Plain language summary
Allergic diseases, including atopic dermatitis (AD), are serious conditions that disrupt the quality of life of affected individuals. AD is a chronic inflammatory skin disease that is relapsing and whose onset is generally related to a patient’s or family’s atopic history such as asthma and allergic rhinitis. The aim of this study was to assess randomized control trials based on the PICO strategy—population = adult with AD; intervention = probiotic intervention; control = standard therapy; and outcome = clinical manifestations (Scoring Atopic Dermatitis index (SCORAD) evaluation, skin severity, itch severity), quality of life, and/or immune response. This study is a systematic review of six randomised controlled trials involving a total of 241 subjects, including 128 subjects in the probiotics group and 113 subjects in the placebo group. Results show that probiotic supplementation may have the potential to decrease disease severity (SCORAD) in adult AD. Therefore, decrease in disease severity may also improve the quality of life. Authors conclude that based on their findings, probiotics can be used as adjuvant treatment of adult AD.
Abstract
BACKGROUND Atopic dermatitis (AD) is chronic inflammatory skin disease that is relapsing and a serious condition that disrupts the quality of life of affected individuals. Probiotics are an immunomodulator that can enhance the immune control of atopic dermatitis. METHODS All randomized controlled trials of probiotics for the treatment of adult AD published before December 2020 were included in this study from the PubMed databases and manual searching. RESULTS Six randomized controlled trials (n = 241) were selected for this meta-analysis study. Probiotics were effective in treating adult patients with AD, indicated by the decrease in Scoring Atopic Dermatitis/SCORAD (Mean Difference (MD) - 7.90, 95% CI - 7.25 to - 6.92; p < 0.00001; I2 = 96%) and improved quality of life (MD - 7.68, 95% CI - 14.08 to - 1.29; p = 0.02; I2 = 47%) which were statistically significant. However, skin severity, itch severity, Dermatology Life Quality Index (DLQI), IL-4, TFN-γ, and IgE showed no significant difference in this meta-analysis study (p > 0.05). LIMITATIONS The study found no available data for side effects of probiotics. STRENGTH This meta-analysis analyzed a total of 241 AD patients of Asian and European origin. CONCLUSION The use of probiotics decreased SCORAD significantly in adult patients with AD. Probiotics can improve the quality of life of patients with AD. The use of probiotics in atopic dermatitis has been widely studied, with controversial results. This meta-analysis suggests that the use of probiotics can improve SCORAD and the quality of life of patients with atopic dermatitis.
Methodological quality
Jadad score
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Allocation concealment
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