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Intestinal permeability and SCORAD of children with atopic dermatitis after six weeks supplementation of Lactobacillus rhamnosus GG (the pilot study)


Authors: L. Šofranková 1;  Ľ. Jakušová 1;  M. Kohútová 1;  L. Marušiaková 1;  O. Petrovičová 1;  M. Šimeková 2;  M. Kuchta 3
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta Univerzity Komenského, Univerzitná nemocnica, Martin prednosta prof. MUDr. P. Bánovčin, CSc. 1;  Ústav klinickej biochémie, Jesseniova lekárska fakulta Univerzity Komenského, Univerzitná nemocnica, Martin prednosta prof. MUDr. D. Dobrota, CSc. 2;  Klinika detí a dorastu UPJŠ LF a DFN, Košice prednostka doc. MUDr. I. Schusterová, PhD. 3
Published in: Čes-slov Pediat 2015; 70 (5): 273-280.
Category: Original Papers

Overview

Background:
Since there is an increasing number of allergic diseases these days, scientists are looking for new ways of prevention and treatment. Disturbed intestinal microflora which lost sufficient protective effect on intestinal barrier plays key role in the development of allergy. Allergic inflammation destroys tight junction and increses intestinal permeability. Adequate probiotic supplementiation renews microbial as well as other intestinal barriers and improves the symptoms of allergy.

Aim:
The objective of this prospective pilot study is to investigate the effects of administration of Lactobacillus rhamnosus GG on intestinal permeability and symptoms of atopic dermatitis in allergic children. Also it is to determine the differences in intestinal permeability in allergic and non-allergic children and to correlate these results with anamnestic data.

Materials and methods:
The pilot study has been conducted on 39 children (22 allergic and 17 healthy children) aged 3 months to 3 years to whom was performed lactulose-manitol intestinal permeability test, determinated lactulose-mannitol (L/M) ratio and completed paper form of basic anamnestic data . In the allergic group of children have been administered for 6 weeks probiotic drops containing Lactobacillus rhamnosus GG in an effective concentration 109 CFU. After 6 weeks the permeability test was performed again. In the allergic group was established score of atopic dermatitis (SCORAD) before and after administration of probiotics. The results were statistically analyzed and evaluated using nonparametric Mann-Whitney U-test and Wilcoxon rank test. Correlation analysis was performed by Spearman.

Results:
In the allergic group after six weeks of supplementation of Lactobacillus rhamnosus GG there has been significant decrease of L/M ratio (p<0.001) and SCORAD (p<0.05). There was a positive correlation between the L/M ratio and the clinical severity of eczema (p<0.05). There were not any significant differences among allergic and control group in delivery method, length of breast-feeding or introduction of non-milk based foods. In the allergic group 89.3% of children had positive family allergic history (in both parents 66.6%, in one parent 22.7%), and in the control group there was positive family history in 29.4% of children (only in one parent) (p<0.001).

Conculsions:
In our pilot study, we have confirmed the effect of Lactobacillus rhamnosus GG on reduction of intestinal permeability and improvement of the symptoms of atopic dermatitis. The question is whether these changes will persist after the withdrawal of probiotic supplementation.

Key words :
intestinal permeability, lactulose-mannitol (L/M) ratio, Lactobacillus rhamnosus GG (LRH 08), SCORAD, atopic dermatitis


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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