{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:49:20Z","timestamp":1789145360273,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Microbiome-targeted treatments have been investigated in atopic dermatitis (AD). We aimed to investigate the tolerability and efficacy of probiotic\n                      <jats:italic>Lactobacillus lactis<\/jats:italic>\n                      lysate cream in AD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 13 patients with mild-to-moderate AD were treated with differently concentrated probiotic creams (3, 10, and 30%) for 4\u202fweeks. The severity of AD [Eczema Area and Severity Index (EASI) and Investigator Global Assessment (IGA)], epidermal barrier function (TEWL), and the impact of AD [Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), Atopic Dermatitis Control Tool (ADCT), and pruritus and sleep disturbance visual analog scale (VAS)] were measured at baseline (BL) and at 4 and 8\u202fweeks. Comprehensive clinical patient data and laboratory values, including blood eosinophil count, total serum IgE levels, and specific IgEs to aeroallergens, were obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Comparison of the treatment groups and longitudinal comparisons at various time points showed no significant differences regarding AD severity (EASI,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.76, CI: 0.65\u20131.00), epidermal barrier dysfunction (TEWL,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.37, CI: 0.19\u20130.73), or patient-reported subjective impact of AD (DLQI,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.76, CI: 0.65\u20131.00; POEM,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.76, CI: 0.35\u20130.88; ADCT,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.72, CI: 0.65\u20131.00; pruritus VAS 0.67, CI: 0.55\u20131.00; sleep disturbance VAS,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f1.00, CI: 0.79\u20131.00) between different probiotic lysate concentrations and placebo. The probiotic lysate cream was well-tolerated, and there were no significant adverse effects. The limitations of the study were the small patient cohort and group sizes. There was also a relatively short follow-up, and no evaluation of long-term effects was conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      In our patient cohort, topical probiotic\n                      <jats:italic>L. lactis<\/jats:italic>\n                      lysate cream showed good tolerability, but it did not show efficacy in the treatment of mild-to-moderate AD. Although topical probiotics have been reported to be effective in a limited number of studies, more placebo-controlled clinical studies are needed to explore their potential role in the treatment of AD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/eudract.ema.europa.eu<\/jats:ext-link>\n                      , Identifier EudraCT 2020-000514-15.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1694229","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:57:07Z","timestamp":1770123427000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Topical probiotic Lactobacillus lactis treatment in atopic dermatitis: a placebo-controlled pilot study on tolerability and efficacy"],"prefix":"10.3389","volume":"13","author":[{"given":"Ville","family":"Salo","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, Helsinki University Hospital and University of Helsinki","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Remitz","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Helsinki University Hospital and University of Helsinki","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Lauerma","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Helsinki University Hospital and University of Helsinki","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Salava","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Helsinki University Hospital and University of Helsinki","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1111\/ijd.15912","article-title":"Atopic dermatitis in adults: a population-based study in Finland","volume":"61","author":"Kiiski","year":"2022","journal-title":"Int J Dermatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"354250","DOI":"10.1155\/2014\/354250","article-title":"Atopic dermatitis: natural history, diagnosis, and treatment","volume":"2014","author":"Thomsen","year":"2014","journal-title":"ISRN Allergy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1038\/ng1767","article-title":"Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis","volume":"38","author":"Palmer","year":"2006","journal-title":"Nat Genet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1361-70.e7","DOI":"10.1016\/j.jaci.2009.03.036","article-title":"Meta-analysis of filaggrin polymorphisms in eczema and asthma: robust risk factors in atopic disease","volume":"123","author":"Rodr\u00edguez","year":"2009","journal-title":"J Allergy Clin Immunol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1111\/j.1398-9995.2010.02464.x","article-title":"Determinants of eczema: population-based cross-sectional study in Germany","volume":"66","author":"Apfelbacher","year":"2011","journal-title":"Allergy"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jid.2020.07.006","article-title":"Which way do we go? Complex interactions in atopic dermatitis pathogenesis","volume":"141","author":"Patrick","year":"2021","journal-title":"J Invest Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/2045-7022-4-33","article-title":"Role of the skin microbiome in atopic dermatitis","volume":"4","author":"Salava","year":"2014","journal-title":"Clin Transl Allergy"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1111\/j.1365-2133.1974.tb06447.x","article-title":"Staphylococcus aureus in the lesions of atopic dermatitis","volume":"90","author":"Leyden","year":"1974","journal-title":"Br J Dermatol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1101\/gr.131029.111","article-title":"Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis","volume":"22","author":"Kong","year":"2012","journal-title":"Genome Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s40001-022-00713-z","article-title":"The effect of probiotics on the clinical status of adult patients with atopic dermatitis: a systematic review","volume":"27","author":"Sodr\u00e9","year":"2022","journal-title":"Eur J Med Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1016\/j.jaip.2020.07.051","article-title":"The use of probiotics and bacteria-derived preparations in topical treatment of atopic dermatitis\u2014a systematic review","volume":"9","author":"Ambro\u017cej","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1034\/j.1600-0625.2001.100102.x","article-title":"The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. 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Bifidobacterium longum extract exerts pro-differentiating effects on human epidermal keratinocytes, in vitro","volume":"26","author":"Sz\u00f6ll\u0151si","year":"2017","journal-title":"Exp Dermatol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"G1029","DOI":"10.1152\/ajpgi.00003.2012","article-title":"Mechanism of protection of transepithelial barrier function by Lactobacillus salivarius: strain dependence and attenuation by bacteriocin production","volume":"303","author":"Miyauchi","year":"2012","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"4887","DOI":"10.1128\/AEM.00982-13","article-title":"Strain-dependent augmentation of tight-junction barrier function in human primary epidermal keratinocytes by Lactobacillus and Bifidobacterium lysates","volume":"79","author":"Sultana","year":"2013","journal-title":"Appl Environ Microbiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1128\/AEM.03440-15","article-title":"Three novel candidate probiotic strains with prophylactic properties in a murine model of cow's milk allergy","volume":"82","author":"Neau","year":"2016","journal-title":"Appl Environ Microbiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"299","DOI":"10.3920\/BM2017.0084","article-title":"Lactobacillus salivarius LA307 and Lactobacillus rhamnosus LA305 attenuate skin inflammation in mice","volume":"9","author":"Holowacz","year":"2018","journal-title":"Benef Microbes"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1186\/cc6843","article-title":"Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin","volume":"12","author":"Lolis","year":"2008","journal-title":"Crit Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1128\/JCM.36.1.325-326.1998","article-title":"Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis","volume":"36","author":"Oggioni","year":"1998","journal-title":"J Clin Microbiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1111\/j.1469-0691.1999.tb00144.x","article-title":"Lactobacillus endocarditis caused by a probiotic organism","volume":"5","author":"Mackay","year":"1999","journal-title":"Clin Microbiol Infect"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"895","DOI":"10.7326\/0003-4819-151-12-200912150-00020","article-title":"A pain in the neck: probiotics for ulcerative colitis","volume":"151","author":"Conen","year":"2009","journal-title":"Ann Intern Med"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.22541\/au.168274264.45913900\/v1","article-title":"Treatment of atopic dermatitis with probiotic L. lactis lysate\u2014a double-blinded, placebo-controlled pilot study","author":"Salo","year":"2023","journal-title":"Authorea"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.22541\/au.168921004.46872916\/v1","article-title":"Topical probiotic L. lactis treatment in atopic dermatitis\u2014a double-blinded, placebo-controlled pilot study","author":"Salo","year":"2023","journal-title":"Authorea"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1694229\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:57:08Z","timestamp":1770123428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1694229\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":38,"alternative-id":["10.3389\/fmed.2026.1694229"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1694229","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]},"article-number":"1694229"}}