title: Probiotic bacteria in the management of atopic disease: underscoring the importance of viability.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of oral supplementation of viable and heat-inactivated probiotic bacteria in the management of atopic disease and to observe their effects on the composition of the gut microbiota.
  
  
  METHODS
  The study population included 35 infants with atopic eczema and allergy to cow's milk. At a mean age of 5.5 months, they were assigned in a randomized double-blind manner to receive either extensively hydrolyzed whey formula (placebo group) or the same formula supplemented with viable (viable LGG group) or heat-inactivated Lactobacillus GG (heat-inactivated LGG group), respectively. The changes in symptoms were assessed by the SCORAD method and the presence of some predominant bacterial genera in the feces detected with 16S rRNA-specific probes.
  
  
  RESULTS
  The treatment with heat-inactivated LGG was associated with adverse gastrointestinal symptoms and diarrhea. Consequently, the recruitment of patients was stopped after the pilot phase. Within the study population, atopic eczema and subjective symptoms were significantly alleviated in all the groups; the SCORAD scores (interquartile range) decreased from 13 (range, 4-29) to 8 (range, 0-29) units in the placebo group, from 19 (range, 4-47) to 5 (range, 0-18) units in the viable LGG group, and from 15 (range, 0-29) to 7 (range, 0-26) units in the heat-inactivated LGG group. The decrease in the SCORAD scores within the viable LGG group tended to be greater than within the placebo group. The treatments did not appear to affect the bacterial numbers within the genera enumerated.
  
  
  CONCLUSIONS
  Supplementation of infant formulas with viable but not heat-inactivated LGG is a potential approach for the management of atopic eczema and cow's milk allergy.
authors.affiliation: Department of Biochemistry and Food Chemistry, University of Turku, FIN-20014 Turku, Finland. pirkka.kirjavainen@utu.fi
authors.forename: Pirkka V
authors.initials: PV
authors.lastname: Kirjavainen
authors.forename: Seppo J
authors.initials: SJ
authors.lastname: Salminen
authors.forename: Erika
authors.initials: E
authors.lastname: Isolauri
mesh_terms: D000284:Administration, Oral; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000628:therapy*; D019587:Dietary Supplements; D004064:Digestive System / Q000382:microbiology*; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007225:Infant Food; D007778:Lactobacillus / Q000276:immunology / Q000502:physiology*; D008297:Male; D016269:Milk Hypersensitivity / Q000628:therapy*; D019936:Probiotics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome