Probiotics Reduce Prevalence of Eczema

by | Aug 24, 2017 | 2014, Infant and Children's Health, Probiotics, Skin Health

Written by Joyce Smith, BS. Genotyping a cohort of children at high risk for eczema revealed that supplementing with Lactobacillus rhamnosus HN001 was more effective in modifying gene susceptibility to eczema than supplementing with Bifidobacterium animalis subsp lactis HN019.

skin healthEczema is a skin disease characterized by puritis, erythema, and edema that affects 15-30% of children, and where a strong genetic predisposition exists, the risk of eczema doubles and even triples 1. There are many non-genetic risk factors for eczema which include socioeconomic status and environment; 2,3 however, a very important risk factor for childhood eczema is the gut microflora 4. Many factors influence a child’s ability to acquire a healthy gut. Noteworthy among them are the health of the existing microflora, the diet and medications of the pregnant mother, a cesarean or vaginal birth, antibiotics, and very importantly, breast feeding. Lack of bacterial diversity due to any one of these risk factors may contribute to an altered immune function and allergic manifestations such as eczema.5

Wickers et al 2013, using a double-blind, randomized, placebo-controlled trial and a high–risk birth cohort, demonstrated that the probiotic, Lactobacillus rhamnosus HN001 (HN001) (6 x 109 cfu/day) was effective in preventing the development of eczema and possibly atopic sensitization in high risk infants up to 6 years of age. Mothers supplemented daily with either HN001 (6 x 109 cfu/day), HN019 (9 x 109 cfu/day) or placebo from 35 weeks gestation until birth and continuing to 6 months after birth in mothers if breastfeeding, and from birth until 2 years in all infants. Researchers found that the probiotic HN001 provided statistically significant protection of 40% against eczema development at age 2, 4 6,7 and 6 years and had an effect on atopic sensitization which became significant by age 6 years 8. These effects were not evident with Bifidobacterium animalis subsp lactis HN019 (HN019) (9 x 109 cfu/day) supplementation, suggesting that the benefits of probiotic supplementation may be species– specific.

In this present study, using the same high–risk birth cohort with a history of allergic disease, Morgan et al 2014 9 explored whether probiotics could modify the genetic predisposition to eczema and atopic sensitization conferred by genetic variation in susceptibility genes. Using buccal swabs, DNA was collected from children at 4 and 6 years of age and extracted by means of a Qingen’s DNA extraction kit. The genetic data along with other data from 331 children of parental-reported sole European ancestry were used in this study. Researchers selected those genes that were susceptible to eczema and genotyped data for 26 genetic variants called single-nucleotide polymorphisms (SNPs) which were all analyzed for their potential association with eczema, SCORAD > 10 and atopy (a genetic tendency to develop eczema), and interactions with the probiotics HNOO1 and HN019.

SCORAD, a clinical tool for assessing the severity (extent, intensity) of atopic dermatitis, was used to exclude trivial rash. A SCORAD value > 10 was considered positive for eczema rash.

Findings included the following:

  • Of the 331 children, 114 were in the HN019 group, 108 were in the HN001 group and 109 were in the placebo group.
  • Out of a possible 26 SNPs, seven were found to be significantly associated with eczema P<0.05.
  • Sixteen genetic variants present in children in the HN001 group and three in the HN019 group showed a significantly reduced risk of eczema compared with the placebo group.
  • Nine of the 26 SNPs were associated with SCORAD > 10.
  • Thirteen genetic variants present in the HN001 group and 6 in the HN019 group showed a significantly reduced risk of SCORAD > 10 compared to placebo P<0.05).
  • 16 genetic variants present in the HN001 and 3 in the HN019 treatment groups showed a significantly reduced risk of atopy (a genetic tendency to developing eczema) compared to placebo P<0.05.

This is the first study to show that probiotic supplementation can modify genetic susceptibility to eczema in high–risk children. It is important because determining the precise mechanisms of probiotic action may lead to more specific and effective strategies for preventing and treating eczema and ectopic disease.

Source: Morgan, Angharad R., Dug Yeo Han, Kristin Wickens, Christine Barthow, Edwin A. Mitchell, Thorsten V. Stanley, James Dekker, Julian Crane, and Lynnette R. Ferguson. “Differential modification of genetic susceptibility to childhood eczema by two probiotics.” Clinical & Experimental Allergy 44, no. 10 (2014): 1255-1265.

© 2014 John Wiley & Sons Ltd

Posted August 24, 2017.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

  1. Wadonda-Kabondo N, Sterne J, Golding J, Kennedy C, Archer C, Dunnill M. Association of parental eczema, hayfever, and asthma with atopic dermatitis in infancy: birth cohort study. Archives of disease in childhood. 2004;89(10):917-921.
  2. Diepgen TL. Atopic dermatitis: the role of environmental and social factors, the European experience. Journal of the American Academy of Dermatology. 2001;45(1):S44-S48.
  3. Heinrich J, Popescu MA, Wjst M, Goldstein IF, Wichmann HE. Atopy in children and parental social class. American Journal of Public Health. 1998;88(9):1319-1324.
  4. Björkstén B, Sepp E, Julge K, Voor T, Mikelsaar M. Allergy development and the intestinal microflora during the first year of life. Journal of allergy and clinical immunology. 2001;108(4):516-520.
  5. Penders J, Stobberingh EE, Thijs C, et al. Molecular fingerprinting of the intestinal microbiota of infants in whom atopic eczema was or was not developing. Clinical & Experimental Allergy. 2006;36(12):1602-1608.
  6. Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology. 2008;122(4):788-794.
  7. Wickens K, Black P, Stanley T, et al. A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years. Clinical & Experimental Allergy. 2012;42(7):1071-1079.
  8. Wickens K, Stanley T, Mitchell E, et al. Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization? Clinical & Experimental Allergy. 2013;43(9):1048-1057.
  9. Morgan AR, Han DY, Wickens K, et al. Differential modification of genetic susceptibility to childhood eczema by two probiotics. Clinical & Experimental Allergy. 2014;44(10):1255-1265.