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• W2003752956 abstract "Authors' replySir—L Niers and colleagues have raised some points about our study; due to limited space available, many details had to be left out of our report.We did assess the severity of atopic eczema at age 4 years with the SCORAD score (mean 17, range 11–26). The score did not differ between groups, and was comparable to the findings presented in our original report of the study in 2001.The diagnosis of atopic eczema was based on the criteria prepared by Hanifin1Hanifin JM Atopic dermatitis in infants and children.Pediatr Clin North Am. 1991; 38: 763-789Crossref PubMed Scopus (126) Google Scholar especially for infants and children. These criteria were the only criteria available at the beginning of the study. Alternative definitions of atopic eczema—eg, atopiform dermatitis and atopic eczema/dermatitis syndrome (AEDS)2Johansson SG Hourihane JO Bousquet J et al.A revised nomenclature for allergy: an EAACI position statement from the EAACI nomenclature task force.Allergy. 2001; 56: 813-824Crossref PubMed Scopus (1568) Google Scholar—have been proposed, since a proportion of patients with atopic eczema do not manifest with skin-prick test reactivity but do display positive patch testing, indicating delayed reactions to antigens.3Isolauri E Turjanmaa K Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis.J Allergy Clin Immunol. 1996; 97: 9-15Summary Full Text Full Text PDF PubMed Scopus (388) Google Scholar So far, however, a universal consensus about these proposed definitions has not been reached.Treatment with lactobacillus resulted in prevention of atopic eczema. The frequencies of skin-prick test reactivity, however, were comparable between the groups. The same distinction between early antigen-specific IgE response and atopic disease has been noted in childhood asthma.4Lau S Illi S Sommerfeld C et al.Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study.Lancet. 2000; 356: 1392-1397Summary Full Text Full Text PDF PubMed Scopus (606) Google Scholar Lau and colleagues postulated that “the induction of specific IgE responses and the development of childhood asthma are determined by independent factors”.4Lau S Illi S Sommerfeld C et al.Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study.Lancet. 2000; 356: 1392-1397Summary Full Text Full Text PDF PubMed Scopus (606) Google Scholar Our observations on atopic eczema, another form of atopic disease, lend support to this suggestion. Moreover, there is a considerable overlap in antigen-specific IgE concentrations between healthy children and those with atopic disease during the first 5 years of life.5Kulig M Bergmann R Klettke U Wahn V Tacke U Wahn U Natural course of sensitization to food and inhalant allergens during the first 6 years of life.J Allergy Clin Immunol. 1999; 103: 1173-1179Summary Full Text Full Text PDF PubMed Scopus (374) Google ScholarTaken together, these clinical findings and the unestablished status of the definitions of atopic eczema, suggest the effects of lactobacillus on antigen-specific IgE and clinical status of individuals should be reported separately. We agree that additional studies to address the role of probiotics in the prevention of atopic disease are warranted. Authors' reply Sir—L Niers and colleagues have raised some points about our study; due to limited space available, many details had to be left out of our report. We did assess the severity of atopic eczema at age 4 years with the SCORAD score (mean 17, range 11–26). The score did not differ between groups, and was comparable to the findings presented in our original report of the study in 2001. The diagnosis of atopic eczema was based on the criteria prepared by Hanifin1Hanifin JM Atopic dermatitis in infants and children.Pediatr Clin North Am. 1991; 38: 763-789Crossref PubMed Scopus (126) Google Scholar especially for infants and children. These criteria were the only criteria available at the beginning of the study. Alternative definitions of atopic eczema—eg, atopiform dermatitis and atopic eczema/dermatitis syndrome (AEDS)2Johansson SG Hourihane JO Bousquet J et al.A revised nomenclature for allergy: an EAACI position statement from the EAACI nomenclature task force.Allergy. 2001; 56: 813-824Crossref PubMed Scopus (1568) Google Scholar—have been proposed, since a proportion of patients with atopic eczema do not manifest with skin-prick test reactivity but do display positive patch testing, indicating delayed reactions to antigens.3Isolauri E Turjanmaa K Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis.J Allergy Clin Immunol. 1996; 97: 9-15Summary Full Text Full Text PDF PubMed Scopus (388) Google Scholar So far, however, a universal consensus about these proposed definitions has not been reached. Treatment with lactobacillus resulted in prevention of atopic eczema. The frequencies of skin-prick test reactivity, however, were comparable between the groups. The same distinction between early antigen-specific IgE response and atopic disease has been noted in childhood asthma.4Lau S Illi S Sommerfeld C et al.Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study.Lancet. 2000; 356: 1392-1397Summary Full Text Full Text PDF PubMed Scopus (606) Google Scholar Lau and colleagues postulated that “the induction of specific IgE responses and the development of childhood asthma are determined by independent factors”.4Lau S Illi S Sommerfeld C et al.Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study.Lancet. 2000; 356: 1392-1397Summary Full Text Full Text PDF PubMed Scopus (606) Google Scholar Our observations on atopic eczema, another form of atopic disease, lend support to this suggestion. Moreover, there is a considerable overlap in antigen-specific IgE concentrations between healthy children and those with atopic disease during the first 5 years of life.5Kulig M Bergmann R Klettke U Wahn V Tacke U Wahn U Natural course of sensitization to food and inhalant allergens during the first 6 years of life.J Allergy Clin Immunol. 1999; 103: 1173-1179Summary Full Text Full Text PDF PubMed Scopus (374) Google Scholar Taken together, these clinical findings and the unestablished status of the definitions of atopic eczema, suggest the effects of lactobacillus on antigen-specific IgE and clinical status of individuals should be reported separately. We agree that additional studies to address the role of probiotics in the prevention of atopic disease are warranted. Probiotics for prevention of atopic disease?Marko Kalliomäki and colleagues (May 31, p 1869)1,2 conclude that the results of their study suggest that the preventive effect of Lactobacillus rhamnosus strain GG on atopic eczema extends beyond infancy. Although their study is well designed, we have several comments. Full-Text PDF" @default.
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• W2003752956 title "Probiotics for prevention of atopic disease?" @default.
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