Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2005 Apr 29;90(9):892–897. doi: 10.1136/adc.2004.060673

Effects of probiotics on atopic dermatitis: a randomised controlled trial

S Weston 1, A Halbert 1, P Richmond 1, S Prescott 1
PMCID: PMC1720555  PMID: 15863468

Abstract

Background: The aim of the study was to investigate the effects of probiotics on moderate or severe atopic dermatitis (AD) in young children.

Methods: Fifty six children aged 6–18 months with moderate or severe AD were recruited into a randomised double blind placebo controlled trial in Perth, Western Australia; 53 children completed the study. The children were given a probiotic (1x109Lactobacillus fermentum VRI-033 PCC; Probiomics) or an equivalent volume of placebo, twice daily for 8 weeks. A final assessment at 16 weeks was performed.

Results: The main outcome measures were severity and extent of AD at the end of the study, as measured by the Severity Scoring of Atopic Dermatitis (SCORAD) index. The reduction in the SCORAD index over time was significant in the probiotic group (p = 0.03) but not the placebo group. Significantly more children receiving probiotics (n = 24, 92%) had a SCORAD index that was better than baseline at week 16 compared with the placebo group (n = 17, 63%) (p = 0.01). At the completion of the study more children in the probiotic group had mild AD (n = 14, 54%) compared to the placebo group (n = 8, 30%).

Conclusion: Supplementation with probiotic L fermentum VRI-003 PCC is beneficial in improving the extent and severity of AD in young children with moderate or severe disease.

Full Text

The Full Text of this article is available as a PDF (89.6 KB).

Figure 1.

Figure 1

Open in a new tab

 Consort statement: progress of participants through the trial.

Figure 2.

Figure 2

Open in a new tab

 Change in extent and severity of AD during the study. (A) The differences in the SCORAD index from baseline (box plot) are shown for the probiotic L fermentum VRI-003 PCC group (shaded boxes) and the placebo group (white boxes) at each follow up visit. (B) Baseline and follow up (week 16) SCORAD index scores are shown for each participant in the placebo and probiotic groups. (C) The proportion of children in the mild, moderate, and severe categories of AD at baseline, end of supplementation (week 8), and at follow up are presented for the placebo and probiotic groups.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ball T. M., Castro-Rodriguez J. A., Griffith K. A., Holberg C. J., Martinez F. D., Wright A. L. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med. 2000 Aug 24;343(8):538–543. doi: 10.1056/NEJM200008243430803. [DOI] [PubMed] [Google Scholar]
  2. Böttcher M. F., Nordin E. K., Sandin A., Midtvedt T., Björkstén B. Microflora-associated characteristics in faeces from allergic and nonallergic infants. Clin Exp Allergy. 2000 Nov;30(11):1590–1596. doi: 10.1046/j.1365-2222.2000.00982.x. [DOI] [PubMed] [Google Scholar]
  3. Eichenfield Lawrence F., Hanifin Jon M., Beck Lisa A., Lemanske Robert F., Jr, Sampson Hugh A., Weiss Scott T., Leung Donald Y. M. Atopic dermatitis and asthma: parallels in the evolution of treatment. Pediatrics. 2003 Mar;111(3):608–616. doi: 10.1542/peds.111.3.608. [DOI] [PubMed] [Google Scholar]
  4. Emerson R. M., Williams H. C., Allen B. R. What is the cost of atopic dermatitis in preschool children? Br J Dermatol. 2001 Mar;144(3):514–522. doi: 10.1046/j.1365-2133.2001.04077.x. [DOI] [PubMed] [Google Scholar]
  5. Heller Frank, Duchmann Rainer. Intestinal flora and mucosal immune responses. Int J Med Microbiol. 2003 Apr;293(1):77–86. doi: 10.1078/1438-4221-00246. [DOI] [PubMed] [Google Scholar]
  6. Illi Sabina, von Mutius Erika, Lau Susanne, Nickel Renate, Grüber Christoph, Niggemann Bodo, Wahn Ulrich, Multicenter Allergy Study Group The natural course of atopic dermatitis from birth to age 7 years and the association with asthma. J Allergy Clin Immunol. 2004 May;113(5):925–931. doi: 10.1016/j.jaci.2004.01.778. [DOI] [PubMed] [Google Scholar]
  7. Isolauri E., Arvola T., Sütas Y., Moilanen E., Salminen S. Probiotics in the management of atopic eczema. Clin Exp Allergy. 2000 Nov;30(11):1604–1610. doi: 10.1046/j.1365-2222.2000.00943.x. [DOI] [PubMed] [Google Scholar]
  8. Kemp Andrew S. Cost of illness of atopic dermatitis in children: a societal perspective. Pharmacoeconomics. 2003;21(2):105–113. doi: 10.2165/00019053-200321020-00003. [DOI] [PubMed] [Google Scholar]
  9. Kilpi Terhi, Kero Jukka, Jokinen Jukka, Syrjänen Ritva, Takala Aino K., Hovi Tapani, Isolauri Erika. Common respiratory infections early in life may reduce the risk of atopic dermatitis. Clin Infect Dis. 2002 Jan 24;34(5):620–626. doi: 10.1086/338783. [DOI] [PubMed] [Google Scholar]
  10. Kunz B., Oranje A. P., Labrèze L., Stalder J. F., Ring J., Taïeb A. Clinical validation and guidelines for the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology. 1997;195(1):10–19. doi: 10.1159/000245677. [DOI] [PubMed] [Google Scholar]
  11. Lammers Karen Manon, Brigidi Patrizia, Vitali Beatrice, Gionchetti Paolo, Rizzello Fernando, Caramelli Elisabetta, Matteuzzi Diego, Campieri Massimo. Immunomodulatory effects of probiotic bacteria DNA: IL-1 and IL-10 response in human peripheral blood mononuclear cells. FEMS Immunol Med Microbiol. 2003 Sep 22;38(2):165–172. doi: 10.1016/S0928-8244(03)00144-5. [DOI] [PubMed] [Google Scholar]
  12. Lawson V., Lewis-Jones M. S., Finlay A. Y., Reid P., Owens R. G. The family impact of childhood atopic dermatitis: the Dermatitis Family Impact Questionnaire. Br J Dermatol. 1998 Jan;138(1):107–113. doi: 10.1046/j.1365-2133.1998.02034.x. [DOI] [PubMed] [Google Scholar]
  13. Majamaa H., Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol. 1997 Feb;99(2):179–185. doi: 10.1016/s0091-6749(97)70093-9. [DOI] [PubMed] [Google Scholar]
  14. Matricardi P. M., Bjorksten B., Bonini S., Bousquet J., Djukanovic R., Dreborg S., Gereda J., Malling H-J, Popov T., Raz E. Microbial products in allergy prevention and therapy. Allergy. 2003 Jun;58(6):461–471. doi: 10.1034/j.1398-9995.2003.00175.x. [DOI] [PubMed] [Google Scholar]
  15. Murch S. H. Toll of allergy reduced by probiotics. Lancet. 2001 Apr 7;357(9262):1057–1059. doi: 10.1016/S0140-6736(00)04305-1. [DOI] [PubMed] [Google Scholar]
  16. Neaville William A., Tisler Christopher, Bhattacharya Abhik, Anklam Kelly, Gilbertson-White Stephanie, Hamilton Rebekah, Adler Kiva, Dasilva Douglas F., Roberg Kathy A., Carlson-Dakes Kirstin T. Developmental cytokine response profiles and the clinical and immunologic expression of atopy during the first year of life. J Allergy Clin Immunol. 2003 Oct;112(4):740–746. doi: 10.1016/s0091-6749(03)01868-2. [DOI] [PubMed] [Google Scholar]
  17. Rosenfeldt Vibeke, Benfeldt Eva, Nielsen Susanne Dam, Michaelsen Kim Fleischer, Jeppesen Dorthe Lisbeth, Valerius Niels Henrik, Paerregaard Anders. Effect of probiotic Lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol. 2003 Feb;111(2):389–395. doi: 10.1067/mai.2003.389. [DOI] [PubMed] [Google Scholar]
  18. Sherriff A., Golding J., Alspac Study Team Hygiene levels in a contemporary population cohort are associated with wheezing and atopic eczema in preschool infants. Arch Dis Child. 2002 Jul;87(1):26–29. doi: 10.1136/adc.87.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sudo N., Sawamura S., Tanaka K., Aiba Y., Kubo C., Koga Y. The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. J Immunol. 1997 Aug 15;159(4):1739–1745. [PubMed] [Google Scholar]
  20. Wadonda-Kabondo N., Sterne J. A. C., Golding J., Kennedy C. T. C., Archer C. B., Dunnill M. G. S., ALSPAC Study Team A prospective study of the prevalence and incidence of atopic dermatitis in children aged 0-42 months. Br J Dermatol. 2003 Nov;149(5):1023–1028. doi: 10.1111/j.1365-2133.2003.05605.x. [DOI] [PubMed] [Google Scholar]
  21. von Mutius E., Braun-Fahrländer C., Schierl R., Riedler J., Ehlermann S., Maisch S., Waser M., Nowak D. Exposure to endotoxin or other bacterial components might protect against the development of atopy. Clin Exp Allergy. 2000 Sep;30(9):1230–1234. doi: 10.1046/j.1365-2222.2000.00959.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES