SKIN AND SEX DISEASE REFERAT

SCIENCE OCTOBER 2019

FACULTY OF MEDICINE
PATTIMURA UNIVERSITY

The effects of probiotics on atopic

dermatitis

By:
Alvionita N.A. Letelay
2011-83-047

Consulent:
dr . Fitri K. Bandjar Sp.KK, M.Kes

BROUGHT IN THE FRAMEWORK OF CLINICAL PARTNERSHIP DUTIES

IN THE SKIN AND SEX DISEASE SCIENCE
FACULTY OF MEDICINE PATTIMURA UNIVERSITY
AMBON
2019
 Preliminary

Atopic dermatitis (DA) or atopic eczema is a chronic and residual

inflammatory skin disease characterized by symptoms of
erythema, papules, vesicles, crusting, squamous and severe
pruritus, and is based on hereditary and environmental factors.

based on immunoglobulin E (IgE) and have a tendency to suffer

from asthma, rhinitis, or both in the future known as allergic
march.

Probiotics will restore the composition and role of beneficial

bacteria and inhibit the allergic response of Th2 cells which also
reduce levels of interleukin-4, IL-5, IL-6, IL-9, IL-10, IL-13 and GM-
CSF, thereby reducing production IgE and eosinophils.
 Probiotic

The definition of probiotics

according to the Joint Food and
Agriculture Organization (FAO)
and the World Health
Organization (WHO) is that
living microorganisms given
to humans, in adequate
quantities, can benefit their
hosts.
criteria for a microorganism
to be accepted as a probiotic

Determination of genus and species of microorganisms

In vitro tests to determine the potential of probiotics, such as resistance

to stomach acid, the ability of antimicrobial probiotics to deal with
pathogenic bacteria, or the ability of probiotics to reduce the adhesion of
pathogenic bacteria to the cell surface.

The probiotic strain is proven to be safe for consumption and there is no

contamination in the dosage form

In vivo experiments have been carried out to determine its role and benefits
in healthy animal or human hosts
Benefits of Probiotics

microbiological
functions

nutritional functions

physiological
functions

immunological
functions
The mechanism of probiotics
on the immune system
The relationship between probiotics and TLR
and stimulation of the immune response.
 Atopic dermatitis

A chronic or chronically relapsing disorder with major feature of :

pruritus, Eczematous dermatitis with tipycal morphology and age
spesific patterns, Facial and extensor involvement in infancy,
Flexural eczema/licenification in children and adults.

Commonly associated with : personalor family history of atopy

(allergic rhinitis, asthma, atopic dermatitis)
Xerosis / skin barrier dysfunction,
Immunoglobulin E reactivity

The prevalence of AD in adulthood is 2-4% and in children is 20%.

Etiopathogenesis of atopic
dermatitis

Endogenous Exogenous
Factors Factors

Skin barrier
irritant
dysfunction

History of
Environment
atopy

Hypersensitivity allergens
Individual skin with atopic dermatitis is
different compared to healthy skin
allergic mechanism
Diagnosis of Atopic
Dermatitis
 The diagnosis of DA is
made if there are at
least 3 major criteria
and 3 minor criteria

 Skin prick tests (SPT) or

specific IgE tests that
show positive results
only indicate
sensitization to the
allergen in question, but
do not necessarily
directly cause
 Management of Atopic
Dermatitis
 EffectiveDA management includes a
combination of avoidance of triggers,
reduction of itching to a minimum,
repair of the skin barrier, and anti-
inflammatory drugs.
Prognosis of Atopic
Dermatitis
 90% of DA patients will recover when
they reach puberty, one-third
become allergic rhinitis and another
third develop asthma.
 Poor prognosis if family history of
having a similar disease, earlier and
broader onset, female sex, and
concomitant allergic rhinitis and
asthma
 Effects of Probiotics on Atopic
Dermatitis
supplementation with certain probiotics (Lactobacillus rhamnosus GG) seems to be an effective
approach for the prevention and reduction of the severity of atopic dermatitis. A mixture of specific
probiotic strains prevents atopic dermatitis in infants. Based on studies with prebiotics, there is a long-
term reduction in the incidence of atopic dermatitis. Supplementation with prebiotics and probiotics
seems to be beneficial for reducing the severity of atopic dermatitis

Probiotics are considered beneficial for the immune system by reducing adhesion
of pathogenic bacteria, helping to maintain mucosal barriers and to reduce
intestinal permeability, help develop intestinal lymphoid tissue (GALT), stimulate
IgA production, and decrease regulation of Th2 cytokines through IL-12 and IFNy
stimulation.

In pregnant women and newborns, probiotics are thought to prevent and treat DA
by promoting the differentiation of naive T cells into mature Th1 cells.

The combination of Bifidobacterium bifidum, Lactobacillus acidophilus,

Lactobacillus casei, and Lactobacillus salivarius for 8 weeks in children suffering
from atopic dermatitis results in decreased dermatitis symptoms based on
SCORing Atopic Dermatitis (SCORAD) index, decreased levels of serum IgE,
interlein (IL) IL -6, and interferon γ significantly compared to the placebo group.
 Lactobacillus rhamnosus GG (LGG) and
Bifidobacteria sp are the most studied types of
probiotics for the treatment of atopic dermatitis
in children. In the literature study, the most
frequent dose of probiotics for pediatric atopic
dermatitis patients is 5 x 109 cfu (colony
forming unit), the lowest is 108 cfu and the
highest is 1010 cfu. The recommended
probiotic concentration is more than 109 cfu
 conclusion
Atopic dermatitis (DA) or atopic eczema is a chronic and
residual inflammatory skin disease characterized by
symptoms of erythema, papules, vesicles, crusting, squamous
and severe pruritus, and is based on hereditary and
environmental factors.
reaction based on immunoglobulin E (IgE) and have a
tendency to suffer from asthma, rhinitis or both in the future
known as allergic march.
Benefits of probiotic supplementation in preventing and
managing allergic diseases, especially in atopic dermatitis
and allergic rhinitis.

Probiotics are expected to cause cellular immune responses

by reducing Th2 so that stimulation to B lymphocytes is
expected to reduce total IgE levels. This will reduce the
meeting between allergen-specific IgE, allergens, and FcE
receptors in mast cells so that there is no degranulation of
mast cells that produce important allergic mediators.
Thank You 