Probiotics in atopic dermatitis: Where do we stand?

Abstract

Introduction: Atopic dermatitis (AD) is a chronic, inflammatory skin disorder that significantly impairs life quality and mostly affects children. Although classical approaches of treatment have been effective in mitigating the symptoms of AD, novel remedial measures based on a better understanding of immunopathogenesis are needed to target the underlying etiology. Aims and Objectives: Probiotics improve the intestinal micro environment and restore the balance of immune responses, thereby, emerging as a novel therapeutic option in the management of AD. Taking into account the updated information available, this review aims to discuss the beneficial effects of probiotics on gut microbiota, their role in strengthening the epidermal barrier and immunological responses, and hence their clinical usage in AD. Results: Classically, AD has been understood as a complex interplay between genetic susceptibility, barrier dysfunction, immune dysregulation, and exogenous factors. Current research has demonstrated that AD is associated with changes in both skin and gut microflora. The "gut-skin" axis hypothesis and the interaction between them have been demonstrated in research. Patients with AD have demonstrated gut dysbiosis, which leads to immune dysregulation and can serve as a potential trigger for AD. Probiotics, by their ability to put right gut dysbiosis, have demonstrated modest efficacy in reducing disease activity in clinical studies. Conclusion: Although multiple randomized controlled trials and meta-analyses have demonstrated the utility of probiotics as adjuvant therapy in the management of AD, the need of the hour is to develop precise guidelines pertaining to their usage in AD.