INFORMING AND ASSESSING THE CLINICAL APPLICATION OF PROBIOTICS IN ATOPIC DERMATITIS

Abstract

There is increasing clinical interest in the therapeutic application of probiotics in various autoimmune and allergic diseases (AADs). However, probiotics appear to be disproportionately researched and accepted in gastroenterological AADs when compared to non-gastroenterological AADs despite similar underlying clinical rationale. Atopic dermatitis, a non-gastroenterological AAD, is used as a case study to explore potential factors which contribute to this bias in research interest. A survey of the literature appears to suggest that despite plausibility of efficacy in probiotic interventions in AD and patient interest and need for alternative therapeutic measures, there is ironically little clinical research interest. This dissonance appears to suggest that there is an inherent bias in the perception of probiotics in AD amongst those in the biomedical community. Exploratory surveys were conducted to gauge both patient and dermatologist perceptions and knowledge of probiotics in the application of atopic dermatitis. The purpose of these surveys is to identify inherent biases amongst dermatologists who are partly responsible for generating clinical research interest while also simultaneously gauging the consequences of inherent biases on both the generation of novel research content and in the potential introduction of probiotics in AD. A total of 195 Princeton University Undergraduate students and 28 dermatologists participated in two separate online surveys distributed by email. Results from the student survey seem to suggest that barriers to the introduction of probiotics are relatively low. However, amongst dermatologists, there appears to be significant skepticism surrounding the use of probiotics in atopic dermatitis. Though some attribute their skepticism to the lack of research available in the literature, similarly low reported confidence in probiotics in Irritable Bowel Disease despite overwhelming gastroenterologist acceptance and use of probiotics suggests that dermatologists harbor ingrained doubts of efficacy of probiotics in all AADs.