Induction of inflammation as a possible mechanism of probiotic effect in atopic eczema-dermatitis syndrome.
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.
Viljanen
Mirva
M
Skin and Allergy Hospital, University of Helsinki, Meilahdentie 2, 00250 Helsinki, Finland. mirva.viljanen@hus.fi
Pohjavuori
Emma
E
Haahtela
Tari
T
Korpela
Riitta
R
Kuitunen
Mikael
M
Sarnesto
Annikki
A
Vaarala
Outi
O
Savilahti
Erkki
E
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*
D019040:E-Selectin; D018836:Inflammation Mediators; D015850:Interleukin-6; D002097:C-Reactive Protein