Probiotic therapy to correct the intestinal microbiota in children with a cow’s milk protein allergy: An observational open parallel case-control study

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Abstract

Background. The intestinal microbiota influences the occurrence, course, and outcome of allergic diseases, including those that develop in young children.

Aim. To evaluate the effectiveness of the probiotic Acipol® Kid in the treatment of skin and gastrointestinal manifestations of food allergy.

Materials and methods. 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 Lactobacillus rhamnosus ATCC 53103 1 × 109 CFU and Bifidobacterium longum CECT 7894 5 × 108 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.

Results. 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%.

Conclusions. The use of the probiotic agent Acipol Kid, containing Lactobacillus rhamnosus ATCC 53103 and Bifidobacterium longum 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 B1, B7, and K support considering the biodiversity an important therapeutic factor for the development of healthy intestinal microflora.

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About the authors

Irina N. Zakharova

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0003-4200-4598

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Diana K. Dmitrieva

Russian Medical Academy of Continuous Professional Education; Bashlyaeva Children's City Clinical Hospital

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-1593-0732

Graduate Student

Russian Federation, Moscow; Moscow

Irina V. Berezhnaya

Russian Medical Academy of Continuous Professional Education

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-2847-6268

Cand. Sci. (Med.)

Russian Federation, Moscow

Narine G. Sugian

Russian Medical Academy of Continuous Professional Education; Khimki Clinical Hospital

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-2861-5619

Cand. Sci. (Med.)

Russian Federation, Moscow; Khimki

Irina N. Kholodova

Russian Medical Academy of Continuous Professional Education

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0003-0090-6980

D. Sci. (Med.)

Russian Federation, Moscow

Yana V. Orobinskaya

Russian Medical Academy of Continuous Professional Education; Khimki Clinical Hospital

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0009-0005-2121-4010

Assistant

Russian Federation, Moscow; Khimki

Marina M. Fedotova

Siberian State Medical University

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0001-7655-7911

Cand. Sci. (Med.)

Russian Federation, Tomsk

Valeria D. Prokopyeva

Siberian State Medical University

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-0728-5825

Assistant

Russian Federation, Tomsk

Vera E. Odintsova

Nobias Technologies LLC

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0003-1897-4033

Сhief Bioinformatician

Russian Federation, Moscow

Stanislav I. Koshechkin

Nobias Technologies LLC

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-7389-0476

Cand. Sci. (Biol.)

Russian Federation, Moscow

Vladimir A. Romanov

Nobias Technologies LLC

Email: zakharova-rmapo@yandex.ru
ORCID iD: 0000-0002-7540-5884

Clinical Research Manager

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Randomization scheme.

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3. Fig. 2. Study flowchart.

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4. Fig. 3. Change in COMISS scores between groups.

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5. Fig. 4. Change of intestinal flora biodiversity.

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