Atopic dermatitis in early childhood: Effect of probiotic intervention; role of gastrointestinal permeability and microflora; quality of life implications
Başlık:
Atopic dermatitis in early childhood: Effect of probiotic intervention; role of gastrointestinal permeability and microflora; quality of life implications
Yazar:
Gore, Claudia, author.
ISBN:
9780355977851
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (304 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Özet:
The prevalence of allergic disease, in particular atopic dermatitis, is increasing and up to 30% today's children are affected by it. We studied a cohort of 208 infants age 3-6 months with eczema, 40 healthy control infants and in addition explored the information needs and decisional role preferences of a subgroup of parents caring for infants with atopic dermatitis. We found that young infants in the community can be affected by eczema of considerable severity (mean scores were moderately severe) and many appear under-treated. The quality of life index under investigation correlated well with eczema severity at this age and it confirmed that the infants' quality of life is significantly impaired by the condition. Parents as their children's surrogate health care users had clearly defined information needs and preferences as to their involvement in treatment decision-making. Health professionals under-estimate the level of distress caused by infant eczema and information-giving regarding this condition is suboptimal. These results emphasise that infant atopic dermatitis deserves to be taken seriously and the identified parental needs and preferences could facilitate enhanced information-giving. Differences in the gastrointestinal microbiota of infants with allergic disease have been reported, noting an apparently reduced number of lactobacilli and bifidobacteria. Large, well designed intervention trials with probiotic strains are however scarce. We compared the effects of Bifidobacterium lactis Bb12 or Lactobacillus casei NCC2461 versus placebo on the severity of infant atopic dermatitis in a large randomised, placebo-controlled clinical trial. We found that supplementation with Bifidobacterium lactis Bb12 or Lactobacillus casei NCC2461 (ST11) does not improve eczema severity in young infants suffering from eczema without concomitant symptomatic food allergy. This is in contrast to all previously reported studies. In addition, we studied differences in gastrointestinal microbiotia (nucleic acid based identification), intestinal permeability (dual sugar probe, lactulose/mannitol) and eosinophilic inflammation (faecal and urinary eosinophilic protein X) in the same cohort of carefully selected very young infants with and without eczema. We found no differences for the "faecal bacterial fingerprints" between infants with and without eczema. Infants with eczema had significantly higher intestinal permeability compared to healthy babies. This was linked with increased faecal eosinophilic protein X suggesting increased intestinal eosinophilic inflammation in infants with eczema in the absence of food allergy. These findings are important stepping stones for further investigations into differences in gastrointestinal homoeostasis between healthy infants and infants with eczema as well as our understanding of the underlying mechanisms in atopic dermatitis.
Notlar:
School code: 1543
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(683821.1) | 683821-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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