Probiotics: a novel approach in the management of food allergy

J Allergy Clin Immunol. 1997 Feb;99(2):179-85. doi: 10.1016/s0091-6749(97)70093-9.


Background: The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier. We have previously shown that a human intestinal floral strain, Lactobacillus GG (ATCC 53103), promotes local antigen-specific immune responses (particularly in the IgA class), prevents permeability defects, and confers controlled antigen absorption.

Objective: The aim of this study was to evaluate the clinical and immunologic effects of cow's milk elimination without (n = 14) and with (n = 13) the addition of Lactobacillus GG (5 x 10(8) colony-forming units/gm formula) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow's milk allergy. The second part of the study involved 10 breast-fed infants who had atopic eczema and cow's milk allergy. In this group Lactobacillus GG was given to nursing mothers.

Methods: The severity of atopic eczema was assessed by clinical scoring. The concentrations of fecal alpha 1- antitrypsin, tumor necrosis factor-alpha, and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention.

Results: The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG. The concentration of alpha 1-antitrypsin decreased significantly in this group (p = 0.03) but not in the group receiving the whey formula without Lactobacillus GG (p = 0.68). In parallel, the median (lower quartile to upper quartile) concentration of fecal tumor necrosis factor-alpha decreased significantly in this group, from 709 pg/gm (91 to 1131 pg/gm) to 34 pg/gm (19 to 103 pg/gm) (p = 0.003), but not in those receiving the extensively hydrolyzed whey formula only (p = 0.38). The concentration of fecal eosinophil cationic protein remained unaltered during therapy.

Conclusion: These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy, and by alleviating intestinal inflammation, may act as a useful tool in the treatment of food allergy.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Proteins / analysis
  • Breast Feeding
  • Dermatitis, Atopic / diet therapy*
  • Double-Blind Method
  • Eosinophil Granule Proteins
  • Feces / chemistry
  • Food Hypersensitivity / blood
  • Food Hypersensitivity / diet therapy*
  • Humans
  • Infant
  • Infant Food
  • Infant, Newborn
  • Inflammation / diet therapy
  • Intestines / immunology
  • Lactobacillus / growth & development
  • Lactobacillus / immunology
  • Lymphocyte Activation
  • Lymphocytes / immunology
  • Milk / adverse effects
  • Milk Hypersensitivity / blood
  • Milk Hypersensitivity / drug therapy
  • Radioallergosorbent Test
  • Ribonucleases*
  • Skin Tests
  • Tumor Necrosis Factor-alpha / analysis
  • alpha 1-Antitrypsin / analysis


  • Blood Proteins
  • Eosinophil Granule Proteins
  • Tumor Necrosis Factor-alpha
  • alpha 1-Antitrypsin
  • Ribonucleases