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Probiotics in the treatment and prevention of allergy in children 英文参考文献
ORIGINALARTICLE
ProbioticsintheTreatmentandPrevention
ofAllergyinChildren
ErkkiSavilahti,MD,KaarinaKukkonen,MD,andMikaelKuitunenMD,PhD
INTRODUCTION
hemarkedincreaseintheprevalenceofallergicdiseases
duringthepast50yearsisassociatedwiththedecreaseof
life-threatening infections during childhood and the postin-
dustrialchangesinlifestyle,characterizedbyahighstandard
ofhygieneandreducedexposuretomicrobesindailyenvi-
Abstract: Several fold increase in allergic diseases in developed,
T
high-income countries during recent decades is attributed to envi-
ronmental changes such as urbanization with improved hygiene.
This, together with conquering severe bacterial infections during
childhood,hasreducedthemicrobialstimulationofthedeveloping
immune system of infants. Studies on the pathogenesis of allergy
bothinmanandexperimentalanimalhaveshowntheimportanceof
commensal bacteria in the gastrointestinal tract in stimulating and
directingtheimmunesystem.Theinterestinmodulatingcommensal
bacterial ?ora with probiotics to prevent and treat allergy has
multipliedinrecentyears.
ronments.
1,2
Gerrardetalalreadyproposedinthe1970sthat
thisincreaseisthepricewehavetopayforbettersurvivalof
children,althoughthe“hygienehypothesis”wasformulated
by Strachan, who found fewer allergies in families with a
greater number of children. This led him to postulate that
infections protected them from allergy.
3,4
Epidemiologic
Inthepresentreviewwereportresultsonrandomized,controlled
studies in which childhood atopic eczema was treated or which
aimedtopreventdevelopmentofallergyduringchildhood.
Nine studies with 639 patients have looked at the effect of
probioticsintreatmentofeczema.While3studiedshowednoeffect,
otherstudiessuggestedamoderatebene?toftheuseofprobioticson
theseverityofeczema.Studiessuggestedthattheeffectmaybeseen
particularlyinpatientswithfoodallergyand/orsensitization.
Ninestudieshavereportedonthepreventionofallergyon6study
populationwithaltogether1989highriskinfants.Whiletheearlystudy
repor
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