Merja Nermes

Interaction of orally administered Lactobacillus rhamnosus GG with skin and gut microbiota and humoral immunity in infants with atopic dermatitis

Cite this as: M. Nermes, J. M. Kantele, T. J. Atosuo, S. Salminen and E. Isolauri, Clinical & Experimental Allergy, 2011 (41) 370–377.

Severity of atopic disease inversely correlates with intestinal microbiota diversity and butyrate-producing bacteria

The reports on atopic diseases and microbiota in early childhood remain contradictory, and both decreased and increased microbiota diversity have been associated with atopic eczema. In this study, the intestinal microbiota signatures associated with the severity of eczema in 6‐month‐old infants were characterized. Further, the changes in intestinal microbiota composition related to the improvement of this disease 3 months later were assessed. The severity of eczema correlated inversely with microbiota diversity (r = −0.54, P = 0.002) and with the abundance of butyrate‐producing bacteria (r = −0.52, P = 0.005). During the 3‐month follow‐up, microbiota diversity increased (P < 0.001) and scoring atopic dermatitis values decreased (P < 0.001) in all infants. This decrease coincided with the increase in bacteria related to butyrate‐producing Coprococcus eutactus (r = −0.59, P = 0.02). In conclusion, the high diversity of microbiota and high abundance of butyrate‐producing bacteria were associated with milder eczema, thus suggesting they have a role in alleviating symptoms of atopic eczema.

Determination of IgE antibodies to Candida albicans mannan with nitrocellulose‐RAST in patients with atopic diseases

A nitrocellulose‐based radioallergosorbent test (RAST) was developed and used for the determination of IgE antibodies to Candida albicans mannan in patients with atopic dermatitis, asthma and allergic rhinitis. The results were expressed as mannan‐RAST index values (an inter‐ and intra‐assay coefficient for variation of 8.0‐10.2%). The normal range for mannan‐RAST index values was determined in 102 non‐atopic adults. Fifty‐three of 78 (67.9%) patients with atopic dermatitis showed elevated mannan‐RAST index values with a significant correlation to the severity of the dermatitis (r= 0.33, P < 0.01). Sixteen of 30(53 3%) patients with asthma had a positive mannan‐RAST index value: however, 12 of the 16 asthmatics (75%) who were positive also suffered from atopic dermatitis. Those who had allergic rhinitis but not atopic dermatitis showed a positive mannan‐RAST index value in 12 of 32 (37.5%) cases. Nitrocellulose‐RAST offered a sensitive method for the determination of polysaccharide‐specific IgE antibodies in alopic diseases. The results show that high values are observed mainly in atopic dermatitis and less sensitization to C. albicans occurs in respiratory allergy.

Impact of maternal probiotic-supplemented dietary counseling during pregnancy on colostrum adiponectin concentration: A prospective, randomized, placebo-controlled study

BACKGROUND The breast milk bioactive substances such as adiponectin, have a presumably long-term impact upon the health and well-being of a child. AIM To determine the impact of probiotic-supplemented dietary counseling during pregnancy on colostrum adiponectin concentration. STUDY DESIGN AND SUBJECTS Altogether 256 pregnant women were randomized into three study groups: dietary intervention with probiotics (diet/probiotics) or with placebo (diet/placebo) and a control group (control/placebo). The intervention group received dietary counseling provided by a nutritionist, the main focus being the amount and the type of dietary fat. The probiotics used were Lactobacillus rhamnosus GG and Bifidobacterium lactis in combination. Dietary intake was evaluated by food records at every trimester of pregnancy. Breast milk samples were collected after birth (colostrum) for adiponectin concentration analysis (n=181). RESULTS The dietary intervention increased the colostrum adiponectin concentration (ng/mL, geometric mean [95% CI]), the difference being significant when comparing to the control group; 12.7 [10.6-29.7] vs. 10.2 [9.9-13.2], P=0.024. Maternal weight gain during pregnancy (kg) correlated inversely with colostrum adiponectin concentration; β (SE)=-1.7 (0.1), P=0.020, and gestational diabetes mellitus was associated with the likelihood of adiponectin concentration falling into the lowest quartile; OR 2.36, 95% CI 1.1-3.2, P=0.028. CONCLUSIONS In showing that the colostrum adiponectin concentration is markedly dependent on maternal diet and nutritional status during pregnancy, and considering that colostrum adiponectin has potential effects on metabolism, nutrition, and immune function in the neonates, the results of this study underscore the importance of the metabolic homeostasis of the mother for the childs initial nutritional environment.

IgE, IgA, and IgG responses to common yeasts in atopic patients

This study was undertaken to analyze the differences in exposure and sensitization to five common environmental yeasts. The responses of IgG, IgA. and IgE to Candida albicans. C. utilis, Cryptococcus albidus, Rhodotorula rubra, and Saccharomyces cerevisiae and purified S. cerevisiae enolase were analyzed by immunoblotting (IgE‐1B), and the cross‐reactivity of their IgE‐binding components by IgE‐1B inhibition. Twenty atopic subjects, with asthma, allergic rhinitis, or atopic dermatitis were included. In skin prick tests (SPT), 12 of the patients showed simultaneous reactivity to at least two of the five yeasts, four reacted to one of the yeasts, and four had no responses. Antigens run in SDS‐PAGE and transferred to nitrocellulose were probed with enzyme‐labeled IgA‐, IgG‐, and IgE‐specific antibodies. The IgE immunoblotting revealed most IgE‐binding bands in C. albicans (11 bands) followed by C. utilis (eight bands), S. cerevisiae (five bands), R. rubra (five bands), and Cr. albidus (four bands). Six of the IgE‐binding bands of C. albicans and C. utilis shared molecular weight, and only two bands shared molecular weight with other yeasts. These were the 46‐kDa band, shared by all five yeasts, and a 13‐kDa band shared by four yeasts. Prominent IgE binding was seen to a 46‐kDa band of C. albicans (seven patients), C. utilis (five patients), and S. cerevisiae (one patient) and to corresponding weak bands of Cr. albidus and R. rubra (one patient). The possible cross‐reactivity of the 46‐kDa band was analyzed by IgE‐IB inhibition and densitometry, revealing clear C albicans inhibition of C. utilis (80%) and enolase (98%) (autoinhibition 100%). The strongest IgG responses were seen against S. cerevisiae and C albicans. The responses were mainly against mannans of C. albicans and S. cerevisiae, suggesting that most of the exposure is to these yeasts. Yeasts with different types of exposure, from saprophytic growth on human mucous membranes to exposure by air and food, were shown to cross‐react at the allergenic level. Atopic patients primarily sensitized by C albicans and S. cerevisiae may develop allergic symptoms by exposure to other environmental yeasts due to cross‐reacting IgE antibodies.

Quality of life in infants with atopic dermatitis and healthy infants: a follow-up from birth to 24 months

Aim:  To evaluate quality of life (QOL) in infants with atopic dermatitis (AD) by comparison with healthy infants to find treatment modalities contributing most to QOL in these patients.

Is There a Role for Probiotics in the Prevention or Treatment of Food Allergy

A balanced gut microbiota is crucial for the development of healthy immunoregulation and gut barrier function to allow brisk immune responses to pathogens and systemic hyporesponsiveness to harmless antigens such as food. Although the first allergic disease to manifest itself, atopic eczema, is not equivalent to food allergy, pre- and postnatal administration of specific probiotic strains has emerged as a promising tool for the prevention of this condition, with potential implications for food allergy development. For food allergy proper, however, we lack markers and risk factors and mechanisms, i.e., targets for preventive measures. The focus here is therefore on the treatment. Indeed, the potential of specific probiotic strains to alleviate food allergy resides in their ability to modify antigens, repair gut barrier functions, balance altered microbiota, and restore local and systemic immune regulation. In patients with multiple food allergies, induction of oral tolerance by specific probiotics continues to attract research interest.

Enhanced IgE response to Candida albicans in postoperative invasive candidiasis

Background Invasive candidiasis is a life‐threatening complication problem in postoperative and immunocompromized patients, e.g. those treated by intensive care. Candida is frequently cultured from the mucous membranes of hospital patients and fungal cultures offer httle diagnostic help. Other diagnostic methods, such as blood cultures, serology and diagnostic imaging techniques produce results too late and, if positive, low sensitivity.

Perinatal Pet Exposure, Faecal Microbiota, and Wheezy Bronchitis: Is There a Connection?

Background. The hygiene hypothesis suggests that high hygiene standards have led to an immune dysfunction and an increase in allergic diseases. Farming-related exposures are associated with a decreased risk of asthma. Since the gut microbiota may be a pivotal component in the hygiene hypothesis, we studied whether perinatal exposure to pets, doctors diagnosed wheezy bronchitis (WB), and compositional changes in the gut microbiota are interrelated among urban infants. Methods. Data were collected prospectively from a mother-infant nutrition study. Data on perinatal pet ownership, WB, and the microbiota composition of faecal samples of the infants assessed by quantitative PCR at 1 month were compared. Results. None of the 30 infants exposed to pets had suffered from WB by 24 months, whereas 15 of the 99 (15%) nonexposed infants had had WB (P = 0.03). The counts of Bifidobacterium longum were higher in samples (n = 17) from nonwheezing infants with pet exposure compared to those (n = 10) in wheezing infants without pet exposure (8.59/10.44 versus 5.94/9.86, resp. (median/upper limit of range, bacteria(log)/g of stool); P = 0.02). B. breve was more abundant in the wheezing infants (P = 0.02).

Cross-reacting IgE and IgG antibodies to Pityrosporum ovale mannan and other yeasts in atopic dermatitis.

Atopic dermatitis (AD) patients often demonstrate positive skin prick test results and serum IgE antibodies to a range of different yeasts. This has been thought to be due to cross‐reactivity. In this study, the cross‐reactivity of IgE and IgG antibodies between mannan and crude antigens of Pityrosporum ovale, Candida albicans, and Saccharomycescerevisiae and crude antigens of Cryptococcus albidus and Rhodotorula rubra was examined by RAST and ELISA inhibition with two serum pools of AD patients. We found cross‐reacting IgE and IgG antibodies. In the IgE response, the main cross‐reacting pattern was the mannan region, although inhibition could be achieved also with crude antigens of C. albicans, S. cerevisiae, and, to some extent, C. albidus. P. ovale was the most potent inhibitor of IgE‐binding components, and against it the highest IgE antibody levels were detected in AD serum pools. In contrast, C. albicans was found to be the most important inducer of IgG antibodies, since the IgG level against P. ovale mannan in both AD serum pools was very low. Cross‐reacting antibodies were also seen in ELISA inhibition with both crude and mannan antigens, but since the IgG antibody level of P. ovale mannan in AD serum pools was low, further studies are needed to confirm the IgG results.