Efficacy of Probiotic Therapy on Atopic Dermatitis in Adults Depends on the C-159T Polymorphism of the CD14 Receptor Gene - A Pilot Study

Abstract

BACKGROUND: The C-159T polymorphism of the CD14 receptor gene can be associated with the development of atopic dermatitis. Probiotics can modulate chronic inflammation through activation of the CD14 receptor. So, the efficacy of probiotic therapy can be dependent on this genetic polymorphism.
 AIM: The purpose of the study was to investigate the efficacy of adding probiotic (Lactobacillus acidophilus, LA-5 and Bifidobacterium animalis subsp. lactis, ВВ-12) to standard treatment (ointment of fluticasone propionate 0.005% and emollient) of atopic dermatitis in adults during 28 days, depending on the stratification of patients on CC or TT genotypes of the CD14 receptor gene.
 MATERIAL AND METHODS: The study included 37 adult patients with AD. There were identified 19 patients with exogenous (IgE-dependent) and 18 with endogenous (IgE-dependent) AD. To evaluate the efficacy of the probiotics all patients were divided into three groups for both exogenous and endogenous AD. The first group was selected from patients with CC genotype (C-159T) who received standard therapy (ointment of fluticasone propionate 0.005% – 2 times a day, emollients – 2 times a day) and probiotic (Lactobacillus acidophilus, LA-5 and Bifidobacterium animalis subsp. lactis, ВВ-12 - 1 capsule 2 times per day) The second group included patients with CC genotype, who received only standard therapy. The third group was presented by patients with TT genotype (C-159T) who received standard therapy and probiotic. The SCORAD and DLQI parameters were evaluated on Day 0, 14 and 28. The level of IL-4, IL-5, IL-10, TGF-β cytokines was determined on Day 0 and Day 28.
 RESULTS: The results of our study found that the addition of probiotics (Lactobacillus acidophilus, LA-5 and Bifidobacterium animalis subsp. lactis, ВВ-12) to standard treatment (ointment of fluticasone propionate 0.005%, emollient) significantly increased the effectiveness of treatment of atopic dermatitis in adults with exogenous form and CC genotype (C-159T), confirmed by clinical (a significant decrease of SCORAD and DLQI indices) and immunological criteria (a significant decrease of IL-4 and an increase of TGF-β).
 CONCLUSION: Simultaneous determination of the exogenous or endogenous form, identification of the C-159T genotypes, evaluation of the serum level of IL-4 and TGF-β can serve as an algorithm for the personalised treatment of patients with atopic dermatitis.

Clinical Efficacy of Nutritional Supplements in Atopic Dermatitis: Systematic Review

“…Litus et al [ 20 ] (N=37) conducted an open, controlled, randomized parallel trial evaluating the efficacy of adding a twice-daily probiotic ( Lactobacillus acidophilus and Bifidobacterium animalis lactis) to standard treatment for AD (fluticasone propionate 0.005% ointment and emollients) for 4 weeks . Participants in this study were divided into groups based on total IgE levels, with exogenous or IgE-dependent AD classified as patients with a total IgE level of >100 IU/mL and endogenous or IgE-independent AD classified as patients with a total IgE level of <100 IU/mL [ 20 ]. Patients were further stratified according to genotypes of the CD14 receptor gene (CC and TT) [ 20 ].…”

“…Participants in this study were divided into groups based on total IgE levels, with exogenous or IgE-dependent AD classified as patients with a total IgE level of >100 IU/mL and endogenous or IgE-independent AD classified as patients with a total IgE level of <100 IU/mL [ 20 ]. Patients were further stratified according to genotypes of the CD14 receptor gene (CC and TT) [ 20 ].…”

“…This study found a significant improvement in SCORAD scores after 28 days in the exogenous AD group for both the CC and TT genotypes in patients who received probiotics in addition to topical therapy ( P =.001 and P =.02, respectively) [ 20 ]. No significant difference was found in the topical treatment–only group.…”

“…No significant difference was found in the topical treatment–only group. In patients with endogenous AD, the study found a significant improvement in SCORAD scores in all groups (those treated with additional probiotics and those not); however, the improvement in SCORAD scores was significantly higher at 28 days in both participants with endogenous and exogenous AD who received probiotics and topical therapy than in the group that received topical therapy alone ( P =.02 and P =.02, respectively) [ 20 ].…”

Microbiota, Oxidative Stress, and Skin Cancer: An Unexpected Triangle

“…Mounting evidence has also shown the potential beneficial effects of probiotics in this context, able to restore the physiological gut microbiota profile [ 152 , 153 ]. Indeed, probiotic administration, which is able to reduce systemic oxidative stress [ 154 ], has been successfully used to treat adult patients with skin inflammatory diseases, such as AD [ 155 ] and psoriasis [ 156 ].…”