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Article ; Online: Safety of probiotics

Kuitunen Mikael

Clinical and Translational Allergy, Vol 1, Iss Suppl 1, p S

2011 Volume 9

Keywords	Immunologic diseases. Allergy ; RC581-607 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Allergy and Immunology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2011-08-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Early-life gut microbiota associates with allergic rhinitis during 13-year follow-up in a Finnish probiotic intervention cohort.

Kallio, Sampo / Jian, Ching / Korpela, Katri / Kukkonen, Anna Kaarina / Salonen, Anne / Savilahti, Erkki / Kuitunen, Mikael / M de Vos, Willem

Microbiology spectrum

2024 , Page(s) e0413523

Abstract: Perinatal and early-life factors reported to affect risk of allergic diseases may be mediated by changes in the gut microbiota. Here, we explored the associations between the infant gut microbiota and allergic morbidity in childhood until 13 years of age ...

Abstract	Perinatal and early-life factors reported to affect risk of allergic diseases may be mediated by changes in the gut microbiota. Here, we explored the associations between the infant gut microbiota and allergic morbidity in childhood until 13 years of age in a subgroup of the FLORA probiotic intervention cohort. A mixture of four probiotic strains with galacto-oligosaccharides was administrated to the mothers from the 36th week of the pregnancy and later to their infants until 6 months of age. The infants were monitored for the manifestations of atopic eczema, food allergy, allergic rhinitis, and asthma by a pediatrician at 2 and 5 years of age; the allergic status was subsequently verified by a questionnaire at 10 and 13 years of age. The fecal microbiota at 3 months was profiled by 16S rRNA amplicon sequencing targeting the V3-V4 region, with and without adjusting for potentially important early-life factors. Overall, the positive diagnosis for allergic rhinitis between 2 and 13 years was associated with microbiota composition both in non-adjusted and adjusted models. This association was more pronounced in children born to one parent with confirmed atopic diseases compared to those who had two atopic parents and was characterized by a lower relative abundance of
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2807133-5
ISSN	2165-0497 ; 2165-0497
ISSN (online)	2165-0497
ISSN	2165-0497
DOI	10.1128/spectrum.04135-23
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Article ; Online: Probiotics and prebiotics in preventing food allergy and eczema.

Kuitunen, Mikael

Current opinion in allergy and clinical immunology

2013 Volume 13, Issue 3, Page(s) 280–286

Abstract: Purpose of review: To describe the current literature on clinical trials of probiotics for eczema and food allergy prevention in view of recent new approaches and long-term follow-ups.: Recent findings: Attempting allergy prevention by probiotic ... ...

Abstract	Purpose of review: To describe the current literature on clinical trials of probiotics for eczema and food allergy prevention in view of recent new approaches and long-term follow-ups. Recent findings: Attempting allergy prevention by probiotic administration has been most successful when assessing atopic eczema, the most prevalent allergic disease at an early age. More than half of the published studies demonstrate a decrease in eczema prevalence until 2 years, whereas the remaining studies fail to show an effect. Effects have been most consistent with combined prenatal and direct postnatal supplementation of the infant and appear strain-specific, with Lactobacillus rhamnosus most often showing an effect. Prenatal-only and postnatal-only studies often fail to show effects. Recent long-time follow-ups have shown promising but not consistent results. A very recent follow-up of a large well conducted cohort shows that long-term effects of eczema prevention persists until age 4 and prevention of respiratory allergies might also be possible. Summary: Prevention of eczema with probiotics seem to work until age 2 years and extended effects until 4 years have been shown in high-risk for allergy cohorts. Effects are strain-specific, with L. rhamnosus showing the most consistent effects especially when combining pre and postnatal administration.
MeSH term(s)	Animals ; Child, Preschool ; Clinical Trials as Topic ; Eczema/microbiology ; Eczema/prevention & control ; Female ; Food Hypersensitivity/prevention & control ; Humans ; Infant ; Infant, Newborn ; Lactobacillus rhamnosus/immunology ; Postnatal Care ; Prebiotics ; Pregnancy ; Prenatal Care ; Prevalence ; Probiotics/administration & dosage
Chemical Substances	Prebiotics
Language	English
Publishing date	2013-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2088710-3
ISSN	1473-6322 ; 1528-4050
ISSN (online)	1473-6322
ISSN	1528-4050
DOI	10.1097/ACI.0b013e328360ed66
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Article ; Online: Allergic symptoms and sensitisation in adolescents with cows' milk allergy and atopic eczema in infancy.

Piippo, Sonja / Viljanen, Mirva / Savilahti, Erkki / Kuitunen, Mikael

Immunity, inflammation and disease

2020 Volume 8, Issue 3, Page(s) 423–433

Abstract: Background: The association between atopic sensitisation, atopic eczema (AE) and asthma is known, but distinct roles of allergies on long-term health are unestablished.: Objective: Evaluation of allergic symptoms and sensitisation in adolescents who ... ...

Abstract	Background: The association between atopic sensitisation, atopic eczema (AE) and asthma is known, but distinct roles of allergies on long-term health are unestablished. Objective: Evaluation of allergic symptoms and sensitisation in adolescents who in infancy had AE and verified cows' milk allergy (CMA) or AE and a negative CMA challenge, and controls. Methods: Children with AE, with and without CMA, from a randomised controlled study in 1999-2001 examining the effect of probiotics on AE severity at older than 12 months of age, attended a follow-up visit at age 16 to 18, with age-matched controls. Data came from a questionnaire (ISAAC questionnaire), analysis of serum antigen-specific immunoglobulin Es (IgEs), and clinical evaluation. Group comparisons were carried out (χ Results: Fifty-two patients with AE and CMA (AE/CMA+ group), 52 with AE and suspicion of CMA (AE/CMA- group), and 57 controls attended a study visit. IgE-mediated sensitisation was significantly more prevalent in the AE/CMA+ group vs the controls, for horse, cat, dog, egg white and wheat (P < .024 for all). For birch, timothy and mugwort (P < .008 for all), sensitisation was more prevalent in both the AE/CMA+ group and the AE/CMA- group vs controls. On the basis of questionnaire data the AE/CMA + group reported a significantly higher lifetime prevalence of wheezing (64% vs 35% and 32%; P = .001), noninfectious rhinitis (85% vs 62% and 56%; P = .004), and hay fever (77% vs 52% and 33%; P < .001) vs the AE/CMA- group and the control group, respectively. Conclusion and clinical relevance: Patients with AE and CMA in infancy, as opposed to patients with AE only, or controls, report more allergic symptoms and exhibit more allergic sensitisation in adolescence. This indicates that CMA in infancy is an independent risk factor of allergic disease in adolescence.
Language	English
Publishing date	2020-06-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2050-4527
ISSN (online)	2050-4527
DOI	10.1002/iid3.324
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Article: Atooppisen ihottuman hoito.

Kuitunen, Mikael

Duodecim; laaketieteellinen aikakauskirja

2009 Volume 125, Issue 5, Page(s) 535–541

Abstract: Atopic dermatitis affects 15 to 20% of the populations, the proportion being even larger in children. The diagnosis is a clinical one. Essential symptoms include itching and eczema on typical regions of the skin, as well as dry skin. The prognosis is ... ...

Title translation	Treatment of atopic eczema.
Abstract	Atopic dermatitis affects 15 to 20% of the populations, the proportion being even larger in children. The diagnosis is a clinical one. Essential symptoms include itching and eczema on typical regions of the skin, as well as dry skin. The prognosis is good, but development of respiratory allergy is common. Instructed self-care constitutes the basis of therapy. The skin is inflamed and its care is essential. First line treatment comprises regular application of emollient cream and intermittent use of ointments containing corticosteroids.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Adult ; Child ; Dermatitis, Atopic/drug therapy ; Emollients/therapeutic use ; Humans
Chemical Substances	Adrenal Cortex Hormones ; Emollients
Language	Finnish
Publishing date	2009
Publishing country	Finland
Document type	English Abstract ; Journal Article
ZDB-ID	127604-9
ISSN	0012-7183
ISSN	0012-7183
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Article ; Online: Probiotics prevent allergic diseases in high-risk children.

Kuitunen, Mikael

Expert review of clinical immunology

2009 Volume 5, Issue 3, Page(s) 221–224

Language	English
Publishing date	2009-05
Publishing country	England
Document type	Editorial
ZDB-ID	2274260-8
ISSN	1744-8409 ; 1744-666X
ISSN (online)	1744-8409
ISSN	1744-666X
DOI	10.1586/eci.09.3
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Article ; Online: Perinatal Probiotic Mixture and Development of Allergic Sensitization up to 13 Years of Age.

Peldan, Päivi Susanna / Kukkonen, Anna Kaarina / Savilahti, Erkki / Kuitunen, Mikael

International archives of allergy and immunology

2020 Volume 181, Issue 4, Page(s) 270–277

Abstract: Background: Probiotics have shown promising results in primary prevention of allergies in early years, but the long-term effects on allergic sensitization need more evaluation.: Objectives: We conducted a randomized double-blind placebo-controlled ... ...

Abstract	Background: Probiotics have shown promising results in primary prevention of allergies in early years, but the long-term effects on allergic sensitization need more evaluation. Objectives: We conducted a randomized double-blind placebo-controlled study to determine whether the use of a mixture of pre- and probiotics perinatally affects the prevalence of immunoglobulin E (IgE) sensitization up to 13 years in high-risk children. Methods: One thousand two hundred twenty-three pregnant women were randomized to receiving probiotics or placebo from 36 gestational weeks until delivery, and their infants received pre- and probiotics or placebo from birth until 6 months. At 2, 5, and 13 years, blood samples were taken to determine specific IgE levels against common foods, pollen, and animal antigens. Results: The prevalence of IgE sensitization to any allergen was high and increased with age. No significant difference in the prevalence of IgE sensitization to any particular one of the tested allergens was found between the groups. At 2, 5, and 13 years these prevalence rates of IgE sensitization to any allergen were 31.1 and 34.1%, 50.1 and 45.6%, and 61.4 and 56.8% in the probiotic and placebo groups, respectively. At 13 years, IgE sensitization to cat/dog dander was more frequent in the probiotic group compared to the placebo group (40.2 vs. 31.0%, p = 0.03). Conclusions: In high-risk children, perinatal use of a mixture of probiotics did not affect the prevalence of sensitization to any one of the tested allergens, but it was associated with more frequent IgE sensitization to cat/dog dander at 13 years.
MeSH term(s)	Adolescent ; Allergens/immunology ; Animals ; Cats ; Child, Preschool ; Dogs ; Double-Blind Method ; Female ; Food Hypersensitivity/immunology ; Humans ; Hypersensitivity/immunology ; Immunoglobulin E/immunology ; Male ; Probiotics/adverse effects
Chemical Substances	Allergens ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2020-02-04
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1108932-5
ISSN	1423-0097 ; 1018-2438
ISSN (online)	1423-0097
ISSN	1018-2438
DOI	10.1159/000504915
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Article ; Online: Decrease in paediatric emergency room visits during the COVID-19 pandemic restrictions: A population-based study.

Wärnhjelm, Elina / Lääperi, Mitja / Kuitunen, Mikael / Helve, Otto / Puhakka, Laura / Harve-Rytsälä, Heini / Salmi, Heli

Acta paediatrica (Oslo, Norway : 1992)

2022 Volume 111, Issue 11, Page(s) 2165–2171

Abstract: Aim: To investigate paediatric emergency room (ER) visits to evaluate the immediate health effects of COVID-19 pandemic restrictions on children.: Methods: We retrospectively examined paediatric ER visits in the Helsinki University Hospital (HUH) ... ...

Abstract	Aim: To investigate paediatric emergency room (ER) visits to evaluate the immediate health effects of COVID-19 pandemic restrictions on children. Methods: We retrospectively examined paediatric ER visits in the Helsinki University Hospital (HUH) district during the first wave of the pandemic (1 March to 31 May 2020), and a 2-month period immediately before and after. These periods were compared to the corresponding time periods in 2015-2019 ('reference period'). Results: The total number of ER visits decreased by 23.4% (mean 6474 during the reference period, 4960 during the pandemic period (incidence rate ratio [IRR] 0.75, 95% confidence interval 0.72-0.77; p < 0.001). This was due to a decrease in visits related to infectious diseases; visits due to surgical reasons did not decrease. The amount or proportion of patients triaged to the most urgent class (Emergency Severity Index 1) did not increase. Paediatric ER visits returned to baseline after lifting of restrictions. Conclusions: Although paediatric ER visits substantially decreased during the pandemic restrictions, children seen at the ER were not more severely ill. Our results do not indicate immediate detrimental health effects of pandemic control measures on children.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; Child ; Emergency Service, Hospital ; Humans ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-08-09
Publishing country	Norway
Document type	Journal Article
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.16498
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Article: The Cow’s Milk Related Symptom Score: The 2022 Update

Vandenplas, Yvan / Bajerova, Katerina / Dupont, Christophe / Eigenmann, Philippe / Kuitunen, Mikael / Meyer, Rosan / Ribes-Koninckx, Carmen / Salvatore, Silvia / Shamir, Raanan / Szajewska, Hania

Nutrients. 2022 June 28, v. 14, no. 13

2022

Abstract: CoMiSS® was developed 7 years ago to increase the awareness of health care professionals towards the possibility that symptoms presented by infants could be related to cow’s milk. While CoMiSS was conceived mostly on theoretical concepts, data is now ... ...

Abstract	CoMiSS® was developed 7 years ago to increase the awareness of health care professionals towards the possibility that symptoms presented by infants could be related to cow’s milk. While CoMiSS was conceived mostly on theoretical concepts, data is now available from 25 clinical trials. Based on this extensive research using the tool since 2015, we aim to propose an updated CoMiSS. The evidence was reviewed, debated and discussed by 10 experts, of whom seven were part of the original group. The panel concluded that the cut-off previously proposed to indicate the likelihood that symptoms may be cow’s milk related should be lowered from ≥12 to ≥10. Data in healthy infants > 6 months are missing. Since the Brussels Infant and Toddlers Stool Scale (BITSS) was recently developed for non-toilet trained children, the Bristol Stool Scale was changed to the BITSS without changing the impact of stool characteristics on CoMiSS. Overall, CoMiSS raises awareness that symptoms might be cow’s milk related. New studies are needed to determine if the change in cut-off and other small adaptions improve its sensitivity and specificity. Data for CoMiSS is still needed in presumed healthy infants between 6 and 12 months old. There may also be regional differences in CoMiSS, in healthy infants as well as in those with cow’s milk allergy. Finally, we emphasize that CoMiSS is an awareness tool and not a diagnostic test.
Keywords	cows ; health services ; milk ; milk allergy
Language	English
Dates of publication	2022-0628
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14132682
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Out-of-hospital deaths among children during COVID-19 pandemic: indicator of collateral damage?

Harve-Rytsälä, Heini / Puhakka, Laura / Kuisma, Markku / Kuitunen, Mikael / Oulasvirta, Jelena / Salmi, Heli

BMJ paediatrics open

2020 Volume 4, Issue 1, Page(s) e000763

Abstract: We aimed to investigate the out-of-hospital mortality, and the actual prevalence of COVID-19 in children requiring paediatric emergency department (ED) care for infectious symptoms. There were four emergency medical services (EMS) responses concerning ... ...

Abstract	We aimed to investigate the out-of-hospital mortality, and the actual prevalence of COVID-19 in children requiring paediatric emergency department (ED) care for infectious symptoms. There were four emergency medical services (EMS) responses concerning children (age 0-15 years) leading to death on-scene in 2 months during the pandemic, and eight during the previous 12 months in the Helsinki University Hospital area, although the number of EMS missions decreased by 18%. The prevalence of COVID-19 in children contacting a paediatric ED for any infectious symptoms during the epidemic peak was only 2.7%.
Language	English
Publishing date	2020-08-13
Publishing country	England
Document type	Journal Article
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2020-000763
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