title: Probiotics reduce gut microbial translocation and improve adult atopic dermatitis.
abstract: BACKGROUND
  It has been suggested that probiotics modulate atopic dermatitis (AD) progression, but no data are actually available on their mechanisms of action and on their ability to act as immunomodulators in this pathology.
  
  
  OBJECTIVE
  The aim of this randomized double-blinded active treatment versus placebo study was to evaluate clinical efficacy of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) for the treatment of adult AD patients.
  
  
  METHODS
  Forty-eight patients were enrolled in the study (randomization ratio 2:1) and treated with a combination (LS01 and BR03) or placebo (maltodextrin) for 12 weeks. Clinical efficacy was assessed from baseline by changes in the SCORAD index and DLQ index improvement. Analysis on the gut permeability barrier, immunologic parameters, and changes in fecal microbiota and recovery of probiotics were performed at baseline, at the end of therapy, and 2 months later.
  
  
  RESULTS
  Patients receiving probiotics showed a significant improvement in clinical parameters (SCORAD, P<0.0001 and DLQ index, P=0.021) from baseline. The probiotics reduced microbial translocation (P=0.050), immune activation (P<0.001), improved T-helper cell (Th)17/regulatory T cell (Treg) (P=0.029) and Th1/Th2 (P=0.028) ratios. None of these changes were observed in the placebo group.
  
  
  CONCLUSIONS
  Our results suggest that this specific mixture of probiotics (LS01 and BR03 strains) may induce beneficial effects for clinical and immunologic alterations in adult AD. This combination could be considered as adjuvant therapy for the treatment of AD in adult patients.
authors.affiliation: Allergy and Clinical Immunology Unit, L. Sacco Hospital, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Iemoli
authors.forename: Daria
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Serena
authors.initials: S
authors.lastname: Parisotto
authors.forename: Linda
authors.initials: L
authors.lastname: Borgonovo
authors.forename: Marco
authors.initials: M
authors.lastname: Toscano
authors.forename: Giuliano
authors.initials: G
authors.lastname: Rizzardini
authors.forename: Mario
authors.initials: M
authors.lastname: Clerici
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fusi
authors.forename: Elena
authors.initials: E
authors.lastname: De Vecchi
authors.forename: Stefania
authors.initials: S
authors.lastname: Piconi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
mesh_terms: D000328:Adult; D001644:Bifidobacterium / Q000254:growth & development* / Q000276:immunology; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D004311:Double-Blind Method; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007778:Lactobacillus / Q000254:growth & development* / Q000276:immunology; D008297:Male; D054892:Metagenome / Q000187:drug effects*; D019936:Probiotics / Q000008:administration & dosage* / Q000494:pharmacology; D012720:Severity of Illness Index; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D016896:Treatment Outcome