Randomized, placebo-controlled trial on clinical and immunologic effects of probiotic containingLactobacillus rhamnosusR0011 andL. helveticusR0052 in infants with atopic dermatitis

Background and aim: A beneficial role of probiotics, especially Lactobacillus rhamnosus, in children with atopic dermatitis (AD) has been reported. Their effects are primarily mediated through immune pathways, which need further investigation. This study aimed to investigate clinical and immunologic effects of probiotics in the treatment of children with AD. Methods: Thirty children with AD received probiotic Lacidofil and 28 other children with AD received placebo, one capsule per day. All children used emollient Trixera. SCORAD, specific IgE, specific IgG4 to cow's milk, CD45RA+, CD45RO+ and transitional CD45RA+RO+ CD4+ T cells were studied at day 1 and day 30. Results: Marked reduction of SCORAD in 63.3% of patients in the treatment group and in 32.1% in the placebo group was reported. The decline of SCORAD in patients who did not use topical steroids during the follow-up period was significant in the treatment group (p < 0.01) and not significant in the placebo group. After the treatment, levels of specific IgG4 to cow's milk increased (p < 0.001) and percentages of transitional recently activated CD45RA+RO+ T cells decreased (p < 0.05). Conclusion: The use of probiotic Lacidofil was associated with a higher number of patients who achieved marked clinical improvement and higher corticosteroid-sparing effect. Synergistic action of Lacidofil and emollient Trixera was also confirmed by significant decline of transitional recently activated CD45RA+RO+ CD4+ T cells. We found significant increase of the levels of specific IgG4 to cow's milk in the group of patients who received probiotic and emollient that was not reported in the treatment group and may be considered as a shift to tolerance.