title: Induction of inflammation as a possible mechanism of probiotic effect in atopic eczema-dermatitis syndrome.
abstract: BACKGROUND
  The immunomodulating mechanisms of Lactobacillus GG (LGG) and other probiotics are poorly understood.
  
  
  OBJECTIVE
  We studied in vivo the immunologic effects of probiotics in infants with atopic eczema-dermatitis syndrome (AEDS) and cow's milk allergy (CMA).
  
  
  METHODS
  Two hundred thirty infants with AEDS and suspected CMA received, concomitant with elimination diet, either LGG, a mixture of 4 probiotic strains (MIX), or placebo for 4 weeks. All available paired pretreatment and posttreatment plasma samples (n = 132) were analyzed for concentrations of IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma, soluble intercellular adhesion molecule 1, soluble E-selectin, TGF-beta1, TGF-beta2, and C-reactive protein.
  
  
  RESULTS
  In infants with IgE-associated AEDS, treatment with LGG induced higher C-reactive protein levels than in the placebo group (geometric mean, 0.83 microg/mL [95% CI, 0.56-0.81] vs 0.42 microg/mL [95% CI, 0.27-0.65]; P = .021). Concomitantly, IL-6 levels increased after treatment with LGG ( P = .023) but not with MIX or placebo. Soluble E-selectin levels were higher after probiotic than after placebo treatment in infants with IgE-mediated CMA (LGG geometric mean, 86.7 ng/mL [95% CI, 75.2-100]; MIX geometric mean, 91.6 ng/mL [95% CI, 74.8-111.9]; and placebo geometric mean, 64.9 ng/mL [95% CI, 53-79.3]; analysis of covariance, P = .035; LGG vs placebo, P = .023; MIX vs placebo, P = .020). Use of MIX induced an increase in plasma IL-10 levels ( P = .016).
  
  
  CONCLUSIONS
  Probiotics induced systemically detectable low-grade inflammation, which might explain the clinical effects of probiotics in AEDS and CMA.
authors.affiliation: Skin and Allergy Hospital, University of Helsinki, Meilahdentie 2, 00250 Helsinki, Finland. mirva.viljanen@hus.fi
authors.forename: Mirva
authors.initials: M
authors.lastname: Viljanen
authors.forename: Emma
authors.initials: E
authors.lastname: Pohjavuori
authors.forename: Tari
authors.initials: T
authors.lastname: Haahtela
authors.forename: Riitta
authors.initials: R
authors.lastname: Korpela
authors.forename: Mikael
authors.initials: M
authors.lastname: Kuitunen
authors.forename: Annikki
authors.initials: A
authors.lastname: Sarnesto
authors.forename: Outi
authors.initials: O
authors.lastname: Vaarala
authors.forename: Erkki
authors.initials: E
authors.lastname: Savilahti
mesh_terms: D000818:Animals; D002097:C-Reactive Protein / Q000032:analysis*; D003876:Dermatitis, Atopic / Q000209:etiology / Q000276:immunology* / Q000628:therapy*; D004311:Double-Blind Method; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000032:analysis* / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007778:Lactobacillus; D008297:Male; D016269:Milk Hypersensitivity / Q000209:etiology / Q000628:therapy*; D019936:Probiotics / Q000627:therapeutic use*
chemical_list: D019040:E-Selectin; D018836:Inflammation Mediators; D015850:Interleukin-6; D002097:C-Reactive Protein