Probiotics Reduce Gut Microbial Translocation and Improve Adult Atopic Dermatitis

Background: It has been suggested that probiotics modulate atopic dermatitis (AD) progression, but no data are actually available on their mechanisms of action and on their ability to act as immunomodulators in this pathology. Objective: The aim of this randomized double-blinded active treatment versus placebo study was to evaluate clinical efficacy of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) for the treatment of adult AD patients. Methods: Forty-eight patients were enrolled in the study (randomization ratio 2:1) and treated with a combination (LS01 and BR03) or placebo (maltodextrin) for 12 weeks. Clinical efficacy was assessed from baseline by changes in the SCORAD index and DLQ index improvement. Analysis on the gut permeability barrier, immunologic parameters, and changes in fecal microbiota and recovery of probiotics were performed at baseline, at the end of therapy, and 2 months later. Results: Patients receiving probiotics showed a significant improvement in clinical parameters (SCORAD, P<0.0001 and DLQ index, P=0.021) from baseline. The probiotics reduced microbial translocation (P=0.050), immune activation (P<0.001), improved T-helper cell (Th)17/regulatory T cell (Treg) (P=0.029) and Th1/Th2 (P=0.028) ratios. None of these changes were observed in the placebo group. Conclusions: Our results suggest that this specific mixture of probiotics (LS01 and BR03 strains) may induce beneficial effects for clinical and immunologic alterations in adult AD. This combination could be considered as adjuvant therapy for the treatment of AD in adult patients.