2 in the milk in mothers receiving probiotics vs in mothers receiving placebo
    • risk of developing atopic eczema during the first 2 years of life in infants whose mothers received probiotics was significantly reduced in comparison with that in infants whose mothers received placebo (15% and 47%, respectively; relative risk, 0.32 [95% CI, 0.12-0.85]; P =.0098)
  • follow-up study at 4 years (3)

Reference:

1. Drug and Therapeutics Bulletin (2005); 43(1): 6-8.
2. Rautava S et al. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. J Allergy Clin Immunol 2002; 109: 119-21.
3. Kalliomäki M et al. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 2003; 361: 1869-71