Pediatric Allergy Immunol 2006: 17: 141-147
2006 The Authors
Journal compilation 2006 Blackwell Munksgaard
PEDIATRIC ALLERGY AND IMMUNOLOGY
Comparison of fecal microflora in children
with atopic eczema/dermatitis syndrome
according to IgE sensitization to food
Kendler M, Uter W, Rueffer A, Shimshoni R, Jecht E. Comparison of fecal microflora in children with atopic eczema/dermatitis syndrome according to IgE sensitization to food.
Pediatr Allergy Immunol 2006:17:141-147.
Atopic eczema/dermatitis syndrome (AEDS) commonly often arises during early infancy. In several intervention studies a beneficial influence on AEDS course of certain intestinal bacteria, administered as ,probiotics', has been described. To evaluate the possible role of the natural intestinal microflora in children with allergic eczema/dermatitis syndrome regarding immediate type hypersensitivity to food allergens, children with food allergy (AAEDS, n = 68) have been compared with children without detectable food allergy (NAEDS, n = 25). All children (n = 93) in preschool age, mean age of 2.6 (± 1.8) years, diagnosed with AEDS who were treated as inpatients in 2003 in a dermatological hospital were included. The correlation between fecal microflora, parasites and specific immunoglobulin E (IgE) antibodies against common food allergens was analyzed. A similar composition of intestinal microflora in children with AAEDS and NAAEDS was found. The food allergens that were most frequently detected were egg white, cow milk, casein, peanut and hazelnut. Furthermore, a significant association between IgE sensitization against important food allergens and components of the fecal microflora could not be demonstrated. With aging changes occur in the intestinal microbiota [Proteus1Klebsiella and age (,o = -0.607) and Enterococcus and age (p = -0.428)]. In two subjects of the AAEDS group Blastocystis hominis was found. The composition of natural intestinal microflora in children with AAEDS and NAAEDS was similar. Hence, there is no evidence of a role of the intestinal microflora with regard to the development of infant (food) allergy in children with AEDS. The possible consequences for allergic diseases later in life require further investigation.
Michael Kendler1, Wolfgang Uter2, Andreas Rueffer3, Raffael Shimshoni1 and Eckehardt Jecht1
1Hospital of Dermatology, Schloß Friedensburg, Leutenberg, Germany, 2Department of MedicalInformatics, Biometry and Epidemiology, University of Erlangen-Nürnberg, Erlangen, Germany, 3Labor L+S AG/EnterosanTM, Bad Bocklet-Großenbrach, GermanyKey words: atopic eczema/dermatitis syndrome; food allergy; intestinal microflora: infant; specific IgE
Michael Kendler, Hospital of Dermatology, SchloßFriedensburg, Schlossstrasse 25, 07338 Leutenberg,
Tel.:+49 36734 80 0
Fax:+49 36734 22362
Accepted 28 November 2005
Kendler et al.
In summary, our study found a similar composition of intestinal microflora in children suffering from the allergic eczema/dermatitis syndrome and the non-allergic eczema/dermatitis syndrome. Furthermore, a quantitative relationship between IgE sensitization against important food allergens and the fecal microflora could not be demonstrated, while age-dependent changes were observed with some bacterial species. This finding is not in contradiction to beneficial effects of probiotics actively administered in the studies quoted, as we focused on the natural flora. This article deals with intestinal flora in two subgroups of children with AD. The conclusions are consistent with reports from the literature stating that the role of intestinal microflora is probably more regulatory in allergic inflammation than in allergic sensitization. Obviously, the role of the natural intestinal microflora, and the role of probiotics with regard to the development of infant immunity/allergy and the possible consequences for allergic diseases later in life requires further investigation.