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Successful management of mild atopic dermatitis in adults with probiotics and emollients

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

Atopic dermatitis is characterized by impaired skin and mucous membrane barrier function. Measures improving barrier integrity decrease the influence of environmental factors that might exacerbate inflammation. Ten adult patients with mild-to-moderate atopic dermatitis consumed for three months fermented with potent antioxidative probiotic, L. fermentum ME-3 (DSM 14241) goat milk 200 mg/day. A control group consisted of six patients, not supplemented by probiotic. All patients used emollients regularly. Skin iron levels, glutathione redox ratios (GSSG/GSH), diene conjugate (DC) amounts, blood glutathione status, oxidized low-density lipoprotein (oxLDL), and total antioxidativity was measured at the baseline and after three months. A significant decrease in skin iron levels, DC amounts, and glutathione redox ratio occurred in the probiotic-supplemented group compared to the control group (P < 0.05 for all indices). In the same group, blood levels of oxLDL decreased (p < 0.05), and GSH levels increased (P < 0.001) with concomitant improvement in the GSSG/GSH ratio. Blood antioxidativity markers also showed an improvement. The results of our study demonstrate that regular use of probiotics with antioxidative properties coupled with the use of lipid-containing emollients considerably decreases inflammation and concomitant oxidative stress in adult patients with mild-to-moderate atopic dermatitis. This effect was observed both in the skin and in the blood.

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Abbreviations

AD:

atopic dermatitis

DC:

diene conjugates

GSH:

reduced glutathione

GSSG:

oxidized glutathione

GSSG/GSH:

glutathione redox ratio

OxS:

oxidative stress

TAA:

total antioxidative activity

TAC:

total antioxidant capacity

References

  1. Proksch E., Fölster-Holst R., Jensen J-M., Skin barrier function, epidermal proliferation and differentiation in eczema, J. Dermatol. Sci., 2006, 43, 159–169

    Article  PubMed  CAS  Google Scholar 

  2. Leung D.Y.M., Boguniewicz M., Howell M.D., Nomura I., Hamid Q. A., New insights into atopic dermatitis, J. Clin. Invest., 2004, 113, 651–7

    PubMed  CAS  Google Scholar 

  3. Isolauri E., Probiotics in human disease, Am. J. Clin. Nutr., 2001, 73, 1142S–6S

    PubMed  CAS  Google Scholar 

  4. Cork M.J., Robinson D.A., Vasilopoulos Y., Ferguson A., Moustafa M., MacGowan A., et al., New perspectives on epidermal barrier dysfunction in atopic dermatitis: gene-environment interactions, J. Allergy Clin. Immunol., 2006, 118, 3–21

    Article  PubMed  CAS  Google Scholar 

  5. Isolauri E., Arvola T., Sütas Y., Moilanen E., Salminen S., Probiotics in the management of atopic eczema, Clin. Exp. Allergy, 2000, 30, 1604–10

    Article  PubMed  CAS  Google Scholar 

  6. Rosenfeldt V., Benfeldt E., Nielsen D.M., Michaelsen K.F., Jeppesen D.L., Valerius N.H., et al., Effect of probiotic Lactobacillus strains in children with atopic dermatitis, J. Allergy Clin. Immunol., 2003, 111, 389–95

    Article  PubMed  Google Scholar 

  7. Weston S., Halbert A., Richmond P., Prescott S. L., Effects of probiotics on atopic dermatitis: a randomized controlled trial, Arch. Dis. Child, 2005, 90, 892–897

    Article  PubMed  CAS  Google Scholar 

  8. Prescott S.L., Björksten B., Probiotics for the prevention or treatment of allergic diseases, J. Allergy Clin. Immunol., 2007, 120, 255–262

    Article  PubMed  CAS  Google Scholar 

  9. Peuhkuri K., Lähteenmäki T., Sievi E., Saxelin M., Vapaatalo H., Korpela R., Antioxidative properties of lactobacillus GG measured as prostacyclin and nitric oxide production in endothelial cell culture, Nutr. Today, 1996, 31, 53S–54S

    Article  Google Scholar 

  10. Kullisaar T., Zilmer M., Mikelsaar M., Vihalemm T., Annuk H., Kairane C., et al., Two antioxidative lactobacilli strains as promising probiotics, Int. J. Food Microbiol., 2002, 72, 215–24

    Article  PubMed  CAS  Google Scholar 

  11. Kullisaar T., Songisepp E., Mikelsaar M., Zilmer K., Vihalemm T., Zilmer M., Antioxidative probiotic fermented goats’ milk decreases oxidative stressmediated atherogenicity in human subjects, Br. J. Nutr., 2003, 90, 449–56

    Article  PubMed  CAS  Google Scholar 

  12. Severity scoring of atopic dermatitis: the SCORAD index. Consensus report of the European Task Force on Atopic Dermatitis, Dermatology, 1993, 186, 23–31

  13. Ristimäe T., Zilmer M., Zilmer K., Kairane C., Kullisaar T., Teesalu, R., Effects of low dose aspirin on the markers of oxidative stress, Cardiovasc. Drug Ther., 1999, 13, 485–490

    Article  Google Scholar 

  14. Griffith O.W., Determination of glutathione and glutathione disulfide using glutathione reductase and 2-vinylpyridine, Anal. Biochem., 1980, 106, 207–12

    Article  PubMed  CAS  Google Scholar 

  15. Kohen R., Skin antioxidants: their role in aging and in oxidative stress — new approaches for their evaluation, Biomed. Pharmacother., 1999, 53, 181–92

    Article  PubMed  CAS  Google Scholar 

  16. Young I.S., Woodside J.V., Antioxidants in health and disease, J. Clin. Pathol., 2001, 54, 176–86

    Article  PubMed  CAS  Google Scholar 

  17. Luyer M.D., Buurman W.A., Hadfoune M., Speelmans G., Knol J., Jakobs J.A., et al., Strainspecific effects of probiotics on gut barrier integrity following hemorrhagic shock, Infect. Immun., 2005, 73, 3686–3692

    Article  PubMed  CAS  Google Scholar 

  18. Murch S.H., Probiotics as mainstream allergy therapy?, Arch. Dis. Child, 2005, 90, 881–882

    Article  PubMed  CAS  Google Scholar 

  19. Ouwehand A., Isolauri E., Salminen S., The role of intestinal microflora for the development of the immune system in early childhood, Eur. J. Nutr., 2002, 41 (suppl 1), 1/32–1/37

    CAS  Google Scholar 

  20. Rachmilewitz D., Karmeli F., Shteingart S., Lee J., Takabayashi K., Raz E., Immunostimulatory oligonucleotides inhibit colonic proinflammatory cytokine production in ulcerative colitis, Inflamm. Bowel Dis., 2006, 12, 339–345

    Article  PubMed  Google Scholar 

  21. Memon R.A., Staprans I., Noor M., Holleran W.M., Uchida Y., Moser A.H., et al., Infection and inflammation induce LDL oxidation in vivo, Arterioscler. Thromb. Vasc. Biol., 2000, 20, 1536–42

    PubMed  CAS  Google Scholar 

  22. Leveque N., Robin S., Muret P., Mac-Mary S., Makki S., Humbert P., High iron and ascorbic acid concentrations in the dermis of atopic dermatitis patients, Dermatology, 2003, 207, 261–264

    Article  PubMed  CAS  Google Scholar 

  23. Pastore A., Federici G., Bertini E., Piemonte F., Analysis of glutathione: implication in redox and detoxification, Clin. Chim. Acta, 2003, 333, 19–39

    Article  PubMed  CAS  Google Scholar 

  24. Hall A.G., The role of glutathione in the regulation of apoptosis, Eur. J. Clin. Invest., 1999, 29, 238–245

    Article  PubMed  CAS  Google Scholar 

  25. Kaur S., Zilmer M., Eisen M., Kullisaar T., Rehema A., Vihalemm T., Patients with allergic and irritant contact dermatitis are characterized by striking change of iron and oxidized glutathione status in nonlesional area of the skin, J. Invest. Dermatol., 2001, 116, 886–90

    Article  PubMed  CAS  Google Scholar 

  26. Rhie G., Shin M.H., Seo J.Y., Choi W.W., Cho K.H., Kim K.H., et al., Aging-and photoaging-dependent changes of enzymic and nonenzymic antioxidants in the epidermis and dermis of human skin in vivo, J. Invest. Dermatol., 2001, 117, 1212–1217

    Article  PubMed  CAS  Google Scholar 

  27. Nogués M.R., Giralt M., Cervelló I., Del Castillo D., Espeso O., Argany N., et al., Parameters related to oxygen free radicals in human skin: a study comparing healthy epidermis and skin cancer tissue, J. Invest. Dermatol., 2002, 119, 645–652

    Article  PubMed  Google Scholar 

  28. Bengtsson Å, Lundberg M., Avila-Carino J., Jacobsson G., Holmgren A., Scheynius A., Thiols decrease cytokine levels and down-regulate the expression of CG30 on human allergen-specific T helper (Th) 0 and Th2 cells, Clin. Exp. Immunol., 2001, 123, 350–360

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Clinic of Dermatology, Faculty of Medicine, University of Tartu, 50417, Tartu, Estonia

    Sirje Kaur & Maigi Eisen

  2. Institute of Biochemistry, Faculty of Medicine, University of Tartu, 50417, Tartu, Estonia

    Tiiu Kullisaar, Aune Rehema, Tiiu Vihalemm, Kersti Zilmer & Mihkel Zilmer

  3. Institute of Microbiology, Faculty of Medicine, University of Tartu, 50417, Tartu, Estonia

    Marika Mikelsaar

Authors
  1. Sirje Kaur
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  2. Tiiu Kullisaar
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  3. Marika Mikelsaar
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  4. Maigi Eisen
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  5. Aune Rehema
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  6. Tiiu Vihalemm
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  7. Kersti Zilmer
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  8. Mihkel Zilmer
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Correspondence to Sirje Kaur.

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Kaur, S., Kullisaar, T., Mikelsaar, M. et al. Successful management of mild atopic dermatitis in adults with probiotics and emollients. cent.eur.j.med 3, 215–220 (2008). https://doi.org/10.2478/s11536-008-0022-1

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  • DOI: https://doi.org/10.2478/s11536-008-0022-1

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