Targeting the Gut Microbiome for Atopic Dermatitis: A Comprehensive Review of Mechanisms and Therapeutic Approaches

Main Article Content

V.J. Sebastian Criton, MD, HOD Joy Sanjana, MBBS

Abstract

Millions worldwide, particularly children, suffer from the prevalent inflammatory skin condition known as Atopic Dermatitis (AD), with its prevalence on a constant rise.It’s impact extends beyond affecting merely the skin, contributing towards more complex health problems. The exact cause of this condition is multifactorial: genetic, environmental and immunologic factors all play significant roles; however, attention has recently focused on the role gut microbiota may have in relation to 'gut-skin' axis disturbances. Gut microbiota imbalances may be influenced by diet, antibiotic use as well as changes in environmental conditions that may contribute to Atopic Dermatits pathogenesis.  New research concentrates on therapies including probiotics, prebiotics and faecal microbiota transplantation. Multi-strain probiotic formulas in particular, are promising; such products have shown to potentially help manage Atopic Dermatitis symptoms by altering the immune response and adjusting the composition of gut microbes. The available evidence also suggests that exclusion diets can be tailored to serve as a form of dietary management. Fecal microbiota transplantation represents an innovative approach that requires additional scrutiny regarding its efficacy and safety in treating Atopic Dermatitis. The complex relationship between skin barrier function, immune responses and gut microbial composition offers possibilities for developing novel therapies targeting the microbiome in Atopic Dermatitis management.

Keywords: Gut microbiome, Atopic dermatitis, Probiotics, Dysbiosis, Short chain fatty acids

Article Details

How to Cite
CRITON, V.J. Sebastian; SANJANA, Joy. Targeting the Gut Microbiome for Atopic Dermatitis: A Comprehensive Review of Mechanisms and Therapeutic Approaches. Medical Research Archives, [S.l.], v. 12, n. 5, may 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5290>. Date accessed: 09 oct. 2024. doi: https://doi.org/10.18103/mra.v12i5.5290.
Section
Review Articles

References

1. Wang Y, Hou J, Joseph Chi-Ching Tsui, et al. Unique Gut Microbiome Signatures among Adult Patients with Moderate to Severe Atopic Dermatitis in Southern Chinese. International Journal of Molecular Sciences. 2023;24(16):12856-12856.
2. Navarro-López V, Núñez-Delegido E, Ruzafa-Costas B, Sánchez-Pellicer P, Agüera-Santos J, Navarro-Moratalla L. Probiotics in the Therapeutic Arsenal of Dermatologists. Microorganisms. 2021;9(7):1513.
3. Fang Z, Li L, Zhang H, Zhao J, Lu W, Chen W. Gut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A Review. Frontiers in Immunology. 2021;12.
4. Pedersen E, Skov L, Thyssen J, Jensen P. Role of the Gut Microbiota in Atopic Dermatitis: A Systematic Review. Acta Dermato Venereologica. Published online 2018:0.
5. Climent E, Martinez-Blanch JF, Llobregat L, et al. Changes in Gut Microbiota Correlates with Response to Treatment with Probiotics in Patients with Atopic Dermatitis. A Post Hoc Analysis of a Clinical Trial. Microorganisms. 2021;9(4).
6. Lee MJ, Park YM, Kim B, et al. Disordered development of gut microbiome interferes with the establishment of the gut ecosystem during early childhood with atopic dermatitis. Gut Microbes. 2022;14(1).
7. Anania C, Brindisi G, Martinelli I, et al. Probiotics Function in Preventing Atopic Dermatitis in Children. International Journal of Molecular Sciences. 2022;23(10):5409-5409.
8. Amornthep Kingkaw, Massalin Nakphaichit, Narissara Suratannon, et al. Analysis of the infant gut microbiome reveals metabolic functional roles associated with healthy infants and infants with atopic dermatitis using metaproteomics. PeerJ. 2020;8:e9988-e9988.
9. Moniaga CS, Tominaga M, Takamori K. An Altered Skin and Gut Microbiota Are Involved in the Modulation of Itch in Atopic Dermatitis. Cells. 2022;11(23):3930. ‌
10. Kim JH, Kim K, Kim W. Gut microbiota restoration through fecal microbiota transplantation: a new atopic dermatitis therapy. Experimental & Molecular Medicine. 2021;53(5):907-916.
11. Kim WK, Jang YJ, Han DH, et al. Lactobacillus paracasei KBL382 administration attenuates atopic dermatitis by modulating immune response and gut microbiota. Gut Microbes. 2020;12(1):1-14.
12. Ye S, Yan F, Wang H, et al. Diversity analysis of gut microbiota between healthy controls and those with atopic dermatitis in a Chinese population. The Journal of Dermatology. 2020;48(2):158-167.
13. Park DH, Kim JW, Park HJ, Hahm DH. Comparative Analysis of the Microbiome across the Gut–Skin Axis in Atopic Dermatitis. International Journal of Molecular Sciences. 2021;22(8).
14. Liu Y, Du X, Zhai S, Tang X, Liu C, Li W. Gut microbiota and atopic dermatitis in children: a scoping review. BMC Pediatrics. 2022;22(1). ‌
15. Polkowska‐Pruszyńska B, Gerkowicz A, Krasowska D. The gut microbiome alterations in allergic and inflammatory skin diseases – an update. Journal of the European Academy of Dermatology and Venereology. 2019;34(3):455-464.
16. Patangia DV, Anthony Ryan C, Dempsey E, Paul Ross R, Stanton C. Impact of antibiotics on the human microbiome and consequences for host health. Microbiologyopen. 2022;11(1):e1260.
17. Zeng MY, Inohara N, Nuñez G. Mechanisms of inflammation-driven bacterial dysbiosis in the gut. Mucosal Immunology. 2016;10(1):18-26.
18. Das A, Panda S. Role of Elimination Diet in Atopic Dermatitis: Current Evidence and Understanding. Indian Journal of Paediatric Dermatology. 2021;22(1):21. ‌
19. Stefanovic N, Irvine AD, Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis. Current Treatment Options in Allergy. 2021;8(3):222-241.
20. D’Elios S, Trambusti I, Verduci E, et al. Probiotics in the prevention and treatment of atopic dermatitis. Marseglia GL, ed. Pediatric Allergy and Immunology. 2020;31(S26):43-45.
21. Aguilera AC, Dagher IA, Kloepfer KM. Role of the Microbiome in Allergic Disease Development. Current allergy and asthma reports. 2020;20(9):44.
22. Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Frontiers in Microbiology. 2018;9(9).
23. Sinha S, Lin G, Ferenczi K. The skin microbiome and the gut-skin axis. Clinics in Dermatology. 2021;39(5).
24. Yoon W, Park SH, Lee JS, et al. Probiotic mixture reduces gut inflammation and microbial dysbiosis in children with atopic dermatitis. Australasian Journal of Dermatology. 2021;62(3). ‌
25. Papapostolou N, Xepapadaki P, Gregoriou S, Makris M. Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn. Journal of Clinical Medicine. 2022;11(14):4232. ‌
26. De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2).
27. Trompette A, Pernot J, Perdijk O, et al. Gut-derived short-chain fatty acids modulate skin barrier integrity by promoting keratinocyte metabolism and differentiation. Mucosal Immunology. Published online June 7, 2022:1-19.
28. Cristofori F, Dargenio VN, Dargenio C, Miniello VL, Barone M, Francavilla R. Anti-Inflammatory and Immunomodulatory Effects of Probiotics in Gut Inflammation: A Door to the Body. Frontiers in Immunology. 2021;12.
29. Widhiati S, Purnomosari D, Wibawa T, Soebono H. The role of gut microbiome in inflammatory skin disorders: a systematic review. Dermatology Reports. Published online December 28, 2021.
30. Mahmud MR, Akter S, Tamanna SK, et al. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes. 2022;14(1): 2096995.‌
31. Rajani PS, Martin H, Groetch M, Järvinen KM. Presentation and Management of Food Allergy in Breastfed Infants and Risks of Maternal Elimination Diets. The Journal of Allergy and Clinical Immunology: In Practice. 2020;8(1):52-67.
32. De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2):353.
33. Ianiro G, Bibbò S, Porcari S, et al. Fecal microbiota transplantation for recurrent C. difficile infection in patients with inflammatory bowel disease: experience of a large-volume European FMT center. Gut Microbes. 2021;13(1). ‌
34. Tan‐Lim CSC, Esteban‐Ipac NAR, Recto MST, Castor MAR, Casis‐Hao RJ, Nano ALM. Comparative effectiveness of probiotic strains on the prevention of pediatric atopic dermatitis: A systematic review and network meta‐analysis. Genuneit J, ed. Pediatric Allergy and Immunology. 2021;32(6):1255-1270.
35. Pujari R, Banerjee G. Impact of prebiotics on immune response: from the bench to the clinic. Immunology & Cell Biology. 2020;99(3):255-273.
36. Eigenmann PA, Beyer K, Lack G, et al. Are avoidance diets still warranted in children with atopic dermatitis? Ebisawa M, ed. Pediatric Allergy and Immunology. 2019;31(1):19-26. ‌
37. Liu Y, Wang J, Wu C. Modulation of Gut Microbiota and Immune System by Probiotics, Pre-biotics, and Post-biotics. Frontiers in Nutrition. 2022;8.