Chemistry Reference
In-Depth Information
natural killer cell activity, macrophage activation, and phagocytosis. There are also
responses of the adaptive immune system like an increase in IgA-, IgG-, and IgM-
secreting cells, an increase in total and specific secretory IgA in serum and intestinal
lumen, and modulation of inflammatory gut responses.
193
Most clinical benefits in
infants are reported on prevention and treatment of allergy and infections, which are
described in more detail in the next two sections.
15.4.3.3.1 Allergy
The incidence and prevalence of allergic diseases in many western countries have
increased during the past 40 to 50 years. It is estimated that around 20 percent of the
population in Western countries suffers from some form of allergy. Development of
asthma and other allergic diseases is strongly influenced by genetic components but
studies suggest that environmental factors through a decreased immune stimulation
also play an important role.
194,195
The concept of probiotics as a possible means for
antiallergic therapy emerged out of indirect evidence linking the composition of the
intestinal microbiota and the incidence rate of allergies in several studies.
133,134,196 -202
Björksten and colleagues compared infants from Sweden, a country with a high
prevalence of allergies, with infants from Estonia, a country with a low prevalence
of allergies. In these studies it was found that allergic infants in both Estonia and
Sweden were less often colonized with lactobacilli and bifidobacteria, whereas they
were more often colonized with aerobic pathogenic microorganisms.
132,196
A reduced
level of bifidobacteria in infants with atopic dermatitis was also reported in children
in Japan.
134
Moreover, the reduced level of bifidobacteria has been shown to precede
the development of the atopic disease in infants from Finland.
202-204
The composition
of bifidobacteria in allergic infants has been reported to be more adultlike with more
B. adolescentis
, whereas in healthy infants,
B. bifidum, B. infantis,
and
B. breve
predominated.
133,198
A limited number of probiotic strains were tested for their efficacy in treatment
and prevention of allergy in infants. A standard scoring system for SCORing Atopic
Dermatitis (SCORAD) as developed by the European task force for atopic dermatitis
is applied in most clinical trials.
143
In a small trial (
n
= 27) the addition of
B. animalis
subsp
. lactis
BB-12 or
L. rhamnosus
GG was found to reduce SCORAD (
p
= 0.01)
in a group of infants who manifested atopic eczema during breastfeeding.
206
Other
clinical trials on treatment of allergy using LGG showed a trend in decrease on
SCORAD (
n
= 43)
170
or no effects on SCORAD (
n
= 50).
200,201
LGG was effective in
prevention of early atopic disease in infants at high risk (
n
= 132); the frequency of
atopic eczema in the LGG group was half that of the placebo group (
p
= 0.008).
197
In
this study, mothers were prenatally administrated with LGG capsules in addition to
administration of LGG to their infants up to an age of 6 months. It was suggested that
probiotic bacteria increased the immunoprotective potential of breast milk as shown
by the increase of transforming growth factor (TGF)-β2 in the milk of mothers
receiving LGG.
203
The preventive effect extended to the age of 4 years.
20
The study
cohort was also reexamined after 7 years showing that the overall risk for develop-
ing eczema during the first 7 years of life was significantly decreased.
206
However,
