背景与目的:糖皮质激素和抗生素联合治疗特应性皮炎(AD)的无效已引起人们的关注。AD的皮肤屏障缺损缓解金黄色葡萄球菌的定植(S.金黄色葡萄球菌),这导致白细胞介素-31(IL-31)的升高。Lumbricusrubellus(L.rubellus)已显示出抗菌和抗过敏作用,但尚未研究降低AD患者中金黄色葡萄球菌和IL-31水平的生长。本研究旨在分析L.rubellus提取物在减少金黄色葡萄球菌定植中的作用,IL-31水平,以及AD的严重程度。材料和方法:一项随机对照试验(RCT)(国际注册号TCTR20231025004)对40名在皮肤性病科综合诊所就诊的AD患者进行,母亲和儿童医院(RSIA)亚齐,印度尼西亚,从2021年10月到2022年3月。8~16岁的特应性皮炎(SCORAD)评分指数>25,血清总IgE水平>100IU/mL的AD患者,健康体重的患者被随机分为两组:一组接受0.025%的醋酸氟轻松和安慰剂(对照组),一组接受0.025%的醋酸氟轻松和L.rubellus提取物(Vermint®)(干预组).金黄色葡萄球菌菌落用过氧化氢酶试验鉴定,凝固酶试验,MSA媒体。采用ELISA法检测血清IL-31水平,而SCORAD指数用于评估AD的严重程度和改善情况。使用非配对t检验和Mann-WhitneyU检验比较两组之间测量变量的平均得分。结果:在本研究中发现接受红斑乳杆菌提取物的患者中金黄色葡萄球菌定植(p=0.001)和IL-31(p=0.013)的显著下降。此外,干预组14例AD患者SCORAD指数改善超过35%(p=0.057)。结论:红斑酵母提取物显著降低AD患者的金黄色葡萄球菌定植和IL-31水平,提示其作为AD患儿辅助治疗的潜力。
Background and Objectives: The ineffective combination of corticosteroids and antibiotics in treating some atopic dermatitis (AD) cases has been concerning. The skin barrier defects in AD ease the colonization of Staphylococcus aureus (S. aureus), which results in a rise in interleukin-31 (IL-31). Lumbricus rubellus (L. rubellus) has shown antimicrobial and antiallergic effects but has not been studied yet to decrease the growth of S. aureus and IL-31 levels in AD patients. This study aimed to analyze the effect of L. rubellus extract in reducing S. aureus colonization, the IL-31 level, and the severity of AD. Materials and Methods: A randomized controlled trial (RCT) (international registration number TCTR20231025004) was conducted on 40 AD patients attending Dermatology and Venereology Polyclinic, Mother and Child Hospital (RSIA), Aceh, Indonesia, from October 2021 to March 2022. AD patients aged 8-16 who had a Scoring Atopic Dermatitis (SCORAD) index > 25, with total IgE serum level > 100 IU/mL, and had healthy weight were randomly assigned into two groups: one received fluocinolone acetonide 0.025% and placebo (control group) and one received fluocinolone acetonide 0.025% combined with L. rubellus extract (Vermint®) (intervention group). The S. aureus colony was identified using a catalase test, coagulase test, and MSA media. The serum IL-31 levels were measured using ELISA assay, while the SCORAD index was used to assess the severity of and improvement in AD. Mean scores for measured variables were compared between the two groups using an unpaired t-test and Mann-Whitney U test. Results: A significant decline in S. aureus colonization (p = 0.001) and IL-31 (p = 0.013) in patients receiving L. rubellus extract was found in this study. Moreover, fourteen AD patients in the intervention group showed an improvement in the SCORAD index of more than 35% (p = 0.057). Conclusions: L. rubellus extract significantly decreases S. aureus colonization and the IL-31 level in AD patients, suggesting its potential as an adjuvant therapy for children with AD.