{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:06:43Z","timestamp":1792789603821,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funziona s.r.l."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The role of the skin\u2013gut axis in atopic dermatitis (AD) remains a subject of debate, limiting non-pharmacological interventions such as probiotics and prebiotics. To improve understanding of their potential as a monotherapy for stable mild cases, we conducted a real-life, multicenter, retrospective observational study in Italy. We administered three selected bacteria (Bifidobacterium animalis subsp. lactis BS01, Lactiplantibacillus plantarum LP14, and Lacticaseibacillus rhamnosus LR05) orally to patients with mild atopic dermatitis without a placebo control group, following up for 12 weeks. Clinical assessments using the Scoring Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), and Three-Item Severity (TIS) score were conducted on 144 enrolled patients (average age: 25.1 \u00b1 17.6 years). Notably, both pruritus and AD-related lesions (erythema, edema\/papules, excoriation) exhibited significant clinical and statistical improvement (p &lt; 0.001) after 12 weeks of exclusive probiotic and prebiotic use. These preliminary results suggest a potential link between the skin\u2013gut microbiome and support the rationale for using specific probiotics and prebiotics in mild AD, even for maintenance, to reduce flares and dysbiosis.<\/jats:p>","DOI":"10.3390\/medicina59122080","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T03:33:56Z","timestamp":1701056036000},"page":"2080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Probiotics and Prebiotics Orally Assumed as Disease Modifiers for Stable Mild Atopic Dermatitis: An Italian Real-Life, Multicenter, Retrospective, Observational Study"],"prefix":"10.3390","volume":"59","author":[{"given":"Delia","family":"Colombo","sequence":"first","affiliation":[{"name":"Independent Researcher, Private Practice, Via Livigno 6, 20158 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Rigoni","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Corso Monteforte 40, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Cant\u00f9","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via Domodossola 9\/A, 20145 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Carnevali","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Str. Colomba Pecorari 32\/a, 06134 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Filippetti","sequence":"additional","affiliation":[{"name":"Private Practice, Via Ruspoli 62, 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Franco","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Viao Veio, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Grassi","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via Coletti 19, 00191 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Loi","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via X Settembre 1943 7 and 9, 40011 Anzola dell\u2019Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Viale di Villa Massimo 48, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivona","family":"Patroi","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via del Tritone 102, 00187 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Raone","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via Ruggero Leoncavallo 5, 40137 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Andrea","family":"Tomassini","sequence":"additional","affiliation":[{"name":"Independent Researcher, Private Practice, Via Ponchielli 30, 06073 Corciano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5919-2658","authenticated-orcid":false,"given":"Angela","family":"Amoruso","sequence":"additional","affiliation":[{"name":"Independent Researcher, Probiotical Research srl, Via Mattei 3, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3575-6919","authenticated-orcid":false,"given":"Marco","family":"Pane","sequence":"additional","affiliation":[{"name":"Independent Researcher, Probiotical Research srl, Via Mattei 3, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-6505","authenticated-orcid":false,"given":"Giovanni","family":"Damiani","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan, 20122 Milan, Italy"},{"name":"Department of Pharmaceutical and Pharmacological Sciences, PhD Degree Program in Pharmacological Sciences, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S0140-6736(20)31286-1","article-title":"Atopic dermatitis","volume":"396","author":"Langan","year":"2020","journal-title":"Lancet"},{"key":"ref_2","first-page":"414","article-title":"Promoting Integrated Care in Eczematous Dermatitis and Dry Sensitive Skin","volume":"20","author":"Hebert","year":"2022","journal-title":"Skinmed"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lobefaro, F., Gualdi, G., Di Nuzzo, S., and Amerio, P. (2022). Atopic Dermatitis: Clinical Aspects and Unmet Needs. Biomedicines, 10.","DOI":"10.3390\/biomedicines10112927"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Moniaga, C.S., Tominaga, M., and Takamori, K. (2022). An Altered Skin and Gut Microbiota Are Involved in the Modulation of Itch in Atopic Dermatitis. Cells, 11.","DOI":"10.3390\/cells11233930"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hammond, M., Gamal, A., Mukherjee, P.K., Damiani, G., McCormick, T.S., Ghannoum, M.A., and Nedorost, S. (2022). Cutaneous dysbiosis may amplify barrier dysfunction in patients with atopic dermatitis. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.944365"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e386","DOI":"10.1111\/ajd.13644","article-title":"Probiotic mixture reduces gut inflammation and microbial dysbiosis in children with atopic dermatitis","volume":"62","author":"Yoon","year":"2021","journal-title":"Australas. J. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.4049\/jimmunol.136.7.2348","article-title":"Two types of murine helper T cell clone. I. Definition according to profiles of lymphokine activities and secreted proteins","volume":"136","author":"Mosmann","year":"1986","journal-title":"J. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"24072","DOI":"10.1038\/srep24072","article-title":"Th17 responses and natural IgM antibodies related to gut microbiota composition in systemic lupus erythematosus patients","volume":"6","author":"Hevia","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4930","DOI":"10.1002\/jsfa.10554","article-title":"Lactobacillus rhamnosus 2016SWU.05.0601 regulates immune balance in ovalbumin-sensitized mice by modulating expression of the immune-related transcription factors and gut microbiota","volume":"100","author":"Song","year":"2020","journal-title":"J. Sci. Food Agric."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"720393","DOI":"10.3389\/fimmu.2021.720393","article-title":"Gut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A Review","volume":"12","author":"Fang","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e13121","DOI":"10.1111\/dth.13121","article-title":"Italian guidelines for therapy of atopic dermatitis-Adapted from consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis)","volume":"32","author":"Damiani","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Damiani, G., Alessandrini, M., Caccamo, D., Cormano, A., Guzzi, G., Mazzatenta, A., Micarelli, A., Migliore, A., Piroli, A., and Bianca, M. (2021). Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS). Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111294"},{"key":"ref_13","first-page":"452","article-title":"The Roberts Skin Type Classification System","volume":"7","author":"Roberts","year":"2008","journal-title":"J. Drugs Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000363149","article-title":"What is sensitive skin? A systematic literature review of objective measurements","volume":"28","author":"Richters","year":"2015","journal-title":"Ski. Pharmacol. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1111\/jocd.13347","article-title":"Oily sensitive skin: A review of management options","volume":"19","author":"Hong","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4162\/nrp.2010.4.3.215","article-title":"Nutritional and antioxidant status by skin types among female adults","volume":"4","author":"Bae","year":"2010","journal-title":"Nutr. Res. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s13555-021-00495-y","article-title":"The Role of Photoprotection in Optimizing the Treatment of Atopic Dermatitis","volume":"11","author":"Carrascosa","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"23s","DOI":"10.36849\/JDD.589D","article-title":"Alteration to the Skin Barrier Integrity Following Broad-Spectrum UV Exposure in an Ex Vivo Tissue Model","volume":"20","author":"Barresi","year":"2021","journal-title":"J. Drugs Dermatol."},{"key":"ref_19","unstructured":"Oakley, A.M., Badri, T., and Harris, B.W. (2023). StatPearls [Internet], StatPearls Publishing."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jaad.2021.12.019","article-title":"Photoprotection for skin of all color: Consensus and clinical guidance from an expert panel","volume":"86","author":"Rigel","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1016\/j.jaad.2021.12.020","article-title":"Misconceptions of photoprotection in skin of color","volume":"86","author":"Taylor","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_22","first-page":"305","article-title":"Direct and Indirect Effects of Blue Light Exposure on Skin: A Review of Published Literature","volume":"35","author":"Suitthimeathegorn","year":"2022","journal-title":"Ski. Pharmacol. Physiol."},{"key":"ref_23","first-page":"e27333","article-title":"An Overview of Ultraviolet-Protective Clothing","volume":"14","author":"Lu","year":"2022","journal-title":"Cureus"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/phpp.12776","article-title":"Photoprotection by clothing: A review","volume":"38","author":"Mohammad","year":"2022","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1708-8305.2012.00667.x","article-title":"Sun exposure behavior and protection: Recommendations for travelers","volume":"20","author":"Diaz","year":"2013","journal-title":"J. Travel Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1080\/000155599750010256","article-title":"Scoring the severity of atopic dermatitis: Three item severity score as a rough system for daily practice and as a pre-screening tool for studies","volume":"79","author":"Wolkerstorfer","year":"1999","journal-title":"Acta Derm. Venereol."},{"key":"ref_27","first-page":"37","article-title":"A visual score for pruritus","volume":"16","author":"Gelmetti","year":"2006","journal-title":"Eur. J. Pediat. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"113024","DOI":"10.1016\/j.celrep.2023.113024","article-title":"Staphylococcus epidermidis activates keratinocyte cytokine expression and promotes skin inflammation through the production of phenol-soluble modulins","volume":"9","author":"Williams","year":"2023","journal-title":"Cell Rep."},{"key":"ref_29","first-page":"926","article-title":"Prebiotics and probiotics in atopic dermatitis","volume":"18","author":"Rusu","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1038876","DOI":"10.3389\/fimmu.2022.1038876","article-title":"The associations of maternal and children\u2019s gut microbiota with the development of atopic dermatitis for children aged 2 years","volume":"13","author":"Fan","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1038\/s41385-022-00564-1","article-title":"Microbiome-based interventions to modulate gut ecology and the immune system","volume":"15","author":"Hitch","year":"2022","journal-title":"Mucosal Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/bjd.20411","article-title":"Dysbiotic gut microbiota in patients with inflammatory rosacea: Another clue towards the existence of a brain-gut-skin axis","volume":"185","author":"Jimenez","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e368","DOI":"10.1111\/jdv.14953","article-title":"Oral psoriasis and SIBO: Is there a link?","volume":"32","author":"Drago","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Zhang, L., Meng, Y., Li, J., Yu, J., Mu, G., and Tuo, Y. (2022). Lactiplantibacillus plantarum Y42 in Biofilm and Planktonic States Improves Intestinal Barrier Integrity and Modulates Gut Microbiota of Balb\/c Mice. Foods, 11.","DOI":"10.3390\/foods11101451"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1126800","DOI":"10.3389\/fimmu.2022.1126800","article-title":"Editorial: Gut microbiome, metabolites, and immune response in lupus, rheumatoid arthritis, and Sj\u00f6gren syndrome","volume":"13","author":"Zhao","year":"2023","journal-title":"Front. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1002\/ski2.191","article-title":"The financial burden of out-of-pocket healthcare expenses on caregivers of children with atopic dermatitis in the United States","volume":"3","author":"Chovatiya","year":"2022","journal-title":"Ski. Health Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1111\/jdv.17094","article-title":"Dupilumab therapy of atopic dermatitis of the elderly: A multicentre, real-life study","volume":"35","author":"Patruno","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2131703","DOI":"10.1080\/09546634.2022.2131703","article-title":"Topical prebiotics\/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients","volume":"34","author":"Gelmetti","year":"2023","journal-title":"J. Dermatol. Treat."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2080\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:30:56Z","timestamp":1760131856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,27]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["medicina59122080"],"URL":"https:\/\/doi.org\/10.3390\/medicina59122080","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,27]]}}}