ATOPIC DERMATITIS (ECZEMA) AND PROBIOTICS
By Jacqueline Wivinus and Kristina Hegarty
“EFFECT OF PROBIOTICS ON THE TREATMENT OF CHILDREN WITH ATOPIC DERMATITIS”
Objective: 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
function GI 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. 1
Probiotics compete with pathogens Probiotics alleviate immunogenicity of potential allergens
METHODS Double-blind randomized, placebo-controlled study Pediatric patients: 1-13 yo Probiotic complex
Bifidobacterium bifidum Lactobacillus acidophilus Lactobacillus casei Lactobacillus salivarius
Placebo control group Skim milk powder dextrose
RESULTS
RESULTS
LIMITATIONS Strengths
Randomized, double-blind, controlled trial Statistically significant results Measuring multiple inflammatory markers
Weaknesses Skim milk placebo Small sample size Limited to pediatric patients Duration SCORAD subjectivity
DATABASE REVIEW The Cochrane Database
12 randomized controlled trials reviewed No significant improvement with probiotics
Up to Date Database Meta-analyses of using probiotics for
eczema treatment Problems of quality with some studies and
heterogeneity Probiotics benefit IgE sensitized individuals
DATABASE REVIEW Natural Standard
Probiotics for children is promising Infants benefit from mothers probiotics use May reduce cow’s milk allergy and other
allergic reactions Stabilize intestinal barrier function
RECOMMENDED TREATMENT STRATEGIES Probiotic supplementation Limit/avoid stress Skin or serum testing Elimination diet
REFERENCES Mahan L, Escott-Stump S, Raymond J. Krause’s 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.
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