Probiotic Mixtures Effective in Managing Atopic Dermatitis in Children

Recent studies conducted in Korea suggested oral administration of probiotic mixtures were effective in reducing the severity of atopic dermatitis (AD) in children. Probiotics were also effective in restoring gut microbiota and reducing intestinal inflammation.

Although the direct cause and pathogenesis of atopic dermatitis are poorly defined, the disorder had been linked to the dysbiosis of the intestinal microbiota in patients and has affected roughly 20% of the global pediatric population.

Gut microbiota are integral in the management of intestinal inflammation and have often influenced systemic immune responses.

The team of investigators, led by Wonsuck Yoon, PhD, touched on the effects of damaged gut epithelium in children.

“The damaged gut epithelium with increased permeability may allow the passage of allergens to the systemic circulation,” the team wrote. “Thus, altered gut microbiota induces epithelial damage resulting in increased intestinal inflammation, permeability and immunological imbalance, which affect the development of AD.”

In recent years, probiotics have become a popular method in treating atopic dermatitis among health care professionals.

Yoon and colleagues proposed the use of probiotics to enhance immunological protection, restore imbalanced gut microbiota and reduce inflammation in patients.

A 4-week open clinical trial was performed on 25 children ages 3-10 years old with atopic dermatitis, all of whom were diagnosed based on criteria within the Scoring of Atopic Dermatitis (SCORAD) index. Roughly half of the group were male, and 72% of all participants had a family history of allergic diseases.

The team took blood and stool samples from each participant before and after the 4-week probiotic trials. During the 4 weeks, participants were orally administered a probiotic mixture.

The mixture contained the following: Lactobacillus vulgaris; Lactobacillus acidophilus, Lactobacillus Cust Hemophilus; Bifidobacterium longum; and Bifidobacterium bifidum.

In addition to blood and stool samples, a MAST-immunoblot assay was performed using a food panel of the AdvanSure Allergy Screen kit (LG Life Sciences, Seoul, Korea), which consisted of 23 types of food allergens.

Trans-epidermal water loss (TEWL) was also assessed noninvasively with a Tewameter TM 300 (Courage + Khazaka, Ko€ln, Germany) under standardized environmental conditions.

The study showed that fecal calprotectin levels decreased after 4 weeks administration of the probiotic mixture, which led to diminished intestinal inflammation in participants. The results mirrored a previous animal study, with probiotics modulating local immunity and enhancing systemic immune responses.

Several other mechanisms were examined after the trial, such as microbiome diversity and the enabling of mononuclear phagocytes by the probiotics to secrete anti-inflammatory mediators.

Despite some limitations, the team concluded that the observed uses of the probiotic regime was very effective in managing pediatric atopic dermatitis. While they admitted further study be conducted on the long-term effects of probiotics on alterations in gut microbiome and modulation of immune responses, the immediate response from participants was overwhelmingly positive.

The diminishment of intestinal inflammation in participants, as well as increased microbiome diversity, provided investigators with a short-term solution for managing atopic dermatitis in children as well as a springboard for future studies.

“The results of this study suggest that a probiotic mixture can alleviate AD by decreasing inflammation and modulating the gut microbiota in children with AD,” the team wrote.

The study, “Probiotic mixture reduces gut inflammation and microbial dysbiosis in children with atopic dermatitis,” was published online in the Australian Journal of Dermatology.