Abstract
Background Patients with psoriasis need long-term medication to control their condition. Recent studies suggest that changing the intestinal flora may be a potential treatment. Methods The databases were utilized to search the randomized controlled trials (RCTs) and preclinical trials about probiotic supplement in the treatment of psoriasis. The retrieval time is from the establishment of these databases to December 2020. RevMan5.3 was used for the risk assessment of bias and meta-analysis. This systematic review was registered in PROSPERO (CRD42021232756). Results A total of 3 RCTs involving 164 participants were included. Two RCTs showed that probiotics can improve PASI and thereby improve the condition. For inflammation-related indicators, only one RCT showed that probiotics can improve the levels of CRP and TNF-α but have no obvious improvement effect on IL6. One RCT demonstrated the total effective rate of probiotics in the treatment of psoriasis. For adverse events, one RCT showed that the incidence of adverse events of probiotic treatment was low. Preclinical studies showed that continuous intervention with oral probiotics can significantly improve the progression of psoriasis and reduce the expression of inflammatory factors. The meta-analysis showed that the PASI between two groups was of no statistical significance (SMD 1.83 [-0.41, 4.07], P = 0.11). Meanwhile, probiotics may improve skin thickness (SMD -5.87 [-11.34, -0.41], P = 0.04) in animal model. Conclusion Prebiotics may have a positive effect on alleviating the clinical symptoms of psoriasis, but a large sample of RCTs is still needed to support its therapeutic effect in psoriasis.
Highlights
Psoriasis is a chronic inflammatory skin disease, which has a long course and tends to recur
For Randomized controlled trial CNKI (RCT), they were considered eligible if they met the PICO criteria: (1) participants: the patient was diagnosed as an adult patient with psoriasis by a doctor with sufficient clinical qualifications according to the clinical diagnostic criteria for psoriasis
The data of two RCTs reporting Psoriasis Area and Severity Index (PASI) supports that probiotics can improve PASI and thereby improve the condition
Summary
Psoriasis is a chronic inflammatory skin disease, which has a long course and tends to recur . The incidence of this disease is mainly young and middle-aged, and it has a greater impact on the physical health and mental status of patients. Patients with psoriasis need long-term medication to control their condition. The databases were utilized to search the randomized controlled trials (RCTs) and preclinical trials about probiotic supplement in the treatment of psoriasis. Two RCTs showed that probiotics can improve PASI and thereby improve the condition. One RCT demonstrated the total effective rate of probiotics in the treatment of psoriasis. Preclinical studies showed that continuous intervention with oral probiotics can significantly improve the progression of psoriasis and reduce the expression of inflammatory factors. Prebiotics may have a positive effect on alleviating the clinical symptoms of psoriasis, but a large sample of RCTs is still needed to support its therapeutic effect in psoriasis
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