Ann Dermatol.  2012 May;24(2):189-193.

Effect of Probiotics on the Treatment of Children with Atopic Dermatitis

Affiliations
  • 1Department of Dermatology, Harran University Faculty of Medicine, Sanliurfa, Turkey. yavuzyesilova@gmail.com
  • 2Department of Dermatology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.
  • 3Department of Microbiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.

Abstract

BACKGROUND
Atopic dermatitis, a chronic recurrent disease, is frequently encountered in clinical practice. In the last 30 years, the prevalence of atopic dermatitis has rapidly increased due to industrialization. Therefore, there have been attempts in recent years to find new ways of treating and preventing atopic dermatitis.
OBJECTIVE
In this double-blind, randomized, placebo-controlled study, a combination of Bifidobacterium bifidum, Lactobacillus acidophilus, Lactobacillus casei, and Lactobacillus salivarius strains were evaluated in the treatment of atopic dermatitis in pediatric patients.
METHODS
Forty pediatric patients (23 males and 17 females) aged 1~13 years were enrolled. One eligible individual who was approached declined to participate. The probiotic group was administered a probiotic complex containing B. bifidum, L. acidophilus, L. casei, and L. salivarius for 8 weeks. The placebo group, on the other hand, was administered skim milk powder and dextrose. All of the parameters including serum cytokines, eosinophil cationic protein), SCORing Atopic Dermatitis (SCORAD) index, and total serum immunoglobulin E (IgE) were measured in both the probiotic group and the placebo group at the end of 8 weeks.
RESULTS
Probiotic intervention in pediatric atopic dermatitis patients effectively reduced the SCORAD index and serum cytokines interleukin (IL)-5, IL-6, interferon (IFN)-gamma, and total serum IgE levels, but did not reduce levels of serum cytokines IL-2, IL-4, IL-10, ECP, or tumor necrosis factor-alpha (TNF-alpha) compared to the placebo group.
CONCLUSION
Our study found probiotics to be effective in reducing atopic dermatitis patients' SCORAD index, serum IL-5, IL-6, IFN-gamma, and total serum IgE levels but not effective in reducing serum IL-2, IL-4, IL-10, ECP, or TNF-alpha levels.

Keyword

Atopic dermatitis; Cytokines; Probiotics; SCORAD index

MeSH Terms

Aged
Bifidobacterium
Child
Cytokines
Dermatitis, Atopic
Eosinophils
Glucose
Hand
Humans
Immunoglobulin E
Immunoglobulins
Interferons
Interleukin-10
Interleukin-2
Interleukin-4
Interleukin-5
Interleukin-6
Interleukins
Lactobacillus
Lactobacillus acidophilus
Lactobacillus casei
Male
Milk
Prevalence
Probiotics
Tumor Necrosis Factor-alpha
Cytokines
Glucose
Immunoglobulin E
Immunoglobulins
Interferons
Interleukin-10
Interleukin-2
Interleukin-4
Interleukin-5
Interleukin-6
Interleukins
Tumor Necrosis Factor-alpha

Figure

  • Fig. 1 Changes in the levels of serum cytokines, SCORAD index, and total serum IgE and comparisons before and after probiotic and placebo administration. SCORAD: SCORing Atoptic Dermatitis, IgE: immunoglobulin E, IL-2: interleukin-2, IL-4: interleukin-4, IL-5: interleukin-5, IL-6: interleukin-6, IL-10: interleukin-10, TNF-α: tumor necrosis factor-α, IFN-γ: interferon-γ, ECP: eosinophil cationic protein.


Reference

1. Kristal L, Klein PA. Atopic dermatitis in infants and children. An update. Pediatr Clin North Am. 2000. 47:877–895.
2. Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001. 56:813–824.
Article
3. Bengmark S, García de Lorenzo A, Culebras JM. Use of pro-, pre- and synbiotics in the ICU--future options. Nutr Hosp. 2001. 16:239–256.
4. Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgrad Med J. 2004. 80:516–526.
Article
5. Cosickic A, Skokic F, Colic-Hadzic B, Jahic M. Clinical characteristics and estimation severity of the atopic dermatitis in children. Med Arh. 2010. 64:178–182.
6. Carr WW. Improvements in skin-testing technique. Allergy Asthma Proc. 2006. 27:100–103.
7. Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007. 157:645–648.
Article
8. Boyle RJ, Robins-Browne RM, Tang ML. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr. 2006. 83:1256–1264.
Article
9. Servin AL, Coconnier MH. Adhesion of probiotic strains to the intestinal mucosa and interaction with pathogens. Best Pract Res Clin Gastroenterol. 2003. 17:741–754.
Article
10. Morita H, He F, Fuse T, Ouwehand AC, Hashimoto H, Hosoda M, et al. Adhesion of lactic acid bacteria to caco-2 cells and their effect on cytokine secretion. Microbiol Immunol. 2002. 46:293–297.
Article
11. Maassen CB, van Holten-Neelen C, Balk F, den Bak-Glashouwer MJ, Leer RJ, Laman JD, et al. Strain-dependent induction of cytokine profiles in the gut by orally administered Lactobacillus strains. Vaccine. 2000. 18:2613–2623.
Article
12. Roessler A, Friedrich U, Vogelsang H, Bauer A, Kaatz M, Hipler UC, et al. The immune system in healthy adults and patients with atopic dermatitis seems to be affected differently by a probiotic intervention. Clin Exp Allergy. 2008. 38:93–102.
Article
13. Betsi GI, Papadavid E, Falagas ME. Probiotics for the treatment or prevention of atopic dermatitis: a review of the evidence from randomized controlled trials. Am J Clin Dermatol. 2008. 9:93–103.
14. Weston S, Halbert A, Richmond P, Prescott SL. Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child. 2005. 90:892–897.
Article
15. Van Leent EJM, Bos JD. Katsambas AD, Lotti TM, editors. Atopic dermatitis. European handbook of dermatological treatments. 2003. 2nd ed. Berlin: Springer-Verlag;54–62.
Article
16. Isolauri E. Probiotics in the prevention and treatment of allergic disease. Pediatr Allergy Immunol. 2001. 12:56–59.
Article
17. Kalliomäki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001. 357:1076–1079.
Article
18. Kalliomäki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet. 2003. 361:1869–1871.
Article
19. Sistek D, Kelly R, Wickens K, Stanley T, Fitzharris P, Crane J. Is the effect of probiotics on atopic dermatitis confined to food sensitized children? Clin Exp Allergy. 2006. 36:629–633.
Article
20. Brouwer ML, Wolt-Plompen SA, Dubois AE, van der Heide S, Jansen DF, Hoijer MA, et al. No effects of probiotics on atopic dermatitis in infancy: a randomized placebo-controlled trial. Clin Exp Allergy. 2006. 36:899–906.
Article
21. Viljanen M, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, et al. Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Allergy. 2005. 60:494–500.
Article
22. Prescott SL, Dunstan JA, Hale J, Breckler L, Lehmann H, Weston S, et al. Clinical effects of probiotics are associated with increased interferon-gamma responses in very young children with atopic dermatitis. Clin Exp Allergy. 2005. 35:1557–1564.
Article
23. Ouwehand AC. Antiallergic effects of probiotics. J Nutr. 2007. 137:794S–797S.
Article
24. Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP. Molecular and cellular basis of microflora-host interactions. J Nutr. 2007. 137:756S–772S.
Article
25. Taylor AL, Hale J, Wiltschut J, Lehmann H, Dunstan JA, Prescott SL. Effects of probiotic supplementation for the first 6 months of life on allergen- and vaccine-specific immune responses. Clin Exp Allergy. 2006. 36:1227–1235.
Article
26. Miniello VL, Brunetti L, Tesse R, Natile M, Armenio L, Francavilla R. Lactobacillus reuteri modulates cytokines production in exhaled breath condensate of children with atopic dermatitis. J Pediatr Gastroenterol Nutr. 2010. 50:573–576.
Article
Full Text Links
  • AD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr