title: Supplementation of a dairy drink enriched with milk phospholipids in patients with atopic dermatitis - a double-blind, placebo-controlled, randomized, cross-over study.
abstract: OBJECTIVE
  Reduced epidermal ceramide content may lead to an impaired skin barrier in atopic dermatitis. Plasma concentration of the ceramide precursor sphingomyelin increases after milk-fat consumption due to affected lipoprotein metabolism, although sphingomyelin, a main component of milk phospholipids, might also directly influence plasma sphingomyelin levels. The aim was to determine whether supplementation of a dairy drink with milk phospholipids improves skin parameters and influences plasma lipid profile.
  
  
  METHODS
  In a double-blind cross-over study, 39 patients were randomized into 2 groups and daily received phospholipid milk (3 g phospholipids ≙ 0.75 g sphingomyelin) or normal whole milk as placebo control for 6 weeks. SCORAD indices, serum immune and plasma lipid parameters were determined.
  
  
  RESULTS
  SCORAD indices did not differ between groups following control and phospholipid milk supplementation (control milk: 10.9 ± 5.9 vs. phospholipid milk: 11.7 ± 6.9, P = 0.416), but were significantly decreased compared to baseline (baseline: 15.6 ± 8.8, P < 0.05). Plasma sphingomyelin proportions were also similar after the treatments (control milk: 27.5 ± 2.3 vs. phospholipid milk: 27.4 ± 2.6% of total phospholipids, P = 0.894), but were significantly increased compared to baseline (20.7 ± 2.4% of total phospholipids, P < 0.05).
  
  
  CONCLUSIONS
  Supplementation of a dairy drink with milk phospholipids has no beneficial effect on skin parameters compared to consumption of whole milk in patients with atopic dermatitis. To elucidate an impact of the plasma sphingomyelin proportion on skin conditions, further studies are necessary. Clinical trial ID: Registered under ClinicalTrials.gov. Identifier no. NCT01326520.
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany. Electronic address: Sylvia.Keller@uni-jena.de.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Keller
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany.
authors.forename: Hai-Yen
authors.initials: HY
authors.lastname: Le
authors.affiliation: University Hospital of the Friedrich Schiller University of Jena, Department of Dermatology, Erfurter Straße 35, D-07740 Jena, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Rödiger
authors.affiliation: University Hospital of the Friedrich Schiller University of Jena, Department of Dermatology, Erfurter Straße 35, D-07740 Jena, Germany.
authors.forename: Uta-Christina
authors.initials: UC
authors.lastname: Hipler
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany.
authors.forename: Romy
authors.initials: R
authors.lastname: Kertscher
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Malarski
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany.
authors.forename: Lisa-Marie
authors.initials: LM
authors.lastname: Hunstock
authors.affiliation: University Hospital of the Friedrich Schiller University of Jena, Institute of Clinical Chemistry and Laboratory Medicine, Erlanger Allee 101, D-07747 Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kiehntopf
authors.affiliation: SRH Wald-Klinikum Gera, Department of Dermatology and Allergology, Straße des Friedens 122, D-07548 Gera, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kaatz
authors.affiliation: University Hospital of the Friedrich Schiller University of Jena, Department of Dermatology, Erfurter Straße 35, D-07740 Jena, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Norgauer
authors.affiliation: Friedrich Schiller University of Jena, Department of Nutritional Physiology, Dornburger Straße 24, D-07743 Jena, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahreis
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D054422:Chemokine CCL22 / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018592:Cross-Over Studies; D003611:Dairy Products; D003876:Dermatitis, Atopic / Q000178:diet therapy*; D004311:Double-Blind Method; D019040:E-Selectin / Q000097:blood; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D019410:Interleukin-16 / Q000097:blood; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage*; D013109:Sphingomyelins / Q000097:blood; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: C515482:CCL22 protein, human; D054422:Chemokine CCL22; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019040:E-Selectin; D019410:Interleukin-16; D010743:Phospholipids; D013109:Sphingomyelins; D014280:Triglycerides; D007073:Immunoglobulin E; D002097:C-Reactive Protein
keywords: Atopic dermatitis; Ceramide; Cholesterol; Human; Phospholipid; Sphingomyelin