Can the Probiotics Change the Spectrum of Atopic Dermatitis
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7/21/2019 Can the Probiotics Change the Spectrum of Atopic Dermatitis http://slidepdf.com/reader/full/can-the-probiotics-change-the-spectrum-of-atopic-dermatitis 1/2 Open Access Editorial Pharmaceutica Analytica Acta P h a r m a c e u t ica A n a l y t i c a A c t a ISSN: 2153-2435 Genel et al., Pharm Anal Acta 2015, 6:4 http://dx.doi.org/10.4172/2153-2435.1000e175 Volume 6 • Issue 4 • 1000e175 Pharm Anal Acta ISSN: 2153-2435 PAA, an open access journal *Corresponding author: Sur Genel, University of Medicine and Pharmacy, Iuliu Hatieganu, Cluj-Napoca, Romania, E-mail: [email protected] Received March 24, 2015; Accepted March 25, 2015; Published April 01, 2015 Citation: Genel S, Lucia SM, Daniel S, Emanuela F (2015) Can the Probiotics Change the Spectrum of Atopic Dermatitis?. Pharm Anal Acta 6: e175. doi: 10.4172/2153-2435.1000e175 Copyright: © 2015 Genel S, et al. This is an open-access article distributed under the terms of the Creative C ommons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Can the Probiotics Change the Spectrum of Atopic Dermatitis? Sur Genel 1,2* , Sur M Lucia 1 , Sur Daniel 1 and Floca Emanuela 1 1 University of Medicine and Pharmacy, Iuliu Hatieganu, Cluj-Napoca, Romania 2 Emergency Clinical Hospital for Children, Cluj-Napoca, Romania Keywords: Atopic dermatitis; Probiotics; reatment Atopic Dermatitis Atopic dermatitis is a pruritic disease o unknown origin that usually occurs in early inancy. [1] It is the rst maniestation o allergic march, which also includes allergic rhinitis and asthma [2,3]. It is known under several names: eczema, dermatitis, atopic eczema, atopic dermatitis. Te primary immune dysunction hypothesis invoke an imbalance in the cell with T2 cells predominanting and T2 cytokines IL4, IL5, IL13 causing an increase in IgE and decreased intereron gamma levels. Te epidermal barrier dysunction hypothesis say thatpatients develop AD as a result o skin barier deect and the antigen penetretion, this barrier resulting in the production o inammatory cytokines. Antigens can also be absorbed rom the gut (rom ood) and lungs (house dust mites) [4]. Mutations in a gene encoding laggrin, a key epidermal protein, cause ichtiosis vulgaris and it is the strong known genetic risk or development AD. Fliaggrin mutations are associated with early onset o AD. Filaggrin deect may inuence inamation via amily o cytokines including thymic stromal lymophoietin (SLP), IL25, IL33 known in the epithelial barier dysunction. Tese cytokines are potent promoters o T2 cytokine response. AD is a complex genetic disease that results rom an assay o gene-gene and gene-environment interaction. Most experts believe that atopic dermatitis has a genetic basis. Chromosome studies suggest that the maternal gene is located on chromosome 11[5]. Te prevalence o AD is 10-12% in children and 0.9% in adults in USA. Worldwide the prevalence o AD is risig and affects 15-30% o children and 2-10% o adults. Most people (90%) get AD beore age 5. About hal o people who get AD during childhood continue to have signs and symptoms as on adult [6]. Signs and Symptoms Vary depending on the age. Maniestations o atopic dermatitis in inant appear at 2-3 months. Rash on the ace is somewhat characteristic – red and rough and appears suddenly. Skin is dry, scaly and itchy. Rubbing and scratching lesions may lead to skin inections. Atopic dermatitis can produce sleep disorders. In children clinical maniestations may occur between 2 years and puberty. Te lesions include rash in the creases o the elbows and knees, the neck, wrists, ankles, buttocks and legs, and itch. In teenagers skin with AD is like permanent goose bumps. Lighten or darken thickened skin develop knots. Patients have itch all the time on the thickened skin, and eczema on back and knees. Adults with AD have rash in the creases o the elbows or knees and neck. Lesions can be especially on the ace and neck, around the eyes, covernudeo the body and cause a very dry skin, continuous itching, and scaly skin. [7,8] History o the patient is very important or diagnostic AD. It will consider the onset o AD, rash appearance, itching. No chemical marker or diagnosis is known. Laboratory testing is seldom necessary. Allergy and radio alergosorbent testing is a little value. Probiotics are live microorganism which, when administered in adequate amounts, coner a health benet o the host. Te hygiene theory suggests that the collective composition o the microbial gut colonization early in lie is very important maturation o immune system. Some studies showen that atopic children have less bidobacteria and lactobacilli in their gut ora than non- atopic children. Several studies have showen that oral Lactobacillus supplementation given prenatally to mothers who had at least one rst degree relative with allergic disease reduces the oncidence o AD. Same studies recommend giving probiotics in children in the rst 6 months o lie to prevent AD occurrence. Te evidence or the effectiveness o probiotics in the treatment or prevention o atopic dermatitis (AD) is nowencouraging.Studies showed that probiotics administration can reduce the incidence o AD and in the same time weaken the clinical maniestations in almost hal o patients. In January 2015 the World Allergy Organization plans to release the rst section o the Guidelines or Allergic Disease Prevention witch will recommended the use o probiotics by pregnant and lactating women and their breasteed inants to prevent the development o AD. Te recommendation was based on a Meta analysis o 29 studies by pregnant women that administration o probiotics has reduced the incidence o AD in children. In the relevant randomized controlled trials (RCs) was a statistically signicant decrease in SCORAD (Scoring Atopic Dermatitis) afer probiotics administration to inant or children with AD in 1 or 2 months compared with placebo. Tey were also ound to reduce the severity a atopic dermatitis in in approximately hal o the RC evaluated. Te administration o a probiotic mixture containing L acidophilus, B lactic and ructo oligosaccharides was associated with signicant clinical improvemet in children with AD [9,10]. It should be understood that treatment with probiotics is preventive and adjuvant, it can decrease the proportion o AD and reduce the intensity o clinical maniestations. reatment can control AD but cannot cure it. reatment is important because prevent AD rom getting worse, calm the skin relieving pain and itch, prevent inection, reduce emotional stress. reatment includes medicine skin care and liestyle changes. Pharmacologic agents used to treat AD include the ollowing: topical corticosteroids (Hydrocortisone topical, riamcinolone topical, Bethametosone topical), antihistamines, immunomodulators (acrolimus, Pimecrolismus, Calcineurin inhibitors, Omalizumab – a monoclonal antibody that blocks IgE unction). Other treatments include UV, phototherapy, antivirals (Acyclovir), and antibiotics [8].
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Transcript of Can the Probiotics Change the Spectrum of Atopic Dermatitis
7/21/2019 Can the Probiotics Change the Spectrum of Atopic Dermatitis
http://slidepdf.com/reader/full/can-the-probiotics-change-the-spectrum-of-atopic-dermatitis 1/2
Open AccessEditorial
PharmaceuticaAnalytica Acta
P h
a r m
a c e
u t i c a A n a l y t i c a
A c t a
ISSN: 2153-2435
Genel et al., Pharm Anal Acta 2015, 6:4http://dx.doi.org/10.4172/2153-2435.1000e175
Volume 6 • Issue 4 • 1000e175Pharm Anal ActaISSN: 2153-2435 PAA, an open access journal
*Corresponding author: Sur Genel, University of Medicine and Pharmacy, IuliuHatieganu, Cluj-Napoca, Romania, E-mail: [email protected]
Received March 24, 2015; Accepted March 25, 2015; Published April 01, 2015
Citation: Genel S, Lucia SM, Daniel S, Emanuela F (2015) Can the ProbioticsChange the Spectrum of Atopic Dermatitis?. Pharm Anal Acta 6: e175.doi: 10.4172/2153-2435.1000e175
Copyright: © 2015 Genel S, et al. This is an open-access article distributed underthe terms of the Creative Commons Attribution License, which permits unrestricteduse, distribution, and reproduction in any medium, provided the original author andsource are credited.
Can the Probiotics Change the Spectrum of Atopic Dermatitis?Sur Genel 1,2*, Sur M Lucia 1, Sur Daniel 1 and Floca Emanuela 1
1University of Medicine and Pharmacy, Iuliu Hatieganu, Cluj-Napoca, Romania2 Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
Keywords: Atopic dermatitis; Probiotics; reatment
Atopic DermatitisAtopic dermatitis is a pruritic disease o unknown origin that
usually occurs in early in ancy. [1] It is the rst mani estation oallergic march, which also includes allergic rhinitis and asthma [2,3].It is known under several names: eczema, dermatitis, atopic eczema,atopic dermatitis.
Te primary immune dys unction hypothesis invoke an imbalancein the cell with T2 cells predominanting and T2 cytokines IL4, IL5,IL13 causing an increase in IgE and decreased inter eron gamma levels.Te epidermal barrier dys unction hypothesis say thatpatients developAD as a result o skin barier de ect and the antigen penetretion, thisbarrier resulting in the production o inammatory cytokines. Antigenscan also be absorbed rom the gut ( rom ood) and lungs (house dustmites) [4].
Mutations in a gene encoding laggrin, a key epidermal protein,cause ichtiosis vulgaris and it is the strong known genetic risk ordevelopment AD. Fliaggrin mutations are associated with early onset oAD. Filaggrin de ect may inuence inamation via amily o cytokinesincluding thymic stromal lym ophoietin ( SLP), IL25, IL33 known inthe epithelial barier dys unction. Tese cytokines are potent promoterso T2 cytokine response. AD is a complex genetic disease that results
rom an assay o gene-gene and gene-environment interaction. Mostexperts believe that atopic dermatitis has a genetic basis. Chromosomestudies suggest that the maternal gene is located on chromosome 11[5].
Te prevalence o AD is 10-12% in children and 0.9% in adults inUSA. Worldwide the prevalence o AD is risig and affects 15-30% ochildren and 2-10% o adults. Most people (90%) get AD be ore age 5.About hal o people who get AD during childhood continue to havesigns and symptoms as on adult [6].
Signs and SymptomsVary depending on the age. Mani estations o atopic dermatitis
in in ant appear at 2-3 months. Rash on the ace is somewhatcharacteristic – red and rough and appears suddenly. Skin is dry, scalyand itchy. Rubbing and scratching lesions may lead to skin in ections.Atopic dermatitis can produce sleep disorders. In children clinicalmani estations may occur between 2 years and puberty. Te lesionsinclude rash in the creases o the elbows and knees, the neck, wrists,ankles, buttocks and legs, and itch. In teenagers skin with AD is likepermanent goose bumps. Lighten or darken thickened skin developknots. Patients have itch all the time on the thickened skin, and eczemaon back and knees. Adults with AD have rash in the creases o theelbows or knees and neck. Lesions can be especially on the ace andneck, around the eyes, covernudeo the body and cause a very dry skin,continuous itching, and scaly skin. [7,8]
History o the patient is very important or diagnostic AD. It
will consider the onset o AD, rash appearance, itching. No chemicalmarker or diagnosis is known. Laboratory testing is seldom necessary.Allergy and radio alergosorbent testing is a little value.
Probiotics are live microorganism which, when administered inadequate amounts, con er a health benet o the host. Te hygienetheory suggests that the collective composition o the microbialgut colonization early in li e is very important maturation oimmune system. Some studies showen that atopic children haveless bidobacteria and lactobacilli in their gut ora than non-atopic children. Several studies have showen that oral Lactobacillussupplementation given prenatally to mothers who had at least one rstdegree relative with allergic disease reduces the oncidence o AD. Samestudies recommend giving probiotics in children in the rst 6 monthso li e to prevent AD occurrence. Te evidence or the effectiveness oprobiotics in the treatment or prevention o atopic dermatitis (AD) isnowencouraging.Studies showed that probiotics administration canreduce the incidence o AD and in the same time weaken the clinicalmani estations in almost hal o patients. In January 2015 the WorldAllergy Organization plans to release the rst section o the Guidelines
or Allergic Disease Prevention witch will recommended the use oprobiotics by pregnant and lactating women and their breast eedin ants to prevent the development o AD. Te recommendationwas based on a Meta analysis o 29 studies by pregnant women thatadministration o probiotics has reduced the incidence o AD inchildren. In the relevant randomized controlled trials (R Cs) wasa statistically signicant decrease in SCORAD (Scoring AtopicDermatitis) afer probiotics administration to in ant or children withAD in 1 or 2 months compared with placebo. Tey were also ound toreduce the severity a atopic dermatitis in in approximately hal o theR C evaluated. Te administration o a probiotic mixture containingL acidophilus, B lactic and ructo oligosaccharides was associated withsignicant clinical improvemet in children with AD [9,10].
It should be understood that treatment with probiotics is preventiveand adjuvant, it can decrease the proportion o AD and reduce theintensity o clinical mani estations.
reatment can control AD but cannot cure it. reatmentis important because prevent AD rom getting worse, calm theskin relieving pain and itch, prevent in ection, reduce emotionalstress. reatment includes medicine skin care and li estyle changes.Pharmacologic agents used to treat AD include the ollowing:topical corticosteroids (Hydrocortisone topical, riamcinolonetopical, Bethametosone topical), antihistamines, immunomodulators( acrolimus, Pimecrolismus, Calcineurin inhibitors, Omalizumab –a monoclonal antibody that blocks IgE unction). Other treatmentsinclude UV, phototherapy, antivirals (Acyclovir), and antibiotics [8].
7/21/2019 Can the Probiotics Change the Spectrum of Atopic Dermatitis
http://slidepdf.com/reader/full/can-the-probiotics-change-the-spectrum-of-atopic-dermatitis 2/2
Citation: Genel S, Lucia SM, Daniel S, Emanuela F (2015) Can the Probiotics Change the Spectrum of Atopic Dermatitis?. Pharm Anal Acta 6: e175.doi: 10.4172/2153-2435.1000e175
Page 2 of 2
Volume 6 • Issue 4 • 1000e175Pharm Anal Acta
ISSN: 2153-2435 PAA, an open access journal
References
1. Eichen eld LF, Tom WL, Chamlin SL, Feldman SR, Hani n JM, et al. (2014) Guidelines of care for the management of atopic dermatitis: Section 1.
Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol 70: 338-351.
2. Spergel JM (2010) From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol 105: 99-106.
3. Genel Sur, Floca Emanuela, Valer Donca1, Talu Simona1 (2014) The Quality of Life - An Indicator of Fair Treatment of Allergic Rhinitis. J Allergy Ther 5.
4. Boguniewicz M, Leung DY (2011) Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev 242: 236-244.
5. Byung Eui Kim, Donald YM Leung (2012) Epidermal Barrier in Atopic Dermatitis. Allergy Asthma Immunol Res4: 12-16.
6. Carlsten C, Dimich-Ward H, Ferguson A, Watson W, Rousseau R, et al. (2013) Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors. Ann Allergy Asthma Immunol110: 24-8
7. Garnacho-Saucedo G, Salido-Vallejo R, Moreno-Giménez JC (2012) Atopic Dermatitis: Update and Proposed Management Algorithm. ActasDermosi liogr 104: 4-16.
8. Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, et al. (2012) Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. J Eur Acad Dermatol Venereol 26: 1176-1193.
9. Yesilova Y, calka O, Akdeniz N, Berktas M (2012) Effect of Probiotics on the Treatment of Children with Atopic Dermatitis. Annals of Dermatology 24: 189-193.
10. Rautava S, Kainonen E, Salminen S, Isolauri E(2012) Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol130: 1355-1360.
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Citation: Genel S, Lucia SM, Daniel S, Emanuela F (2015) Can the ProbioticsChange the Spectrum of Atopic Dermatitis?. Pharm Anal Acta 6: e175.doi: 10.4172/2153-2435.1000e175
