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Efficacy of Probiotics in Children and Adolescents With Atopic Dermatitis: A Randomized, Double-Blind,
Paula Danielle Santa Maria Albuquerque de Andrade1, Jorgete Maria E Silva1, Vanessa Carregaro2
1Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Insights
A probiotic mixture significantly improved atopic dermatitis (AD) in children and adolescents, reducing SCORing Atopic Dermatitis (SCORAD) scores. This clinical benefit persisted post-treatment, suggesting probiotics as a valuable adjuvant therapy for AD.
Area of Science:
- Microbiology
- Immunology
- Dermatology
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting children and adolescents.
- Current treatments for AD have limitations and side effects.
- Probiotics, particularly Lactobacillus and Bifidobacterium species, show potential in modulating immune responses.
Purpose of the Study:
- To assess the clinical efficacy of a probiotic mixture in pediatric AD patients.
- To investigate the impact of probiotics on AD-related sensitization, inflammation, and immunological tolerance.
- To evaluate the effect of probiotics on the need for conventional AD treatments.
Main Methods:
- A double-blind, randomized, placebo-controlled trial involving 60 pediatric patients with AD.
- Patients received daily probiotics (Lactobacillus and Bifidobacterium) or placebo for six months.
- Primary outcome: reduction in SCORing Atopic Dermatitis (SCORAD) index; secondary outcomes: IgE levels, skin prick tests, and cytokine profiles.
Main Results:
- Significant SCORAD reduction in the probiotic group compared to placebo after six months.
- Sustained clinical improvement observed for three months after probiotic discontinuation.
- Reduced need for topical immunosuppressants in the probiotic group.
Conclusions:
- A probiotic mixture demonstrated significant clinical efficacy in children and adolescents with AD.
- The therapeutic benefit of probiotics for AD is linked to treatment duration.
- Probiotics can be considered as an effective adjuvant therapy for managing atopic dermatitis.
Objective:
To evaluate the clinical efficacy of a mixture of probiotics (Lactobacillus and Bifidobacterium) in children and adolescents with atopic dermatitis (AD) and the effects on sensitization, inflammation, and immunological tolerance.
Methods:
In this double-blind, randomized, placebo-controlled clinical trial, we enrolled 60 patients aged between 6 months and 19 years with mild, moderate, or severe AD, according to the criteria proposed by Hanifin and Rajka. Patients were stratified to receive one gram per day of probiotics or placebo for 6 months. The primary outcome was a decrease in SCORing Atopic Dermatitis (SCORAD). Secondary outcomes were to assess the role of probiotics on the use of topical and oral medicines (standard treatment), serum IgE levels, skin prick test (SPT), and tolerogenic and inflammatory cytokines. Background therapy was maintained.
Results:
Forty patients completed the study (24 probiotics, 16 placebo). After treatment for six months, the clinical response was significantly better in the probiotics group; the SCORAD decreased [mean difference (MD) 27.69 percentage points; 95% confidence interval (CI), 2.44-52.94], even after adjustment for co-variables (MD 32.33 percentage points; 95%CI, 5.52-59.13), especially from the third month of treatment on. The reduction of the SCORAD in probiotic group persisted for three more months after the treatment had been discontinued, even after adjustment for co-variables (MD 14.24 percentage points; 95%CI, 0.78-27.70). Patients in the probiotics group required topical immunosuppressant less frequently at 6 and 9 months. No significant changes were found for IgE levels, SPT and cytokines.
Conclusions:
Children and adolescents with AD presented a significant clinical response after 6 months with a mixture of probiotics (Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus paracasei, and Bifidobacterium lactis. However, this clinical benefit is related to treatment duration. Probiotics should be considered as an adjuvant treatment for AD.
