Probiotics: A novel approach in the management of food allergy☆,☆☆,★,★★
Section snippets
Patients and study design
In the first part of the study 31 infants, aged 2.5 to 15.7 months, fulfilling the Hanifin criteria18 for atopic eczema in infants, were evaluated. They had been referred to a pediatric clinic because of atopic eczema and a clinical history suggestive of cow's milk allergy. In addition to atopic eczema, gastrointestinal disturbances such as loose stools, vomiting, or diarrhea were seen in six (19%) patients. A positive family history of atopic diseases (asthma, atopic eczema, and allergic
Clinical data
The mean (95% CI) age at onset of symptoms of atopic eczema was 2.4 months (1.4 to 3.3 months) in patients in the first part of the study (n = 27). The durations of exclusive and total breast-feeding were 2.8 months (2.1 to 3.5 months) and 5.9 months (4.5 to 7.2 months), respectively. The mean (95% CI) serum total IgE was 31 kU/L (15 to 61 kU/L). RAST for cow's milk was positive (>0.4 kU/L) in 10 patients (37%). The result of skin prick test with cow's milk was positive in eight patients (30%).
Discussion
Antigen processing in the gut is associated with the generation of oral tolerance.25 There is evidence that during the process of absorption across the intestinal mucosa, antigens are subtly altered into tolerogenic form.26 Newborns lack many specific and nonspecific intestinal features that are necessary for protecting them from environmental antigens.1 In the immature gut, because of an immature mucosal barrier, antigen transfer in intact form is increased,27 an important prerequisite for the
Acknowledgements
We thank Ms. Marjo Leponiemi and Soili Mäkinen-Kiljunen, MSc, for their excellent assistance; Leena Metsäniitty, MSc, for providing extensively hydrolyzed whey formulas from Valio Ltd.; and Maija Saxelin, PhD, for the determinations of Lactobacillus GG concentrations in feces.
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Cited by (0)
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From the Medical School, University of Tampere and the Department of Pediatrics, Tampere University Hospital.
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Supported by the Academy of Finland, the Medical Research Fund of Tampere University Hospital, and the Finnish Foundation for Pediatric Research.
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Reprint requests: Erika Isolauri, MD, Medical School, University of Tampere, P.O. Box 607, 33101 Tampere, Finland.
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