Role of Probiotics in Treatment of Paediatric Atopic Dermatitis

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Efficacy of Probiotic Supplementation in Paediatric Atopic Dermatitis Treatment

In the past few decades, the prevalence of atopic dermatitis (AD) has risen. Increased Th2-type allergic response due to early exposure to microbial stimuli is a major contributor of AD. Immune-modulatory Th2 response suppression effects of probiotics can help in AD prophylaxis. This study published in the journal of Clinical and Experimental Allergy assessed the efficacy of Lactobacillus paracasei (LP) and Lactobacillus fermentum (LF) alone and in combination (LP+LF) on the quality of life, disease severity and immune biomarkers of children with AD.

In this prospective, double-blind, placebo-controlled trial, 220 children with moderate-to-severe AD (aged 1–18 years) were randomised (n=55 per group) to receive LP, LF (2×109 colony-forming units [CFU] qd), LP+LF (4×109 CFU qd) or placebo for three months. The four groups were evaluated using changes in severity of SCORing Atopic Dermatitis (SCORAD), Children’s Dermatology Life Quality Index (CDLQI) and Family Dermatology Life Quality Index (FDLQI) scores, wherein lower scores correlated with better quality of life. Skin prick test, urine biomarkers and IgE, IL-4, TNF-α, TGF-β and IFN-γ levels were also assessed.

The SCORAD, CDLQI and FDLQI scores of the LP, LF and LP+LF groups were lower compared to the placebo group. A reduction in urine eosinophilic protein X, IgE, TNF-α and 8-OHdG levels and an increase in IFN-γ and TGF-β levels were observed in the probiotics group; however, the results were not statistically significant except for IL-4. In subgroup analysis, significant reduction in SCORAD scores was achieved after probiotics treatment, particularly in children aged <12 years, with breastfeeding >6 months, and with mite sensitization.

The study concluded that LP and LF supplementation results in clinical improvements in children with AD.

News Source: Wang IJ, Wang JY. Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. Clin Exp Allergy. 2015;45(4):779–787.