THE EFFECTIVENESS OF TREATMENT WITH ORAL PROBIOTICS IN PATIENTS WITH ATOPIC DERMATITIS: A REVIEW OF LITERATURE (Atena Editora)

Abstract

INTRODUCTION: Atopic dermatitis is a chronic inflammatory skin condition that begins in childhood and continues into adulthood. Currently, the treatment recommended by the Dermatology Guidelines corresponds to the use of topical corticosteroids in most cases. However, recent research highlights new therapeutic approaches, including the use of oral probiotics in order to optimize treatment. Although probiotics show potential in modulating the immune system, there are gaps in understanding their mechanisms of action, indicating the need for more research. GOAL: To analyze the effectiveness of the use of oral probiotics in the treatment of atopic dermatitis and identify divergences in response to treatment between the adult and pediatric population. METHODOLOGY: A literature review was carried out by selecting studies in the MEDLINE-PubMed database (National Library of Medicine, National Institutes of Health) published between the years 2014 and 2024. 57 studies were found, of which 11 were selected by critical analysis. Articles published in English and/or Portuguese that addressed the relationship between oral probiotics and the treatment of atopic dermatitis and available in full were included in this review. The descriptors used were ("atopic dermatitis" OR "eczema") AND "probiotics". Through analysis, articles that did not meet the inclusion criteria were excluded, such as animal studies, narrative reviews, treatment with prebiotics and skin probiotics. RESULTS: Studies have shown that probiotics demonstrate an immunomodulatory effect and are capable of improving the integrity of the intestinal barrier, which contributes to reducing the inflammatory reaction in AD. Furthermore, these probiotics help regulate the immune system response, specifically the TH1 and TH2 cytokines. Another important finding is the specific combination of microorganisms that showed better results in AD inflammation. DISCUSSION: The interaction between the intestinal and skin microbiota plays a crucial role in atopic dermatitis, influencing the immune response and the integrity of the skin barrier. Probiotic supplementation, especially with a mixture of Lactobacillus salivarius and Bifidobacterium, resulted in an improvement in the clinical severity and quality of life of patients. However, not all probiotic strains were beneficial, highlighting the need to identify more effective Lactobacillus strains. Furthermore, limitations such as lack of precise data on probiotic dosage and composition highlight the importance of further research to better guide the clinical use of probiotics in atopic dermatitis. CONCLUSION: Therefore, supplementation with probiotics has been shown to reduce the clinical manifestations of Atopic Dermatitis, evidenced by the decrease in the SCORAD index, which evaluates the intensity of skin lesions. This improvement is attributed to the protective action of probiotics, which control inflammatory reactions, resulting in a reduction in the severity of the disease and a consequent improvement in patients' quality of life. However, despite the observed efficacy, there are still uncertainties regarding the ideal dosage and long-term effects, as well as differences in treatment between children and adults. Given this, the need to invest in more research to optimize the clinical use of probiotics in atopic dermatitis is evident.