Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis.
OBJECTIVE
To determine whether probiotic lactobacilli may alleviate small intestinal inflammation and strengthen the intestinal barrier function in children with atopic dermatitis.


METHODS
In a double-blinded, placebo-controlled, cross-over study, probiotic lactobacilli (Lactobacillus rhamnosus 19070-2 and L reuteri DSM 12246) were administered for 6 weeks to 41 children with moderate and severe atopic dermatitis. Gastrointestinal symptoms were registered before and during treatment and small intestinal permeability was measured by the lactulose-mannitol test.


RESULTS
During Lactobacillus supplementation, there was a significant decrease in the frequency of gastrointestinal symptoms (39% during the placebo period versus 10% during active treatment, P=.002). There was a positive association between the lactulose to mannitol ratio and the severity of the eczema (r=0.61, P=.02 after placebo and r=0.53, P=.05 after active treatment). After probiotic treatment, the lactulose to mannitol ratio was lower (0.073) than after placebo (0.110, P=.001).


CONCLUSIONS
Impairment of the intestinal mucosal barrier appears to be involved in the pathogenesis of atopic dermatitis. The study suggests that probiotic supplementation may stabilize the intestinal barrier function and decrease gastrointestinal symptoms in children with atopic dermatitis.
Rosenfeldt
Vibeke
V
Department of Human Nutrition, The Royal Veterinary and Agricultural University, Germany. Vrosenfeldt@dadlnet.dk
Benfeldt
Eva
E
Valerius
Niels Henrik
NH
Paerregaard
Anders
A
Michaelsen
Kim Fleischer
KF
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003876:Dermatitis, Atopic / Q000150:complications / Q000378:metabolism*; D004311:Double-Blind Method; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000378:metabolism*; D007778:Lactobacillus; D010539:Permeability; D019936:Probiotics / Q000627:therapeutic use*