Effectiveness of Oral Probiotics in Treating Atopic Dermatitis
Overview of Atopic Dermatitis
A randomized clinical trial featured in JAMA Dermatology investigates the role of oral probiotics in managing atopic dermatitis, a chronic inflammatory skin condition affecting up to 20% of children globally. This condition is marked by recurrent episodes of severe inflammation and itching, and it predisposes affected children to other health issues, including asthma and chronic sinusitis.
Immune Response and Atopic Dermatitis
Atopic dermatitis is characterized by an imbalanced immune response, specifically an increased ratio of T helper-2 cells compared to T helper-1 cells. T helper cells are crucial for immune system function, and their imbalance leads to elevated levels of Immunoglobulin E (IgE), an antibody integral to allergic responses. Previous research has indicated a potential connection between compromised intestinal barriers and the T helper-2 dominant inflammation seen in atopic dermatitis. Notably, patients with this condition often exhibit reduced populations of gut bacteria that produce beneficial compounds like butyrate and propionate, which possess anti-inflammatory properties and support intestinal barrier health.
Research Objective
In light of the relationship between gut microbiota and immune response, a team of Spanish researchers aimed to evaluate the efficacy of oral probiotics in treating atopic dermatitis. Their findings were recently published in JAMA Dermatology.
Study Design
The investigation employed a randomized, double-blind, placebo-controlled trial over 12 weeks at a dermatology center in Spain. Fifty children aged 4 to 17 with moderate atopic dermatitis participated. To minimize confounding variables, the study excluded participants who had recently used immunosuppressive medications or antibiotics, or who had diagnoses of bowel disease or bacterial infections.
Outcome Measures
The primary outcome assessed was the Scoring Atopic Dermatitis (SCORAD) index, which evaluates the severity and extent of atopic dermatitis symptoms. Researchers also tracked the number of days that topical steroids were necessary during flare-ups. The treatment group received a daily maltodextrin capsule containing probiotic strains Bifidobacterium lactis, B. longum, and Lactobacillus casei, while the placebo group took a maltodextrin-only pill.
Results of the Study
Following the treatment period, children in the probiotic group exhibited a more significant decrease in SCORAD index scores. An impressive 96% of those receiving probiotics experienced improvements, compared to just 46% in the placebo group. Furthermore, the probiotic participants required notably fewer days of topical steroids to manage flare-ups.
Study Limitations
Despite its promising findings, the study has limitations, including a relatively short follow-up duration and being conducted at a single center. While the duration of corticosteroid use was noted, the specific dosages were not recorded. The researchers caution that the applicability of these results may be limited to the studied demographic, and further research is needed to understand the implications for different age groups and dietary backgrounds.
Conclusion
This significant trial suggests that probiotics could serve as an effective and safe adjunct treatment to decrease the SCORAD index and reduce the reliance on topical steroids in children suffering from atopic dermatitis.
Reference
Navarro-López V, Ramírez-Boscá A, Ramón-Vidal D, et al. Effect of oral administration of a mixture of probiotic strains on SCORAD index and use of topical steroids in young patients with moderate atopic dermatitis. JAMA Dermatology. 2018;154(1):37. doi:10.1001/jamadermatol.2017.3647