Efek Pemberian Lactobacillus plantarum IS-10506 terhadap Indeks Scoring Atopic Dermatitis (SCORAD) Pasien Dermatitis Atopik Dewasa Derajat Ringan-Sedang: Uji Klinis Acak Terkontrol, Tersamar Ganda
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Latar belakang: Efek terapi probiotik pada dermatitis atopik (DA) telah dibuktikan, namun hanya beberapa studi pada populasi dewasa dan hasilnya masih tidak konsisten. Ketidakseimbangan sel T-helper (Th)1 dan Th2 diduga memengaruhi kadar imunoglobulin (Ig) E, yang juga memengaruhi indeks Scoring Atopic Dermatitis (SCORAD). Penatalaksanaan standar yang telah ada hanya mengurangi gejala DA. Lactobacillus plantarum (LP) IS-10506 merupakan probiotik yang diisolasi dari dadih, suatu fermentasi susu kerbau tradisional asli Indonesia yang diharapkan akan memperbaiki gejala DA karena efek imunomodulator. Tujuan: Mengevaluasi perbaikan indeks SCORAD setelah pemberian LP IS-10506 pada DA dewasa derajat ringan-sedang. Metode: Uji klinis acak terkontrol tersamar ganda terhadap 30 pasien DA dewasa derajat ringan-sedang dirandomisasi untuk mendapatkan LP (dosis: 2x1010 cfu/hari) atau plasebo selama 8 minggu di Divisi Alergi Imunologi Instalasi Rawat Jalan (IRJ) Kesehatan Kulit dan Kelamin RSUD Dr. Soetomo Surabaya. Indeks SCORAD dievaluasi sebelum, minggu ke-4, dan sesudah intervensi (minggu ke-8). Hasil: Sebesar 15 sampel pada kelompok LP dan 15 sampel pada kelompok plasebo dapat menyelesaikan studi. Nilai SCORAD pada kelompok LP lebih rendah dibanding plasebo dengan rerata selisih yang berbeda bermakna pada minggu ke-4 (p = 0,040) dan minggu ke-8 (p = 0,022). Simpulan: Pemberian LP IS-10506 dapat dipertimbangkan sebagai terapi tambahan pada DA dewasa derajat ringan-sedang karena memiliki efek imunomodulator.
Leung DYM, Eichenfield LF, Boguniewicz M. Atopic dermatitis (Atopic eczema). In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick's dermatology in general medicine. 8th ed. New York: Mc Graw Hill; 2012.p.165-82.
Remitz A, Reitamo S. The clinical manifestations of atopic dermatitis. In Reitamo S, Luger TA, Steinhoff M. Textbook of atopic dermatitis. United Kingdom: Informa Healthcare; 2008.p. 1-11.
Silverberg I, Hanifin J. Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population–based study. J Allergy Clin Immunol 2013;132: 1132-8.
Vinding R, Zarchi K., Ibler S., Miller M., Ellervik., Jemec G. Is adult atopic eczema more common than we think? – A population-based study in danish adults. Acta Derm Venereol 2014; 94: 480–2.
Yamanaka K, Mizutani H. The role of cytokines/chemokines in the pathogenesis of atopic dermatitis. Curr Probl Dermatol 2011; 41: 80–92.
Vakirlis E, Lazaridou E, Tzellos T, Gerou S, Chatzidimitriou D, Ioannides D et al. Investigation of 21 cytokine level and their association with SCORAD index in adult with acute atopic dermatitis. J Eur Acad Dermatol Venereol 2011; 25(4): 409-16.
James WD, Berger TG, Elston DM, Neuhaus IM. Atopic dermatitis, eczema, and noninfectious immunodeficiency disorders. In: James WD, Berger TG, Elston DM, Neuhaus IM. Andrew's diseases of the skin. 12th ed. Philadelphia: Elsevier; 2016. p.62-89.
Leung DYM. New insights into atopic dermatitis: role of skin barrier and immune dysregulation. Allergology International 2013; 62:151-61.
Bieber T. Mechanisms of disease. Atopic Dermatitis. N Engl J Med 2008; 358:1483-94.
Saucedo GG, Vallejo RS, Gimenez JCM. Atopic dermatitis: update and proposed management algorithm. Actas Dermosifiliogr 2013; 104(1):4-16.
Brenninkmeijer EEA, Schram ME, Leeflang MMG, Bos JD, Spuls PI. Diagnostic criteria for atopic dermatitis: systematic review. Br J Dermatol 2008; 158:754-65.
Eichenfield LF, Tom WL, Chamlin SL, Feldma S, Hanifin JM, Simpson EL et al. Guidelines of care of the management of atopic dermatitis section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol 2014;71(1):116-32.
Rather IA, Bajpai VK, Kumar S, Lim J, Paek WK and Park Y-H. Probiotics and atopic dermatitis: an overview. Front. Microbiol 2016; 7: 507-14.
Kim SO, Ah YM, Yu YM, Choi KY, Shin WG, Lee JY. Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol 2014; 113(2): 217-26.
Notay M, Foolad N, Vaughn AR, Sivaman RK. Probiotics, prebiotics, and synbiotics for the treatment and prevention of adult dermatological diseases. Am J Clin Dermatol 2017; 18: 721-32.
Surono IS. Traditional Indonesian dairy foods. Asia Pac J Clin Nutr 2015;24(1):26-30.
Adib A, Wahid MH, Sudarmono P, Surono IS. Lactobacillus plantarum in stool of apparently healthy adults consuming Lactobacillus plantarum IS-10506 from Dadih. JTIP 2013;24(2):154-60.
Harima M, Kamachi K, Kano M, Nozaki D, Uetake T, Yokomizo Y et al. Beneficial effects of citrus juice fermented with L. plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials. Biosci Microbiota Food Health 2016; 35(1): 29-39.
Prakoeswa CRS, Herwanto N, Prameswari R, Astari L, Sawitri, Hidayati AN et al. Lactobacillus plantarum IS-10506 supplementation reduced SCORAD in children with atopic dermatitis. Benef Microbes 2017;8(5):833-840.
Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J, 2015:2: 242-46
Pate MB, Smith JK, Chi DS, Krishnaswamy G. Regulation and dysregulation of immunoglobulin E: a molecular and clinical perspective. Clin Mol Allergy 2010; 8:1-13.
Yoshida Y, Seki T, Matsunaka H, Watanabe T, Shindo M, Yamada N, et al. Clinical effect of probiotic Bifidobacterium breve supplementation in adult with atopic dermatitis. Yonago Acta Med 2010; 53:37-45.
Inoue Y, Kambara T, Murata N, Yamaguchi JK, Matsukura S, Takahashi Y et al. Effects of Oral Administration of Lactobacillus acidophilus L-92 on the symptoms and serum cytokines of atopic dermatitis in japanese adults: A double-blind, randomized, clinical trial. Int Arch Allergy Immunol 2014; 165:247–54.
Orihara K, Nakae S, Pawankar R, Saito H. Role of regulatory and proinflammatory T-cells populations in allergic disease. World Allergy Organ J 2008; 1(1): 9-14.
Drago L, Iemolo E, Rodighiero V, Nicola, Vecchi E, Piconi S et al. Effects of Lactobacillus salivarus LS01 (DSM 22775) treatment on adult atopic dermatitis: a randomized placebo-controlled study. Int J Immunopathol Pharmacol 2011; 24: 1037-48.
Lemoli E, Trabattoni D, Parisotto S, Borgonovo L, Toscano M, Rizzardini G et al. Probiotics reduce gut microbial translocation and improve adult atopic dermatitis. J Clin Gastroenterol 2012; 46: 33–40.
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