Lactobacillus for the treatment and prevention of atopic dermatitis: Clinical and experimental evidence

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease, accompanied by itching and swelling. The main pathological mechanism of AD is related to the imbalance between Type 2 helper cells (Th2 cells) and Type 1 helper cells (Th1 cells). Currently, no safe and effective means to treat and prevent AD are available; moreover, some treatments have side effects. Probiotics, such as some strains of Lactobacillus, can address these concerns via various pathways: i) facilitating high patient compliance; ii) regulating Th1/Th2 balance, increasing IL-10 secretion, and reducing inflammatory cytokines; iii) accelerating the maturation of the immune system, maintaining intestinal homeostasis, and improving gut microbiota; and iv) improving the symptoms of AD. This review describes the treatment and prevention of AD using 13 species of Lactobacillus. AD is commonly observed in children. Therefore, the review includes a higher proportion of studies on AD in children and fewer in adolescents and adults. However, there are also some strains that do not improve the symptoms of AD and even worsen allergies in children. In addition, a subset of the genus Lactobacillus that can prevent and relieve AD has been identified in vitro. Therefore, future studies should include more in vivo studies and randomized controlled clinical trials. Given the advantages and disadvantages mentioned above, further research in this area is urgently required.

Dietary Galacto-oligosaccharides Ameliorate Atopic Dermatitis-like Skin Inflammation and Behavioral Deficits by Modulating Gut Microbiota–Brain–Skin Axis

“…For example, Lactobacillus could exert beneficial effects on AD by accelerating the maturation of the immune system and maintaining intestinal homeostasis. 7 Alloprevotella, as the SCFA-producing bacteria, could restore the damaged intestinal epithelial barrier and reduce inflammation. 49 Additionally, the correlation among inflammatory cytokines, depression behaviors, the levels of neurotransmitters, and the differential gut microbiota were determined through Pearson correlation analysis.…”

“…5,6 Administration of Lactobacillus could protect cutaneous immune homeostasis following UV exposure and prevent AD because of its anti-inflammatory and skin barrier-protective characteristics. 7,8 Additionally, Ait-Belgnaoui et al 9 disclosed that oral supplementation with the integration of Lactobacillus and Bif idobacterium effectively ameliorated the brain function abnormalities induced by chronic stress through modulation of HPA (hypothalamic− pituitary−adrenal) axis. Hence, targeting modulation of gut homeostasis might be a novel possible target for clinically diagnosing and treating AD-like phenotypes accompanied by psychological abnormalities, such as anxiety and depression.…”

“…Recently, emerging evidence suggests that disturbed gut microbiota closely mediate the pathophysiology of inflammatory skin disease and psychiatric disorders. Although not yet fully elucidated, researchers have confirmed that gut microbiota is highly correlated with the skin microbiome and the disruptions of both can contribute to an abnormal immune response and a defective epidermal barrier involved in the pathogenesis of skin disorders, especially in AD, psoriasis, and hidradenitis suppurativa. , Administration of Lactobacillus could protect cutaneous immune homeostasis following UV exposure and prevent AD because of its anti-inflammatory and skin barrier-protective characteristics. , Additionally, Ait-Belgnaoui et al . disclosed that oral supplementation with the integration of Lactobacillus and Bifidobacterium effectively ameliorated the brain function abnormalities induced by chronic stress through modulation of HPA (hypothalamic–pituitary–adrenal) axis.…”

Esculentoside A ameliorates DNCB‐induced atopic dermatitis by suppressing the ROS‐NLRP3 axis via activating the Nrf2 pathway

“…Despite an incomplete understanding of the pathogenesis of AD, several mechanisms, including heredity, environmental factors, impaired skin barrier, immunological defects, oxidative stress and microbial dysregulation, are known to be involved in the progression and development of AD 10–12 . A variety of approaches have been used to treat AD, such as topical glucocorticoids, narrow‐spectrum ultraviolet radiation B, phototherapy, Janus kinase inhibitors (i.e., abrocitinib, baricitinib and upadacitinib) and biologics (i.e., dupilumab, nemolizumab and tralokinumab) 13,14 . Although topical corticosteroids are the most common choice for the treatment of moderate to severe AD, their long‐term use may result in side effects, such as hormonal dermatitis and adrenal insufficiency 15 .…”

“…[10][11][12] A variety of approaches have been used to treat AD, such as topical glucocorticoids, narrow-spectrum ultraviolet radiation B, phototherapy, Janus kinase inhibitors (i.e., abrocitinib, baricitinib and upadacitinib) and biologics (i.e., dupilumab, nemolizumab and tralokinumab). 13,14 Although topical corticosteroids are the most common choice for the treatment of moderate to severe AD, their long-term use may result in side effects, such as hormonal dermatitis and adrenal insufficiency. 15 The longterm administration of narrow-spectrum ultraviolet radiation B may lead to abnormal skin reactions.…”