Skin microbiome in children with atopic dermatitis: possibilities of prebiotic and probiotic correction

Skin microbiome disturbance is one of the factors of atopic dermatitis (AD). Objective. To assess the effectiveness of AD treatment in children with the inclusion of prebiotics and probiotics complex in the external therapy on the basis of dynamic analysis of the clinical picture, skin and intestinal microbiome. Material and methods. A number of children equal 19 (9 boys and 10 girls) with AD in the phase of exacerbation remitting aged from 2 months to 5 years were examined, for whom a series of agents with a biotic complex (inulin and oligosaccharides prebiotics + lactobacilli) were used as external therapy. SCORAD, pH and skin moisture (Multi Skin MC 750, Germany) were assessed at the time of inclusion in the study and after 1 month of therapy. Research of microbiome from the affected area of the skin and in feces by PCR and 16S sequencing were conducted. Results. A decrease in SCORAD (18.0 (11.9-23.5) and 7.0 (3.0-9.0); p<0.001), an increase in skin moisture in the affected areas of the skin with differences in the cheek region (23.2 (13.33-33.67) and 36.50 (16.3-41.5); p=0.002), pH drift towards optimum values in the cheek region (6.04±0.97 and 5.64±0.77; p=0.043) have been obtained. After external therapy of AD a negative correlation of SCORAD and phylum Actinobacteriota has been revealed (r= –0.79; p=0.036), positive correlations between SCORAD and percentage of phylum Bacteroidota (r=0.96, p<0.001), class Bacteroidia (r=0.96, p<0.001), class Clostridia (r=0.89, p=0.007), family Prevotellaceae (r=0.86, p=0.014), family Peptostreptococcales (r=0.79, p=0.036), genus Prevotella (r=0.98, p<0.001) have been noted. Conclusion. Therapy of AD in children using external care products with biotic complex allowed to achieve improvement in functional indicators, change in skin microbiome with an increase in the percentage of normal microbiota and a decrease in the count of opportunistic pathogens.