Lactobacillus reuteri DSM 17938 as a Novel Topical Cosmetic Ingredient: A Proof of Concept Clinical Study in Adults with Atopic Dermatitis.

Éile Butler,Jakob Axelsson,Christoffer Lundqvist

doi:10.3390/microorganisms8071026

Abstract

Atopic Dermatitis (AD) is a chronically relapsing skin condition characterized by dry, itchy, and inflamed skin where sufferers can frequently be subject to infections. Probiotics are known to be potent immune-modulators, and live Lactobacillus reuteri DSM 17938 has shown to be anti-inflammatory but also to possess antimicrobial and barrier function properties. This study aimed to investigate and compare two investigational ointment products (topical probiotic and control) for cutaneous acceptability, safety, and efficacy under normal conditions of use, in adult subjects with atopic dermatitis. The products were applied twice daily for 8 weeks, and cutaneous acceptability, SCORAD index, local SCORAD, and adverse events were evaluated after 4 and 8 weeks of treatment. At the end of the observations, it was demonstrated that both the probiotic-containing and probiotic-free ointments were both cutaneously acceptable and safe. It importantly showed a statistically and clinically significant improvement of the SCORAD index and local SCORAD in adult subjects with AD after 4 and 8 weeks of continuous use. In conclusion, we show evidence that the probiotic product, containing live L. reuteri DSM 17938 as an extra ingredient, is safe and promising as a novel topical cosmetic ointment and with further testing could be a standard topical product for the management of atopic dermatitis or other disorders associated with the skin.

Highlights

Atopic Dermatitis (AD) is a chronically relapsing skin condition characterized by dry, itchy, and inflamed skin where sufferers can frequently be subject to infections [1]
The skin microbiome has been implicated in AD, a dysbiosis in the skin microbiome, and increased Staphylococcus aureus colonization has been shown to correlate with increased lesion infection and is an exacerbating factor of the condition [7,8,9]
There was a slight difference between the SCORing Atopic Dermatitis (SCORAD) index and local SCORAD; there was no significant difference between the scores at day 0 (p = 0.512))

Summary

Introduction

Atopic Dermatitis (AD) is a chronically relapsing skin condition characterized by dry, itchy, and inflamed skin where sufferers can frequently be subject to infections [1]. According to the International Study of Asthma and Allergies in Childhood (ISAAC), the prevalence of AD in children varies significantly from 0.3% to 20.5% among 56 countries [2] with the condition usually clearing up as the child ages. The mechanism behind AD can be seen as multifactorial, where allergens from food and the environment, as well as genetics, have a part to play in AD development and manifestation. The skin microbiome has been implicated in AD, a dysbiosis in the skin microbiome, and increased Staphylococcus aureus colonization has been shown to correlate with increased lesion infection and is an exacerbating factor of the condition [7,8,9]

Objectives

Results

Discussion

Conclusion