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Efficacy of Probiotic Therapy on Atopic Dermatitis in Children: A Randomized, Double-blind, Placebo-controlled Trial
Hyeon-Jong Yang1, Taek Ki Min1, Hae Won Lee1
1Pediatric Allergy and Respiratory Center, Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Insights
This study found that while probiotics colonized the gut in children with atopic dermatitis (AD), they did not offer additional therapeutic benefits beyond placebo. Further research is needed to confirm long-term efficacy.
Area of Science:
- Clinical immunology
- Microbiology
- Pediatric dermatology
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting children.
- Probiotics are being investigated for their potential therapeutic effects in various inflammatory conditions, including AD.
- Understanding the efficacy of probiotic interventions is crucial for developing new treatment strategies.
Purpose of the Study:
- To evaluate the therapeutic efficacy of a specific probiotic mixture in treating mild-to-moderate atopic dermatitis (AD) in children.
- To assess the impact of probiotics on clinical severity scores and immunological markers.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 100 children aged 2-9 years with mild-to-moderate AD.
- Participants received either a probiotic mixture (Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus plantarum, Bifidobacterium lactis) or a placebo for 6 weeks.
- Efficacy was measured by changes in Eczema Area Severity Index (EASI), Visual Analogue Scale for Pruritus (VASP), fecal bacterial counts, and serum cytokine levels (IL-4, IL-10, TNF-α).
Main Results:
- Probiotics successfully colonized the intestines, evidenced by increased fecal bacterial counts in the probiotic group.
- Both the probiotic and placebo groups showed significant improvements in clinical severity (EASI and VASP).
- No significant differences in serum cytokine levels (IL-4, IL-10, TNF-α) were observed between the groups.
Conclusions:
- The probiotic mixture demonstrated gut colonization but did not provide additional therapeutic or immunomodulatory benefits for atopic dermatitis compared to placebo after 6 weeks.
- The observed clinical improvements in both groups suggest a potential placebo effect or spontaneous remission.
- Further long-term studies are required to definitively ascertain the therapeutic efficacy of probiotics in managing childhood atopic dermatitis.
Purpose:
To evaluate a therapeutic efficacy of probiotics mixture (probiotics) in the treatment of children with mild-to-moderate atopic dermatitis (AD).
Methods:
Randomized, double-blind, placebo-controlled, parallel trial with a washout period of 2 weeks and an intervention period for 6 weeks, conducted from November 2010 to October 2011. One hundred children with mild to moderate AD (2-9 years old) were randomly allocated to the probiotics (Lactobacilluss casei, Lactobacillus rhamnosus, Lactobacillus plantarum, and Bifidobacterium lactis) or placebo groups. The assessment of efficacy was based on the change in eczema area severity index (EASI), visual analogue scale for pruritus (VASP), fecal cell counts of each strains (log10[cell counts/g stool]), and serum cytokine levels (Interleukin-4 [IL-4]; IL-10; Tumor necrosis factor alpha, [TNF-α]) in weeks 0 and 6.
Results:
Demographics and baseline characteristics at the week 0 were not significantly different between the 2 groups. The significant increments in fecal-cell counts were observed in the probiotcs group at week 6 (P=0.00), while the cytokine levels between the 2 groups were not significantly different in week 6 (IL-4, P=0.50; IL-10, P=0.58; TNF-α, P=0.82). The probiotics significantly improved clinical severity after 6 weeks' intervention of probiotics; however, the placebo group also showed significant improvement (EASI; P=0.00, VASP; P=0.00).
Conclusions:
Our findings showed that probiotics successfully colonized in the intestine after 6 weeks' intervention; nevertheless, we could not find an additional therapeutic or immunomodulatory effects on the treatment of AD. Further long-term studies will be necessary to clarify the therapeutic efficacy of probiotics.