A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Oral Administration of a Heat-Treated <b><i>Lactobacillus paracasei  </i></b>Supplement in Infants with Atopic Dermatitis Receiving Topical Corticosteroid Therapy

Abstract

&lt;b&gt;&lt;i&gt;Background/Aims:&lt;/i&gt;&lt;/b&gt; Atopic dermatitis (AD) is a common disease in infancy, for which topical steroids are the first-line therapy but have side effects. Innovative approaches are needed to reduce the burden of AD and corticosteroid usage in infants. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The once-daily consumption of heat-treated probiotic &lt;i&gt;Lactobacillus paracasei&lt;/i&gt; GM-080 or placebo for 16 weeks as supplementary approach to topical treatment with fluticasone propionate cream was compared in AD infants aged 4–30 months. Outcomes were SCORAD and its subscores, TEWL, Infants’ Dermatitis Quality of Life Index (IDQOL), corticoid “sparing effect,” CCL17/TARC, and IgE status. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; SCORAD, objective SCORAD, itching, and IDQOL decreased significantly (&lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001) over the treatment period in both treatment groups. Slight decreases (ns) were noted in TEWL in lesional and unaffected skin and CCL17 levels. There were no differences between the treatment groups. Total IgE increased over the treatment period in both groups, with significantly higher increase in the heat-treated probiotic group (&lt;i&gt;p&lt;/i&gt; = 0.038). There was no evidence of a corticoid “sparing effect” by the probiotic. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; In this design, the probiotic &lt;i&gt;L. paracasei&lt;/i&gt; was not beneficial as a complementary approach to topical corticosteroids in infants with AD. However, slight beneficial effects may have been masked by the moderate potency corticoid.

Polyphenols and Cannabidiol Modulate Transcriptional Regulation of Th1/Th2 Inflammatory Genes Related to Canine Atopic Dermatitis

“…The ccl2 promoter was strongly methylated in monocytes, for both exposure times and in different sites, while the mixture did not exert any effect on ccl2 promoter methylation in keratinocytes. In fact, our data agree with literature that ccl2 gene promoter methylation is widely reported in human monocytes in vitro and in vivo, whereas no evidence can be found for the methylation of the ccl2 promoter in keratinocytes (56,57). This can be explained by taking into account that the transcriptional regulation of ccl2, in the context of non-resolving inflammation, appears to be more related to histone modification (58,59).…”

Probiotics in the prevention and treatment of atopic dermatitis

“…However, the amount of topical corticosteroids showed no difference between groups, nor was there any significant difference noted in the overall symptom‐free duration 5 . Yan et al demonstrated that the probiotic L paracasei (1 × 1010 CFU daily) was not beneficial as a complementary approach to topical corticosteroids in infants with AD; however, slight beneficial effects may have been masked by the moderate potency of the corticosteroid used 6 …”

Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: A systematic review and network meta‐analysis

“…This review includes 22 trials involving 1420 children ranging from 1 month to 18 years old with atopic dermatitis. Twenty‐one studies were double‐blind, randomized, placebo‐controlled trials on the use of various probiotic strains for the treatment of pediatric atopic dermatitis 23‐43 . One study was a randomized trial comparing probiotic strains to no treatment 44 .…”