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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Pediatrics. Consilium Medicum</journal-id><journal-title-group><journal-title xml:lang="en">Pediatrics. Consilium Medicum</journal-title><trans-title-group xml:lang="ru"><trans-title>Педиатрия. Consilium Medicum</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2658-6630</issn><issn publication-format="electronic">2658-6622</issn><publisher><publisher-name xml:lang="en">Consilium Medicum</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">691508</article-id><article-id pub-id-type="doi">10.26442/26586630.2025.3.203459</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Probiotic therapy to correct the intestinal microbiota in children with a cow’s milk protein allergy: An observational open parallel case-control study</article-title><trans-title-group xml:lang="ru"><trans-title>Применение пробиотической терапии для коррекции микробиоты кишечника у детей с пищевой аллергией к белку коровьего молока</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4200-4598</contrib-id><name-alternatives><name xml:lang="en"><surname>Zakharova</surname><given-names>Irina N.</given-names></name><name xml:lang="ru"><surname>Захарова</surname><given-names>Ирина Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Med.), Prof.</p></bio><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. каф. педиатрии им. акад. Г.Н. Сперанского, засл. врач РФ</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1593-0732</contrib-id><name-alternatives><name xml:lang="en"><surname>Dmitrieva</surname><given-names>Diana K.</given-names></name><name xml:lang="ru"><surname>Дмитриева</surname><given-names>Диана Кирилловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Graduate Student</p></bio><bio xml:lang="ru"><p>аспирант каф. педиатрии им. акад. Г.Н. Сперанского; врач-педиатр</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2847-6268</contrib-id><name-alternatives><name xml:lang="en"><surname>Berezhnaya</surname><given-names>Irina V.</given-names></name><name xml:lang="ru"><surname>Бережная</surname><given-names>Ирина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доц. каф. педиатрии им. акад. Г.Н. Сперанского</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2861-5619</contrib-id><name-alternatives><name xml:lang="en"><surname>Sugian</surname><given-names>Narine G.</given-names></name><name xml:lang="ru"><surname>Сугян</surname><given-names>Нарине Григорьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доц. каф. педиатрии им. акад. Г.Н. Сперанского; зам. глав. врача</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0090-6980</contrib-id><name-alternatives><name xml:lang="en"><surname>Kholodova</surname><given-names>Irina N.</given-names></name><name xml:lang="ru"><surname>Холодова</surname><given-names>Ирина Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>д-р мед. наук, проф. каф. педиатрии им. Г.Н. Сперанского</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-2121-4010</contrib-id><name-alternatives><name xml:lang="en"><surname>Orobinskaya</surname><given-names>Yana V.</given-names></name><name xml:lang="ru"><surname>Оробинская</surname><given-names>Яна Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant</p></bio><bio xml:lang="ru"><p>ассистент каф. педиатрии им. акад. Г.Н. Сперанского; врач-педиатр</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7655-7911</contrib-id><name-alternatives><name xml:lang="en"><surname>Fedotova</surname><given-names>Marina M.</given-names></name><name xml:lang="ru"><surname>Федотова</surname><given-names>Марина Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук, доц. каф. факультетской педиатрии с курсом детских болезней лечебного фак-та</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0728-5825</contrib-id><name-alternatives><name xml:lang="en"><surname>Prokopyeva</surname><given-names>Valeria D.</given-names></name><name xml:lang="ru"><surname>Прокопьева</surname><given-names>Валерия Дмитриевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant</p></bio><bio xml:lang="ru"><p>ассистент каф. факультетской педиатрии с курсом детских болезней лечебного фак-та</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1897-4033</contrib-id><name-alternatives><name xml:lang="en"><surname>Odintsova</surname><given-names>Vera E.</given-names></name><name xml:lang="ru"><surname>Одинцова</surname><given-names>Вера Евгеньевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Сhief Bioinformatician</p></bio><bio xml:lang="ru"><p>гл. биоинформатик</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7389-0476</contrib-id><name-alternatives><name xml:lang="en"><surname>Koshechkin</surname><given-names>Stanislav I.</given-names></name><name xml:lang="ru"><surname>Кошечкин</surname><given-names>Станислав Игоревич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Biol.)</p></bio><bio xml:lang="ru"><p>канд. биол. наук, дир. по науке</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7540-5884</contrib-id><name-alternatives><name xml:lang="en"><surname>Romanov</surname><given-names>Vladimir A.</given-names></name><name xml:lang="ru"><surname>Романов</surname><given-names>Владимир Андреевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Clinical Research Manager</p></bio><bio xml:lang="ru"><p>менеджер клинических исследований</p></bio><email>zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff5"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Russian Medical Academy of Continuous Professional Education</institution></aff><aff><institution xml:lang="ru">ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Bashlyaeva Children's City Clinical Hospital</institution></aff><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Детская городская клиническая больница им. З.А. Башляевой» Департамента здравоохранения г. Москвы</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Khimki Clinical Hospital</institution></aff><aff><institution xml:lang="ru">ГБУЗ МО «Химкинская клиническая больница»</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Siberian State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Nobias Technologies LLC</institution></aff><aff><institution xml:lang="ru">ООО «Нобиас Технолоджис»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-10-14" publication-format="electronic"><day>14</day><month>10</month><year>2025</year></pub-date><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>255</fpage><lpage>263</lpage><history><date date-type="received" iso-8601-date="2025-09-26"><day>26</day><month>09</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-10-03"><day>03</day><month>10</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://pediatria.orscience.ru/2658-6630/article/view/691508">https://pediatria.orscience.ru/2658-6630/article/view/691508</self-uri><abstract xml:lang="en"><p><bold>Background.</bold> The intestinal microbiota influences the occurrence, course, and outcome of allergic diseases, including those that develop in young children.</p> <p><bold>Aim.</bold> To evaluate the effectiveness of the probiotic Acipol® Kid in the treatment of skin and gastrointestinal manifestations of food allergy.</p> <p><bold>Materials and methods.</bold> The study included 153 children aged 1–6 months: 122 subjects diagnosed with cow’s milk protein allergy and 31 healthy subjects. Children with allergies were divided into two groups: Group 1 (n = 60) received elimination treatment (mother’s milk-free diet and/or therapeutic formula), and Group 2 (n = 62) received elimination treatment and the probiotic Acipol® Kid containing <italic>Lactobacillus rhamnosus</italic> ATCC 53103 1 × 10<sup>9</sup> CFU and <italic>Bifidobacterium longum</italic> CECT 7894 5 × 10<sup>8 </sup>CFU. Healthy children comprised the comparison group. On Days 1, 45, and 90 of the study, symptoms were assessed, and feces were analyzed for fecal calprotectin on Days 1 and 45.</p> <p><bold>Results.</bold> The use of the probiotic Acipol Kid contributed to a 25% reduction in crying frequency, a 76% reduction in the number of children with prolonged crying, and a 26% reduction in intestinal manifestations, as measured by the COMISS index. The probiotic demonstrated high activity against skin symptoms, reducing the severity of lichenification and excoriations by 13% and 9%, respectively, and decreasing intestinal mucosa inflammation by 41%.</p> <p><bold>Conclusions.</bold> The use of the probiotic agent Acipol Kid, containing <italic>Lactobacillus rhamnosus</italic> ATCC 53103 and <italic>Bifidobacterium longum</italic> CECT 7894, in addition to basic therapy, helps eliminate symptoms in children with severe intestinal and skin symptoms of cow’s milk protein allergy. The obtained data on increasing the biodiversity of commensal microbiota and the potentiating effect on the synthesis of short-chain fatty acids and vitamins B<sub>1</sub>, B<sub>7</sub>, and K support considering the biodiversity an important therapeutic factor for the development of healthy intestinal microflora.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование.</bold> Микробиота кишечника оказывает влияние на развитие, течение и исход аллергических заболеваний, в том числе в раннем возрасте.</p> <p><bold>Цель.</bold> Оценить эффективность применения пробиотика Аципол® Малыш в лечении кожных и гастроинтестинальных проявлений пищевой аллергии.</p> <p><bold>Материалы и методы.</bold> В исследование включены 153 ребенка в возрасте 1–6 мес: 122 с диагностированной аллергией к белку коровьего молока и 31 здоровый. Дети с аллергией разделены на 2 группы, в которых группа 1 (n = 60) получала элиминационную терапию (безмолочную диету матери и/или лечебную смесь), а группа 2 (n = 62) – элиминационную терапию и пробиотик Аципол Малыш с содержанием лактобактерий <italic>Lactobacillus rhamnosus</italic> ATCC 53103 1 × 10<sup>9</sup> КОЕ, бифидобактерий <italic>Bifidobacterium longum</italic> CECT 7894 5 × 10<sup>8</sup> КОЕ. Группа здоровых детей составила группу сравнения. На 1, 45 и 90-й дни исследования оценивали симптомы, на 1 и 45-й дни брали анализ кала на содержание фекального кальпротектина.</p> <p><bold>Результаты.</bold> Применение пробиотика Аципол Малыш способствует снижению на 25% частоты плача, уменьшению числа детей с длительным плачем на 76%, редуцированию кишечных проявлений по индексу COMISS на 26%. Пробиотик обладает высокой активностью в отношении кожных симптомов, снижает выраженность лихенификации и экскориации на 13 и 9% соответственно, способствует уменьшению воспаления слизистой кишечника на 41%.</p> <p><bold>Заключение.</bold> Использование пробиотического средства Аципол Малыш с содержанием <italic>Lactobacillus rhamnosus</italic> ATCC 53103, <italic>Bifidobacterium longum</italic> CECT 7894 в добавление к основной терапии у детей с выраженными кишечными и кожными симптомами аллергии к белку коровьего молока способствует устранению симптомов заболевания. Полученные данные в отношении увеличения биоразнообразия комменсальной микробиоты и потенцирующий эффект на синтез короткоцепочечных жирных кислот и витаминов B<sub>1</sub>, B<sub>7</sub> и K дают возможность рассматривать его в качестве важного лечебного фактора для формирования здоровой микрофлоры кишечника.</p></trans-abstract><kwd-group xml:lang="en"><kwd>cow’s milk protein allergy</kwd><kwd>infants</kwd><kwd>probiotic therapy</kwd><kwd>gut microbiota</kwd><kwd>Acipol Kid</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>аллергия к белку коровьего молока</kwd><kwd>младенцы</kwd><kwd>пробиотическая терапия</kwd><kwd>микробиота кишечника</kwd><kwd>Аципол Малыш</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Диагностика аллергических заболеваний. Федеральные клинические рекомендации. РААКИ, 2015 г. [Diagnostika allergicheskikh zabolevanii. Federal'nye klinicheskie rekomendatsii. RA-AKI, 2015 g. 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