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Published on: September 26, 2019
Children with atopic dermatitis show clinical improvement after Lactobacillus exposure
1Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan; College of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Health Risk Management, China Medical University, Taichung, Taiwan.
Insights
Probiotic supplementation with Lactobacillus paracasei (LP) and Lactobacillus fermentum (LF) improved atopic dermatitis (AD) severity and quality of life in children. Clinical benefits persisted even after treatment cessation, suggesting a lasting impact on AD management.
Area of Science:
- Microbiology and Immunology
- Pediatric Dermatology
- Gastroenterology
Background:
- The efficacy of probiotics for atopic dermatitis (AD) remains unclear, necessitating further research into novel probiotic formulations.
- Existing studies have not definitively established the role of specific probiotic strains in managing AD symptoms.
Purpose of the Study:
- To evaluate the impact of Lactobacillus paracasei (LP) and Lactobacillus fermentum (LF), individually and combined, on AD severity.
- To assess changes in quality of life and immune biomarkers in pediatric AD patients receiving probiotic treatment.
- To investigate the long-term effects of probiotic supplementation on AD management.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 220 children (1-18 years) with moderate-to-severe AD.
- Participants received LP, LF, a combination of LP + LF, or placebo for three months.
- Evaluated outcomes included SCORAD, FDLQI, CDLQI, skin prick tests, IgE, and cytokine levels (IFN-γ, IL-4, TGF-β, TNF-α).
Main Results:
- Probiotic groups (LP, LF, LP+LF) demonstrated significantly reduced SCORAD scores compared to placebo (P < 0.001), with sustained effects post-treatment.
- Improvements in FDLQI and CDLQI scores were observed in children receiving probiotics (P = 0.02 and 0.03).
- While some immune markers showed trends, only IL-4 reached statistical significance (P = 0.04). Subgroup analysis revealed significant SCORAD reduction in children under 12, with prolonged breastfeeding, and mite sensitization.
Conclusions:
- Supplementation with a probiotic mixture of LP and LF is linked to significant clinical improvements in pediatric atopic dermatitis.
- The findings support the use of specific probiotic strains for managing AD symptoms and enhancing patient quality of life.
- Further investigation into the immunomodulatory mechanisms of these probiotics in AD is warranted.
Background:
The role of probiotics in the treatment of atopic dermatitis (AD) is not clearly established. Further clinical trials with new probiotic formulations are warranted.
Objectives:
To assess the effects of Lactobacillus paracasei (LP) and Lactobacillus fermentum (LF), and their mixture on the disease severity, quality of life, and immune biomarkers of children with AD.
Method:
A double-blind, prospective, randomized placebo-controlled study was conducted on 220 children aged 1-18 years with moderate-to-severe AD (Trial number: NCT01635738). The children were randomized to receive LP, LF, LP + LF mixture, and placebo for 3 months. Changes in severity scoring of atopic dermatitis (SCORAD), Family Dermatology Life Quality Index (FDLQI), and Children's Dermatology Life Quality Index (CDLQI) scores in the different groups and at different visits were evaluated. Skin prick tests, levels of IgE, IFN-γ, IL-4, TGF-β, and TNF-α, and urine biomarkers were also evaluated.
Results:
Children who received LP, LF, and LP + LF mixture showed lower SCORAD scores than the placebo group (P < 0.001), and this difference remained even at 4 months after discontinuing the probiotics. The FDLQI and CDLQI scores were lower in the LP, LF, and LP + LF mixture group than in the placebo group (P = 0.02 and 0.03). IgE, TNF-α, urine eosinophilic protein X, and 8-OHdG levels decreased, whereas IFN-γ and TGF-β increased in the probiotic groups, but these did not reach statistical significance except for IL-4 (P = 0.04). In subgroup analyses, SCORAD scores significantly decreased after probiotic treatment especially in children younger than age 12, with breastfeeding > 6 months, and with mite sensitization (P < 0.001).
Conclusion:
Supplementation of a probiotic mixture of LP and LF is associated with clinical improvement in children with AD.
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