Skip to main content

Advertisement

Log in

Investigation of the Efficacy of Lactobacillus rhamnosus GG in Infants With Cow’s Milk Protein Allergy: a Randomised Double-Blind Placebo-Controlled Trial

  • Published:
Probiotics and Antimicrobial Proteins Aims and scope Submit manuscript

Abstract

This investigation has been performed to show the efficacy of Lactobacillus rhamnosus GG (LGG) together with milk-free diet in patients with cow’s milk protein allergy (CMPA). This multicentre prospective investigation has been performed in 0–12 months of age children diagnosed as CMPA clinically and biochemically. Patients have been randomly divided in to two groups. İnfants in probiotic group were received with cow’s milk protein free diet and per oral (p.o.) daily 1X109 CFU LGG and in placebo group with milk-free diet and placebo. Mothers of all breast-fed patients have been put on milk-free diet and all patients fed with formula, offered to extensively hydrolysed formula. Symptoms like diarrhoea, vomiting, mucousy or bloody stool, abdominal pain or distension, constipation, dermatitis and restiveness were recorded at the beginning and weekly during the receiving dietary by the investigator. One-hundred infants diagnosed CMPA were included in this double-blind placebo controlled study. Forty-eight infants placed in probiotic group and 52 in placebo group. After 4 weeks of receiving dietary, infants in probiotic group have showed statistically significant improvement in symptoms of bloody stool, diarrhoea, restiveness and abdominal distension (p ≤ 0.001). Whilst statistically significant improvement was also observed in symptoms of mucousy stool (p = 0.038) and vomiting (p = 0.034), no significant improvement were observed in abdominal pain (p = 0.325), constipation (p = 0.917) and dermatitis (p = 0.071). In this study we observed significant improvement in symptoms of infants diagnosed CMPA receiving dietary LGG with cow’s milk-free diet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sicherer SH (2011) Epidemiology of food allergy. J Allergy Clin Immunol 127:594–602

    Article  Google Scholar 

  2. Boyce JA, Assa’ad A, Burks AW et al (2010) Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-Sponsored expert panel report. J Allergy Clin Immunol 126:1105–1118

    Article  Google Scholar 

  3. Høst A, Halken S, Jacobsen HP, Christensen AE, Herskind AM, Plesner K (2012) Clinical course of cow’s milk protein allergy/intolerance and atopic diseases in childhood. Pediatr Allergy Immunol 13(Suppl 15):23–28

    Google Scholar 

  4. Skripak JM, Matsui EC, Mudd K, Wood RA (2007) The natural history of IgEmediated cow’s milk allergy. J Allergy Clin Immunol 120:1172–1177

    Article  CAS  Google Scholar 

  5. Levy Y, Segal N, Garty B, Danon YL (2007) Lessons from the clinical course of IgE-mediated cow milk allergy in Israel. Pediatr Allergy Immunol 18:589–593

    Article  CAS  Google Scholar 

  6. Machida HM, Catto Smith AG, Gall DG, Trevenen C, Scott RB (1994) Allergic colitis in infancy: clinical and pathologic aspects. J Pediatr Gastroenterol Nutr 19:22–26

    Article  CAS  Google Scholar 

  7. Koletzko S, Niggemann B, Arato A, Dias JA, Heuschkel R, Husby S, Mearin ML, Papadopoulou A, Ruemmele FM, Staiano A, Schäppi MG, Vandenplas Y, European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (2012) Diagnostic approach and management of cow’s milk protein allergy in infants and children: a practical guideline of the GI-committee of ESPGHAN. J Pediatr Gastroenterol Nutr 55:221–229

    Article  CAS  Google Scholar 

  8. Venter C, Arshad SH (2012) Guideline fever: an overview of DRACMA, US NIAID, and UK NICE guidelines. Curr Opin Allergy Clin Immunol 12:302–315

    Article  Google Scholar 

  9. Guarner F, Schaafsma GJ (1998) Probiotics. Int J Food Microbiol 39(3):237–238

    Article  CAS  Google Scholar 

  10. Isolauri E, Arvola T, Sutas Y, Moilanen E, Salminen S (2000) Probiotics in the management of atopic eczema. Clin Exp Allergy 30:1604–1610

    Article  CAS  Google Scholar 

  11. Kalliomakki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E (2001) Probiotics in primary prevention of atopic disease: a randomized placebocontrolled trial. Lancet 357:1076–1079

    Article  Google Scholar 

  12. Kalliomaki M, Salminen S, Poussa T, Arvilommi H, Isolauri E (2003) Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 361:1869–1871

    Article  Google Scholar 

  13. Majamaa H, Isolauri E (1997) Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 99:179–185

    Article  CAS  Google Scholar 

  14. Schrezenmeir J, de Vrese M (2001) Probiotics, prebiotics, and symbiotics: approaching a definition. Am J Clin Nutr 73(2):361–364

    Article  Google Scholar 

  15. Goldin BR, Gorbach SL, Saxelin M, Barakat S, Gualtieri L, Salminen S (1992) Survival of Lactobacillus species (strain GG) in human gastrointestinal tract. Dig Dis Sci 37:121–128

    Article  CAS  Google Scholar 

  16. Rosenfeldt V, Benfeldt E, Nielsen SD, Michaelsen KF, Jeppesen DL, Valerius NH, Paerregaard A (2003) Effect of probiotic Lactobacillus strains in infants with atopic dermatitis. J Allergy Clin Immunol 111:389–395

    Article  Google Scholar 

  17. Kalliomaki M, Salminen S, Poussa T, Isolauri E (2007) Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. J Allergy Clin Immunol 119:1019–1021

    Article  Google Scholar 

  18. Viljanen M, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, Tuure T, Kuitunen M (2005) Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Allergy 60:494–500

    Article  CAS  Google Scholar 

  19. Szajewska H, Gawronska A, Wos H, Banaszkiewicz A, Grzybowska-Chlebowczyk U (2007) Lack of effect of Lactobacillus GG in breast-fed infants with rectal bleeding: a pilot double-blind randomized controlled trial. J Pediatr Gastroenterol Nutr 45:247–251

    Article  CAS  Google Scholar 

  20. Muraro A, Hoekstra MO, Meijer Y, Lifschitz C, Wampler JL, Harris C, Scalabrin DMF (2012) Extensively hydrolysed casein formula supplemented with Lactobacillus rhamnosus GG maintains hypoallergenic status: randomised double-blind, placebo-controlled crossover trial. BMJ Open 2(2):e000637

    Article  Google Scholar 

  21. Baldassarre ME, Laforgia N, Fanelli M, Laneve A, Grosso R, Lifschitz C (2010) Lactobacillus GG improves recovery in infants with blood in the stools and presumptive allergic colitis compared with extensively hydrolyzed formula alone. J Pediatr 156(3):397–401

    Article  CAS  Google Scholar 

  22. Berni Canani R, Nocerino R, Terrin G, Coruzzo A, Cosenza L, Leone L, Troncone R (2012) Effect of Lactobacillus GG on tolerance acquisition in infants with cow's milk allergy: a randomized trial. J Allergy Clin Immunol 129(2):580–582

    Article  Google Scholar 

  23. Millar MR, Bacon C, Smith SL, Walker V, Hall MA (1993) Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child 69(5):483–487

    Article  CAS  Google Scholar 

  24. Laitinen K, Kalliomaki M, Poussa T, Lagström H, Isolauri E (2005) Evaluation of diet and growth in children with and without atopic eczema: follow-up study from birth to 4 years. Br J Nutr 94(4):565–574

    Article  CAS  Google Scholar 

  25. Rinne M, Kalliomaki M, Salminen S, Isolauri E (2006) Probiotic intervention in the first months of life: short-term effects on gastrointestinal symptoms and long-term effects on gut microbiota. J Pediatr Gastroenterol Nutr 43(2):200–205

    Article  Google Scholar 

  26. Gorbach SL (1996) The discovery of Lactobacillus GG. (Lactobacillus GG). Nutr Today 31:5S

    Article  Google Scholar 

  27. Ivakhnenko ES, Nian'kovskii SL (2013) Effect of probiotics on the dynamics of gastrointestinal symptoms of food allergy to cow's milk protein in infants. Georgian Med News 219:46–52

    Google Scholar 

  28. Ezaki S, Itoh K, Kunikata T, Suzuki K, Sobajima H, Tamura M (2012) Prophylactic probiotics reduce cow's milk protein intolerance in neonates after small intestine surgery and antibiotic treatment presenting symptoms that mimics postoperative infection. Allergol Int 61(1):107–113. https://doi.org/10.2332/allergolint.11-OA-0305

    Article  PubMed  CAS  Google Scholar 

Download references

Funding

This study was supported by funding from unconditional scientific support of the Mamsel Pharmaceutical Industry and Joint-Stock Company (Turkey).

Author information

Authors and Affiliations

Authors

Contributions

Concept—A.B., A.Y.; design—A.B., İ.I.; supervision—A.Y.; resource—A.B., A.Y., A.A.; materials—A.B., A.Y., İ.I.; data collection and/or processing—A.B., A.Y., A.A.; analysis and/or interpretation—A.B., İ.I.; literature search—A.B., A.A., İ.I.; writing—A.B.; critical reviews—A.B., A.Y.

Corresponding author

Correspondence to Ahmet Basturk.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Committee Approval

The approval of the Antalya Education and Research Hospital Ethical Committee for the Clinical Studies was obtained before the study initiated (date and number of ethic committee approval: 30 November 2017/18–01).

Informed Consent

Written informed consent was obtained from patients who participated in this study.

Peer Review

Externally peer-reviewed.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Basturk, A., Isik, İ., Atalay, A. et al. Investigation of the Efficacy of Lactobacillus rhamnosus GG in Infants With Cow’s Milk Protein Allergy: a Randomised Double-Blind Placebo-Controlled Trial. Probiotics & Antimicro. Prot. 12, 138–143 (2020). https://doi.org/10.1007/s12602-019-9516-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12602-019-9516-1

Keywords

Navigation