Gut Microbiota in Children with Atopic Dermatitis

Introduction

The gut microbiota is found in the gastrointestinal tract. They are formed in the human body since the age of three years and play an essential part in maintaining the gut health of humans. The gut microbiota is involved in many processes inside the human body, such as enzyme production and nutrient synthesis. Moreover, they are involved with vitamin synthesis, gut barrier maintenance, inflammation, glucose homeostasis, and energy harvesting. Furthermore, the microbiota builds the cellular mucosal immune system in the body. Recent studies show that microbiota is also responsible for allergic conditions in children. As much as they play an essential role in maintaining mucosal and cellular immunity, their imbalance can also cause mucosal inflammation and allergic diseases. Atopic dermatitis is a very common, severe inflammatory disease in children affected by microbiota.

What Is Gut Microbiota?

There are trillions of microorganism species living and colonizing the human body. These species include bacteria, fungi, parasites, and viruses. Among these, there is some microbiota beneficial to the body, and some are harmful. The microbiota benefits the body by providing many physiological functions such as gut strengthening, providing energy, shaping intestinal epithelium, pathogen protection, and balancing the immunity in the host. The composition of the microbiota is influenced by the human diet and genetics.

Some studies show that the development of the microbiota begins from birth, and other studies show evidence of development from the womb tissue. Right after birth, the infant’s gastrointestinal tract is rapidly colonized, and this is mainly affected by diet. Additionally, the type of delivery also affects the process of colonization. For instance, a vaginally delivered baby contains a high amount of lactobacilli colonization as a result of vaginal flora. On the other hand, when a baby is delivered via cesarean section, there is a significant delay and decline in the amount and diversity of microbiota colonization seen in newborns.

What Is Atopic Dermatitis in Children?

Atopic dermatitis is an inflammatory skin condition where there is recurrent itching and redness seen on the skin. This condition is more commonly seen in children and infants. Because of its relapsing nature, there are chances of young children developing this condition during adulthood too. There are many factors affecting this condition, such as damaged skin barrier, compromised immune system, environmental exposure, or hereditary disease. The composition of the microbiota of healthy children and those with atopic dermatitis have a significant amount of change. If there are any changes in the immune system of the young ones, the chances of changes in gut bacteria are more likely to be seen.

What Are the Causes of Atopic Dermatitis in Children?

There are mainly few reasons behind this condition in children, such as:

• Dysbiosis: Dysbiosis is when there is a decrease in activity and diversity of beneficial bacteria seen in the body. Another reason behind dysbiosis can be the increased amount of harmful bacteria in the body. Dysbiosis shows raised levels of bacteria such as Staphylococcus aureus, Faecalibacterium prausnitzii, Clostridium, and Escherichia.

Some of the reason that promotes dysbiosis in children are:

• Oral Antibiotics: Over-dose of oral antibiotics can kill all the species of bacteria without discriminating between “good” and “bad” bacteria.

• Lack of Human Contact During and After Birth: When doctors recommend mothers to breastfeed or give skin-to-skin contact to newborns, there is another reason behind this. Initial human contact exposes newborns to another human’s microbiota, and this can initiate their bodies to create their own.

• Diet: A Diet containing a high amount of inflammatory ingredients aids dysbiosis. Food containing more saturated fat is the main culprit here.

• Lack of Vitamin D: If children’s diet or their body lacks vitamin D, the chances of dysbiosis are more likely.

• Immune Response: Atopic dermatitis occurs due to the immune system of the body. When there is a threat to the body or skin, the immune system reacts to it by causing inflammation or rash with itching. Also, when a body detects harmful bacteria on skin or body, it reacts to it in the same way, causing itchy rashes. As a result, eczema and dysbiosis are part of the same cycle.

• Intestinal Permeability: Permeability is when a substance can pass through the barrier from one side to another. The walls of the intestine are permeable, and in some children, they allow more substance to pass than they should to another side. The terminology for this condition is commonly used as “leaky gut.” Due to this condition, the skin reacts by causing rashes or inflammation of the skin.

What Are the Symptoms Associated With Atopic Dermatitis in Children?

Depending on the severity of the condition, there are different symptoms seen at different stages of the disease. Some of the symptoms are:

• Dry skin.

• Thickened skin.

• Raw Skin.

• Pale skin.

• Redness.

• Swelling.

• Small and raised red bumps.

• Scaly skin.

• Red rashes and hives.

How to Diagnose Gut Microbiota and Atopic Dermatitis in Children?

There are no known diagnostic methods to test the relationship between the gut and ectopic dermatitis in children. Although there are some tests to check gut health, such as:

• Gut Microbiome Test: It is the test that shows information about the types and levels of gut bacteria in the large intestine. The test is usually done with a stool sample.

• Intestinal Permeability Test: It is specifically used for diagnosing gastrointestinal mucosal integrity.

• Calprotectin Test: It is a stool test done to diagnose inflammation related to the intestine.

How to Manage Atopic Dermatitis in Children?

If a child is facing some severe symptoms of constant itching and rashes, it is time to see a doctor. Occasionally, the skin rashes show skin scabs with pus formation. This is the most severe condition, where the severity of the condition can lead to many health-related complications. Atopic dermatitis is treated with the following treatment options.

• Identify the triggers that can worsen skin dermatitis. Usually, the skin conditions show their signs and symptoms as itchy rashes and red bumps on the skin. If certain products, food, or situations are triggering the condition, a parent should keep an eye on them and try to avoid them.

• Children should be bathed with mild and fragrance-free soaps. The moisturizers or baby powders should also be of the same kind to avoid any irritants contacting the skin.

• After bathing, children’s skin should be pat dry gently with moisture application.

• Apply Cortisol ointment or cream at least twice daily. Using moisturizing products on the skin can lock the moisture in the skin and keep it nourished and soft.

• In severe conditions where there is a sign of bacterial invasion, antibiotic medicine is the next choice.

• When a doctor identifies the skin condition to be an allergic reaction, they usually recommend an antihistamine.

• Light therapy is recommended in cases of dermatitis, and it shows promising results.

• A simple change in diet can eliminate the trigger that causes skin conditions.

Conclusion:

The link between atopic dermatitis and gut microbiota is undeniably there. However, there are still many aspects of the subject that need to be researched deeply. Any imbalances in the level of gut microbiota can show visible skin reactions in children. And if the reaction is persistent and recurrent, the parents should immediately seek a doctor's help.