Журнал «Здоровье ребенка» 6 (49) 2013

Introduction.

The problem of cow's milk food allergies in children is highly important. Allergic diseases are widespread among children, including infants. Formation of intestinal microbiocenosis is occurring during the same time. There are some research data about the influence of probiotic on clinical course of atopic dermatitis.

Because we have the theoretical possibility to influence the clinical course of allergic diseases by correcting intestinal microbiocenosis in infants we have planned and carried out this study.

Aim of the study.

This open randomized clinical study evaluated the effect of Bifidobacterium lactis BB-12 (1х10⁹ CFU) and Streptococcus thermophilus TH-4 (1х10⁸ CFU) administration to infants with atopic dermatitis and cow's milk allergy.

Material and methods.

We conducted an open randomized prospective clinical study.

Sixty infants aged of 3-12 months with the diagnosis of atopic dermatitis and allergy to cow's milk protein were enrolled. They were randomly divided into 2 groups, one of which (n=30) received probiotic preparation during 4 weeks. Treatment effectiveness was evaluated after 4 and 8 weeks of the study.

Elimination diet.
All children were administered a standard elimination diet excluding cow's milk protein.

The statistical analysis was conducted with the use of software Statistica 8 (StatSoft Inc., 2008; USA). 

Results.

We found significant positive impact of probiotic treatment on reducing the SCORAD scores in infants with atopic dermatitis. Results were estimated with SCORAD scoring after 4 and 8 weeks of treatment. The difference in SCORAD scores between a visit 1 and a visit 3 in infants who in complex treatment received the probiotic strains was 44.05 (3.97) as compared with 38.94 (5.65) in the control group (р<0.05).

We found significant impact on reducing the frequency of constipation in the group of infants who received the probiotics in complex treatment. After 4 weeks of treatment constipation was absent in 85.71% infants who received probiotics as compared to 48.15% in the control group (р=0.02), after 8 weeks the same numbers were 92.86% vs. 62.96% accordingly (p=0.04). Significant differences between the groups were also determined by the incidences of infantile colic through 4 and 8 weeks and on diarrhea through 8 weeks of studies.

At the same time, after 8 weeks only 1 child (3.7%) in the control group who did not receive probiotics had obstructive bronchitis. There were no cases of obstructive bronchitis in infants who received probiotics but difference between the groups was not significant (p = 0.3).

Conclusions.

It is possible to draw a conclusion that 4 weeks administration of Bifidobacterium lactis BB-12 (1х10⁹ CFU) and Streptococcus thermophilus TH-4 (1х10⁸ CFU) to infants with atopic dermatitis and cow's milk allergy in addition to elimination diet and base treatment relieves clinical symptoms of atopic dermatitis and has little impact on the incidence of obstructive bronchitis and improves clinical symptoms of the disease and decreases gastrointestinal clinical manifestations of cow's milk allergy.