Probiotics Improve Atopic Dermatitis

EDEN PRAIRIE, Minn.According to a paper recently presented at the New York Academy of Sciences symposium, Probiotics: From Bench to Market, held on June 11, 2010, two probiotic strains significantly improved atopic dermatitis, which affects 17.2 percent of the U.S. population. The clinical study evaluated the impact of a mixture of Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABLA-12 (from UAS Labs) on 90 preschool children (ages 1 to 3 years) with moderate to severe atopic dermatitis (AD) versus a placebo demonstrated a 33.7-percent decrease in SCORAD (scoring of atopic dermatitis) versus 19.4 percent in the placebo group. Other outcome measures included a 33-percent increase in IDQOL (infant dermatitis quality of life) 19 percent in placebo and a 34.4-percent increase in DFI (dermatitis family impact) in probiotic group versus 23.8 percent in placebo. 

SV Gerasimov, M.D., Ph.D., from the Department of Pediatrics, Lviv National Medical University, Lviv, Ukraine, conducted the study on children with AD, which often occurs in early childhood and persists into adult life (more 60 percent of patients). Current treatments include skin hydration, emollients, avoidance of allergens and irritants, use of antihistamines or topical corticosteroids. The therapeutic use of probiotics has attracted considerable attention after publication of the hygiene hypothesis (BMJ 1989;299:1259-60). Several clinical studies have demonstrated mild to complete resolution of AD following treatment with probiotics while others have suggested the effect is limited to select children with atopy.

This study was designed to determine the clinical efficacy of a new probiotic preparation and to determine the impact on peripheral lymphocytes.  A total of 90 preschool children were randomly divided into two groups to receive either the probiotic or the placebo. Parents administered the doses twice per day to provide a total of 10 billion CFU/g of a combination of L. acidophilus DDS-1 and B. lactis UABLA-12 with fructooligosaccharides (FOS).  The primary outcome measure was percent change in SCORAD index at week eight.  Secondary outcomes were changes in IDQOL, DFI at weeks 2, 4 and 8 frequency, and amount of topical corticosterioid used and absolute number and percent of peripheral blood lymphocyte subsets at week eight.  Patients displayed a progressive decline in SCORAD indexes reaching significant difference at week four in both groups; however children receiving probiotics experienced a more rapid decline.

Patients with active AD had a reduced percentage of CD3 and CD8 peripheral lymphocytes and increased CD4 and CD25 counts. Hypothetically, the recovery from AD due to use of probiotics may be accompanied by normalization of CD3, CD4, CD8 and CD25 numbers.  The study showed a correlation between reduction in CD4 and CD25 percent/absolute number and SCORAD values at week eight in the probiotic group.

The researchers concluded, the use of a probiotic mixture containing L. acidophilus DDS-1, B. lactis UABLA-12 and fructooligosaccharide was associated with significant clinical improvement in children with AD, and corresponding lymphocyte subset changes in peripheral blood.  The efficacy of probiotic therapy in adults with AD will need more investigation.