Meeting NewsPerspective

Probiotics do not improve children’s atopic dermatitis treatment

Supplementing atopic dermatitis treatment with probiotics does not benefit children, according to research presented at the American Academy of Allergy, Asthma and Immunology annual meeting.

“This is a double-blind, placebo-controlled clinical study that aimed to look at the effects of Lactobacillus pentosus in children with atopic dermatitis (AD),” Young Yoo, MD, PhD, of the department of pediatrics at Korea University in Seoul, South Korea, told Infectious Diseases in Children. “L. pentosus is a microbe, derived from kimchi, in the same genus as L. plantarum that has been registered in the Korea Food Research Institute database.”

In the study, the researchers randomly assigned 82 children aged 3 to 18 years with AD to a dose of 1 x 1010 colony forming units or placebo twice a day for 12 weeks. The research team measured the severity of AD using the SCORAD clinical tool, and they conducted blood tests for total immunoglobulin E, eosinophil counts and cytokine concentrations.

The probiotics cohort (n = 41) and the placebo cohort (n = 41) had no significant differences in baseline characteristics, including clinical severity of their AD, the researchers said.

The probiotics cohort experienced a mean change in SCORAD score of 6.8 from weeks 2 to 12 of treatment, which was significantly lower than the placebo cohort’s score of 11.2 (P < .001). The two groups had similar changes in epidermal water loss at week 12.

“In my opinion, even though the severity of AD was reduced, 12 weeks of administration of probiotics was not enough to bring substantial changes in cytokine levels,” Yoo said.

The researchers also noted that there were no significant changes of gut microbiome in either cohort.

“Administration of probiotics is not always effective in children with AD,” Yoo concluded. – by Bruce Thiel

Reference:

Yoo Y, et al. Abstract 385. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.

Disclosures: Yoo reports that the study was supported partly by Korea Food Research Institute, in Wanju, Korea and by Korea University Alumnai Research.

Supplementing atopic dermatitis treatment with probiotics does not benefit children, according to research presented at the American Academy of Allergy, Asthma and Immunology annual meeting.

“This is a double-blind, placebo-controlled clinical study that aimed to look at the effects of Lactobacillus pentosus in children with atopic dermatitis (AD),” Young Yoo, MD, PhD, of the department of pediatrics at Korea University in Seoul, South Korea, told Infectious Diseases in Children. “L. pentosus is a microbe, derived from kimchi, in the same genus as L. plantarum that has been registered in the Korea Food Research Institute database.”

In the study, the researchers randomly assigned 82 children aged 3 to 18 years with AD to a dose of 1 x 1010 colony forming units or placebo twice a day for 12 weeks. The research team measured the severity of AD using the SCORAD clinical tool, and they conducted blood tests for total immunoglobulin E, eosinophil counts and cytokine concentrations.

The probiotics cohort (n = 41) and the placebo cohort (n = 41) had no significant differences in baseline characteristics, including clinical severity of their AD, the researchers said.

The probiotics cohort experienced a mean change in SCORAD score of 6.8 from weeks 2 to 12 of treatment, which was significantly lower than the placebo cohort’s score of 11.2 (P < .001). The two groups had similar changes in epidermal water loss at week 12.

“In my opinion, even though the severity of AD was reduced, 12 weeks of administration of probiotics was not enough to bring substantial changes in cytokine levels,” Yoo said.

The researchers also noted that there were no significant changes of gut microbiome in either cohort.

“Administration of probiotics is not always effective in children with AD,” Yoo concluded. – by Bruce Thiel

Reference:

Yoo Y, et al. Abstract 385. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.

Disclosures: Yoo reports that the study was supported partly by Korea Food Research Institute, in Wanju, Korea and by Korea University Alumnai Research.

    Perspective
    Lawrence Eichenfield

    Lawrence Eichenfield

    AD is an inflammatory skin condition that is associated with changes in the cutaneous microbiome, whereas the gut microbiome in AD has not been well-categorized.

    The study by Yoo and colleagues presented at the American Academy of Asthma, Allergy and Immunology annual meeting is a well-designed study of an oral probiotic L. pentosus, which is administered to children and adolescents with established AD. The study did not show changes in standard outcome measures of eczema severity, nor changes in skin function or gut microbiome.  

    There are tremendous variations in probiotic composition, so this negative study does not mean that another probiotic in a different study might not give a signal of efficacy.  

    There are also studies that examine selective microbe application on the skin, or a “skin probiotic,” to influence the skin microbiome, with some potentially promising results to date on active dermatitis. This will be an intriguing area of further investigation.

    • Lawrence Eichenfield, MD
    • Infectious Diseases in Children Editorial Board member
      Chief of pediatric and adolescent dermatology
      Vice chair of the department of dermatology
      University of California, San Diego
      Rady Children’s Hospital

    Disclosures: Eichenfield reports serving as a consultant for Matrisys Bioscience and Forte Biosciences.

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