EFFICACY OF PROBIOTIC SUPPLEMENTATION FOR THE TREATMENT OF PEDIATRIC ATOPIC DERMATITIS. A SYSTEMATIC REVIEW AND META-ANALYSIS: ASSESSMENT OF SCORAD INDEX, SERUM IMMUNOGLOBULIN-E, AND INTERLEUKIN-4 PARAMETERS

Efficacy of Probiotic Supplementation for the Treatment of Pediatric Atopic Dermatitis. A Systematic Review and Meta-analysis: Assessment of SCORAD Index, Serum Immunoglobulin-E, and Interleukin-4 Parameters

Eunice Gunawan*, Retno Indar Widayati, Puguh Riyanto, Asih Budiastuti, Diah Adriani Malik, Muslimin, Suhartono
Dermatovenereology Department, Faculty of Medicine, Diponegoro University / Dr. Kariadi Hospital, Dr. Sutomo street No. 16 Semarang-Indonesia.

Background: Atopic Dermatitis (AD)  is a chronic, recurring inflammatory skin disease affecting 15-30% of childhood population. Its standard management entails the right skin care, avoidance of triggers, and topical corticosteroid treatment. However, long term topical corticosteroid usage produces significant side effects. Pathogenesis of AD is mainly influenced by the response of one of the main immune cells, type Th2. In AD, a change of intestinal microbiome composition takes place, which influences gut-skin axis. Probiotics are living organisms, which when consumed regularly and in adequate amount, promotes health benefits for the host. Probiotics modulate the immune system and cytokine production, causing a balance in Th1 and Th2 immune responses. This also regulates intestinal and skin microbiome homeostasis in AD. Methods: Online database research is conducted in Pubmed-MEDLINE, Cochrane Library, ProQuest, EBSCOhost, and Scopus. Seven articles are included in qualitative analysis (n = 701), between which four (n = 473) are included in quantitative analysis. Results: SCORAD Index meta-analysis with random effect model shows heterogenity test of I2 = 73% (p=0.003). Standardized mean difference is found to be -0.42 with CI 95%, -0.76 to -0.08. This shows a significant decrease in SCORAD Index in probiotic group, compared to placebo (p=0.01). Meta-analysis of serum IgE with fixed effect model shows heterogenity test of I2 = 0% (p=0.71). The standardized mean difference of IgE is -0.03 with CI 95%, -0.24 to 0.17. This shows a non-significant decrease on IgE serum in probiotic group, compared to placebo (p=0.74). Meta-analysis of serum IL-4 with fixed effect model shows heterogenity test of I2 = 0% (p=0.76). The standardized mean difference of IL-4 is -0.16, with CI 95%, -0.35 to 0.02. The result shows a greater but statistically non-significant decrease of serum IL-4 in probiotic group, compared to placebo (p=0.09). Conclusion: Probiotic supplementation may reduce AD lesion severity, but has no effect on the patient’s immunoserological profile.

Keywords: Atopic dermatitis, probiotic, SCORAD, Immunoglobulin-E, Interleukin-4

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How to cite this article:
Eunice Gunawan*, Retno Indar Widayati, Puguh Riyanto, Asih Budiastuti, Diah Adriani Malik, Muslimin, Suhartono. Efficacy of Probiotic Supplementation for the Treatment of Pediatric Atopic Dermatitis. A Systematic Review and Meta-analysis: Assessment of SCORAD Index, Serum Immunoglobulin-E, and Interleukin-4 Parameters.American Journal of Dermatological Research and Reviews, 2022, 5:50. DOI: 10.28933/ajodrr-2022-03-3105

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