Probiotics for the prevention of atopic dermatitis and other allergic diseases: What are the real facts?

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases diagnosed all over the world. The course of this complicated disease is chronic and relapsing and there have been many variants both endogenic and phenotypic already described and despite of our better understanding of AD we have no well “structured” therapeutical approach to many of our patients. Mainly because we do not understand it in an adequate way and complexity of treatment must be highly individualized. Recent studies suggest prevention of AD can be achieved through early intervention to protect the disturbed skin barrier. While the skin lesions are developed AD requires appropriate control of local and systemic immune activation for optimal management which obviously may cause the whole variety of adverse events. Therefore it seems that early intervention might improve long-term outcomes of AD and reduce the risk of development of systemic sensitization that leads to associated allergic/atopic diseases within the gastrointestinal and respiratory tract. For some time probiotics have been suggested as an intervention to prevent allergic diseases such as AD. Therefore besides many publications, a systematic review of randomized trials assessing the effect of any probiotics administered to pregnant women breast-feeding mothers, and/or infants have been analyzed in this review paper in order to state what is the “real truth” about this type of preventive approach.