How probiotics can help to prevent and/or improve atopic eczema.
By Dr Georges Mouton
Dr Georges Mouton looks into the possibilities of preventing and alleviating eczema with probiotics and prebiotics.
More than ten years ago, a Finnish team from the University of Tampere was the first to suggest the use of probiotics in the management of allergic diseases such as eczema: “Probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy (…) by alleviating intestinal inflammation” [1]. In 2000, another Finnish team from the University of Turku recommended “Probiotics in the management of atopic eczema” as stated in their publication’s title [2].
The major publication in this field has appeared on April 7th 2001 in the Lancet [3]. “We gave Lactobacillus GG prenatally to mothers (…) and postnatally for 6 months to their infants. (…) The frequency of atopic eczema in the probiotic group was half that of the placebo group (23% versus 46%)” [3]. Very interestingly, this trial has been followed-up regularly since, i.e. when the children turned two years-old [4], four years-old [5], and seven years-old [6]. Striking results confirmed the long-term benefit: “We demonstrated here that the overall risk for developing eczema during the first 7 years of life was significantly decreased in the Lactobacillus GG group in accordance with our earlier findings with shorter follow-up” [6].
Besides this series of articles, several other studies supporting the administration of probiotics for alleviating atopic eczema have been published in major mainstream medical journals [7, 8], including a randomised controlled trial [9] and two double-blind placebo-controlled trials [10, 11]. In conclusion, “The first clinical trials with probiotics (…) in the treatment of atopic eczema have yielded encouraging results.
Experimental studies have found that probiotics exert strain-specific effects in the intestinal lumen, on epithelial cells and immune cells with anti-allergic potential” [12]. Multiple synergistic mechanisms are considered to explain such a favorable impact on skin atopic disease: “Degradation/structural modification of enteral antigens, normalization of the properties of aberrant indigenous microbiota and of gut barrier functions, regulation of the secretion of inflammatory mediators, and promotion of the development of the immune system”[13].
Dr Georges Mouton is a practitioner and lecturer of Functional Medicine, specializing in topics such as probiotics and essential fatty acids. He is the author of The methods of Doctor Mouton and The intestinal ecosystem and optimal health and is currently working on a book about dairy and gluten free diets. Born in Haiti to Belgian parents, currently living in Spain, and practising in Madrid, Brussels and London, Dr Georges Mouton’s efforts are internationally recognized as pioneering work in the domain of Functional Medicine.
1. Majamaa, H. and E. Isolauri, Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol, 1997. 99(2): p. 179-85.
2. Isolauri, E., et al., Probiotics in the management of atopic eczema. Clin Exp Allergy, 2000. 30(11): p. 1604-10.
3. Kalliomaki, M., et al., Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet, 2001. 357(9262): p. 1076-9.
4. Rautava, S., M. Kalliomaki, and E. Isolauri, Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. J Allergy Clin Immunol, 2002. 109(1): p. 119-21.
5. Kalliomaki, M., et al., Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet, 2003. 361(9372): p. 1869-71.
6. Kalliomaki, M., et al., Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. J Allergy Clin Immunol, 2007. 119(4): p. 1019-21.
7. Rosenfeldt, V., et al., Effect of probiotic Lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol, 2003. 111(2): p. 389-95.
8. Prescott, S.L., et al., Clinical effects of probiotics are associated with increased interferon-gamma responses in very young children with atopic dermatitis. Clin Exp Allergy, 2005. 35(12): p. 1557-64.
9. Weston, S., et al., Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child, 2005. 90(9): p. 892-7.
10. Viljanen, M., et al., Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Allergy, 2005. 60(4): p. 494-500.
11. Kukkonen, K., et al., Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol, 2007. 119(1): p. 192-8.
12. Kalliomaki, M.A. and E. Isolauri, Probiotics and down-regulation of the allergic response. Immunol Allergy Clin North Am, 2004. 24(4): p. 739-52, viii.
13. Isolauri, E., Dietary modification of atopic disease: Use of probiotics in the prevention of atopic dermatitis. Curr Allergy Asthma Rep, 2004. 4(4): p. 270-5.
