Atopic Dermatitis ( Eczema) and Probiotics
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Atopic Dermatitis (Eczema) and Probiotics
Atopic Dermatitis (Eczema) and ProbioticsBy Jacqueline Wivinus and Kristina Hegarty1Effect of probiotics on the treatment of children with atopic dermatitisObjective: To study the effects of the use of probiotics in pediatric patients that suffer from atopic dermatitis.
Clinical Significance: Intestinal permeability and dysbiosis influence gut immune functionGI permeability is thought to be greatest in early infancy and to decline with intestinal maturation. GI permeability and microbiota are thought to be critical influences in allergic disease. 1Probiotics compete with pathogensProbiotics alleviate immunogenicity of potential allergens
2MethodsDouble-blind randomized, placebo-controlled studyPediatric patients: 1-13 yoProbiotic complex Bifidobacterium bifidumLactobacillus acidophilusLactobacillus caseiLactobacillus salivariusPlacebo control groupSkim milk powderdextrose
5LimitationsStrengthsRandomized, double-blind, controlled trialStatistically significant resultsMeasuring multiple inflammatory markersWeaknessesSkim milk placeboSmall sample sizeLimited to pediatric patientsDuration SCORAD subjectivity
6Database reviewThe Cochrane Database12 randomized controlled trials reviewedNo significant improvement with probioticsUp to Date DatabaseMeta-analyses of using probiotics for eczema treatmentProblems of quality with some studies and heterogeneityProbiotics benefit IgE sensitized individuals
7Database reviewNatural StandardProbiotics for children is promisingInfants benefit from mothers probiotics useMay reduce cows milk allergy and other allergic reactionsStabilize intestinal barrier function
8Recommended treatment strategiesProbiotic supplementationLimit/avoid stressSkin or serum testingElimination diet
9ReferencesMahan L, Escott-Stump S, Raymond J. Krauses Food and the Nutrition Care Process. St. Louis, Missouri: Elsevier Inc; 2012.Yesilova Y, Calka O, Akdeniz N, Berktas M. Effect of Probiotics on the Treatment of Children with Atopic Dermatitis. Ann Dermatol. 2012; 24: 189-193.Boyle, RJ, Bath-Hextall, FJ, Leonardi-Bee, J, Murrell, DF, Tang, MLK. Probiotics for treating eczema (Review). Wiley [serial online]. 2008; 4: 1-57. Available from: The Cochrane Library. Accessed June 1, 2012.West, C, Prescott, S. Prebiotics and probiotics for treatment of allergic disease. Wolters Kluwer Health [serial online]. 2011. Available from: UpToDate. Accessed June 1, 2012.Natural Standard. Probiotics (Bifidobacterium, Lactobacillus, Saccharomyces boulardii) page. Available at: http://www.naturalstandard.com/databases/ herbssupplements/patient-probiotics.asp#. Accessed May 30, 2012.