Novel Therapeutic Approaches for Treating Moderate-to-Severe Atopic Dermatitis in Infants with Polyvalent Allergic Sensitisation

TL;DR

A new combined therapy significantly improved eczema and allergic symptoms in infants, outperforming standard treatments.

Contribution

A novel combination therapy with pseudoceramides, a calcineurin inhibitor, and synbiotics showed superior efficacy in treating atopic dermatitis in infants with multiple allergies.

Findings

The experimental group showed over 60% reduction in SCORAD index and significant decreases in pruritus and POEM scores.

The therapy suppressed Th2 immune response and improved gut microbiota composition.

Microbiota changes included increased Bifidobacterium and reduced E. coli levels.

Abstract

The aim of this study was to evaluate the therapeutic efficacy of a comprehensive treatment approach in infants with moderate-to-severe eczema complicated by polyvalent allergic sensitisation. The methodology involved a randomised controlled trial that included 87 children aged 3 to 12 months. Participants were divided into two groups. The experimental group received combined therapy comprising pseudoceramides, a calcineurin inhibitor, and an oral synbiotic, while the control group received standard therapy with emollients and antihistamines. The results demonstrated that by the eighth week, patients in the experimental group exhibited a reduction in SCORAD index of more than 60% (to 21.4 ± 6.5); a 2.7-fold decrease in pruritus severity according to the VAS scale (to 2.9±1.3); and a 61% reduction in POEM score (to 7.3). This was accompanied by improved sleep, reduced irritability, and decreased behavioural disturbances. The control group showed less-pronounced positive dynamics. Immunological changes included a significant decrease in total and specific IgE levels, as well as a marked reduction in IL-4 and IL-13 concentrations, indicating attenuation of the Th2-mediated immune response. The prevalence of severe sensitisation decreased by 20%. Microbiota analysis demonstrated increased Bifidobacterium spp. abundance (+89%; p = 0.011); higher alpha-diversity (Shannon index + 27%; p = 0.004); and reduced E. coli levels (−36%; p = 0.018), suggesting restoration of microbial balance. Thus, this combined therapy demonstrated significant superiority, providing clinical improvement, suppression of the Th2 response, and normalisation of gut microbiota in infants with atopic dermatitis and multiple allergic sensitisation.