Ann Dermatol Vol. 24, No. 2, 2012 ORIGINAL ARTICLE The Effect of Probiotics in Atopic Dermatitis http://dx.doi.org/10.5021/ad.2012.24.2.189 Effect of Probiotics on the Treatment of Children with Atopic Dermatitis Yavuz Yeşilova, M.D., Ömer Çalka, M.D.1, Necmettin Akdeniz, M.D.1, Mustafa Berktaş, M.D.2 Department of Dermatology, Harran University Faculty of Medicine, Sanliurfa, Departments of 1Dermatology, 2Microbiology and Yüzüncü Yil University, Faculty of Medicine, Van, Turkey Background: Atopic dermatitis, a chronic recurrent disease, is frequently encountered in clinical practice. In the last 30 years, the prevalence of atopic dermatitis has rapidly increased due to industrialization. Therefore, there have been attempts in recent years to find new ways of treating and preventing atopic dermatitis. Objective: In this double-blind, randomized, placebo-controlled study, a combination of Bifidobacterium bifidum, Lactobacillus acidophilus, Lacto- bacillus casei, and Lactobacillus salivarius strains were evaluated in the treatment of atopic dermatitis in pediatric patients. Methods: Forty pediatric patients (23 males and 17 females) aged 1∼13 years were enrolled. One eligible individual who was approached declined to participate. The probiotic group was administered a probiotic complex containing B. bifidum, L. acidophilus, L. casei, and L. salivarius for 8 weeks. The placebo group, on the other hand, was administered skim milk powder and dextrose. All of the parameters including serum cytokines, eosinophil cationic protein), SCORing Atopic Dermatitis (SCORAD) index, and total serum immunoglobulin E (IgE) were measured in both the probiotic group and the placebo group at the end of 8 weeks. Results: Probiotic intervention in pediatric atopic dermatitis patients effectively reduced the SCORAD index and serum cytokines interleukin (IL)-5, IL-6, interferon (IFN)- γ, and total serum IgE levels, but did not reduce levels of Received March 15, 2011, Revised August 16, 2011, Accepted for publication August 17, 2011 Corresponding author: Yavuz Yeşilova, M.D., Department of Dermatology, Harran University Faculty of Medicine, 63300, Sanliurfa, Turkey. Tel: +90-414-318-30-00, Fax: +90-414-312-81-44, E-mail: yavuzyesilova@gmail.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. serum cytokines IL-2, IL-4, IL-10, ECP, or tumor necrosis factor-α (TNF-α) compared to the placebo group. Conclusion: Our study found probiotics to be effective in reducing atopic dermatitis patients' SCORAD index, serum IL-5, IL-6, IFN-γ, and total serum IgE levels but not effective in reducing serum IL-2, IL-4, IL-10, ECP, or TNF-α levels. (Ann Dermatol 24(2) 189∼193, 2012) -Keywords- Atopic dermatitis, Cytokines, Probiotics, SCORAD index INTRODUCTION Atopic dermatitis (AD) is a common infant or early childhood disease for which genetic factors may create a disposition and is triggered by a variety of antigens. AD is characterized by chronic or relapsing inflammatory der- matitis1. Atopy is described as “a personal or familial tendency to produce IgE antibodies in response to low doses of allergens, usually proteins, and to develop typical 2 symptoms such as asthma, rhinoconjunctivitis, or AD .” The prevalence of AD has increased in with industriali- zation3. Thus, new approaches have attracted interest in the treatment of AD. While probiotic means “for life,” allergic diseases (AD, allergic rhinitis, asthma, etc.) have been demonstrated in the treatment of many systemic diseases4. In this study, we have examined the clinical and anti-inflammatory effects of probiotic supplementation in pediatric patients with AD. MATERIALS AND METHODS Forty pediatric patients (23 males and 17 females) aged 1 ∼13 years participated in the study between October Vol. 24, No. 2, 2012 189