Presenter: Shabalov
Aleksandr
Affiliation: Military
medical academy of S.M. Kirov, Russian Federation
Presentation Type: Oral Presentation (Virtual)
🌿 Understanding the Gut–Skin Connection in
Children with Atopic Dermatitis
📌 Background
Atopic dermatitis (AD) is a common chronic inflammatory skin
disease in children. It is influenced by several factors, including genetic predisposition, impaired skin
barrier function, immune system imbalance, and disruptions in the microbiome
of both the skin and gastrointestinal tract.
Recent research highlights the
importance of the gut–skin
axis, suggesting that changes in intestinal
microbiota—particularly in the small
and large intestines—may influence the severity and progression
of atopic dermatitis. One condition of interest is Small Intestinal Bacterial Overgrowth
(SIBO), which may contribute to inflammation and alter immune
responses. However, the exact relationship between skin microbiota, intestinal microbiota, and
AD in children still requires further investigation.
🎯 Aim of the Study
The primary goal of this study was
to:
·
Determine
the prevalence of Small
Intestinal Bacterial Overgrowth (SIBO) in children diagnosed
with atopic dermatitis.
·
Evaluate
the effectiveness of
treatment for mild to moderate AD when topical therapy includes
prebiotic and probiotic
components.
·
Examine
the changes in skin and
intestinal microbiota during therapy.
🧪 Materials and Methods
A total of 82 children participated in
the study:
·
33
children with mild to moderate atopic dermatitis (main group)
o
Median
age: 8 years
o
48.5%
girls and 51.5% boys
·
49
healthy children
(control group)
o
Median
age: 9 years
o
55.1%
girls and 44.9% boys
To detect SIBO, researchers used non-invasive diagnostic methods,
including:
·
💨 Hydrogen
breath test (Lactofan)
·
💨 Hydrogen–methane
breath test (GastroCheck Gastrolyzer)
Additionally, 19 children with AD in the recovery stage
were monitored while receiving topical
therapy containing a biotic complex (lactobacilli +
fructooligosaccharides).
The study included:
·
📊 SCORAD
index evaluation (to assess AD severity)
·
🧬
Microbiome analysis
from skin lesions and stool samples using 16S PCR sequencing
·
🧪
Measurement of short-chain
fatty acids (acetic, propionic, butyric acids and isoacids)
using gas–liquid chromatography
Statistical analysis was performed
using StatTech software
and Omics data analysis
platforms.
📊 Key Findings
The results revealed several
important insights:
·
SIBO
was detected in 93.9% of children with atopic dermatitis, which is significantly higher than in
healthy children.
·
In the
control group,
SIBO was identified in 57.1%
of participants.
·
The hydrogen-producing variant of SIBO
occurred significantly more often in children with AD.
·
The methanogenic variant of SIBO
showed no significant difference
between children with AD and healthy participants.
Children with atopic dermatitis
also showed:
·
💧 Reduced
skin moisture
·
⚖️
Higher skin pH levels
·
🦠
Altered skin and intestinal
microbiome composition
·
📉 Lower
microbial diversity, reflected by decreased Shannon and Pielou biodiversity indices
🌱 Effects of Biotic-Based External Therapy
Topical therapy containing a biotic complex (lactobacilli +
fructooligosaccharides) produced encouraging results:
·
✔️
Improved skin hydration
·
✔️
Normalization of skin pH
·
✔️
Positive changes in the skin
microbiome
·
✔️
Noticeable clinical
improvement in AD symptoms
However, the therapy did not significantly improve intestinal
microbiota diversity. This may be because oral probiotics were not included in the
treatment, suggesting that combined topical and oral microbiome-targeted therapies may be
more effective.
🔬
Conclusion
The study highlights the strong association between SIBO and atopic
dermatitis in children, emphasizing the importance of the gut–skin axis in pediatric
dermatology.
While topical biotic therapies
can significantly improve skin
health and clinical symptoms, restoring intestinal microbiota balance
may require additional
interventions such as oral probiotics or dietary modifications.
Understanding the complex
relationship between the skin
microbiome and gut microbiome may open new pathways for personalized treatment strategies for
children with atopic dermatitis.
💡
Final Thought
🌿 Healthy microbes mean healthier skin.
Future therapies for atopic dermatitis may increasingly focus on restoring microbial balance both inside the
gut and on the skin.
👩⚕️ About the Speaker
Aleksandr M. Shabalov has
completed his PhD at the age of 30 years from Saint Petersburg State Pediatric
Medical University, Ministry of Health of the Russian Federation, Saint
Petersburg, Russia. He is the MD, Assistant Professor of the Department of
Children's Diseases, Kirov Military Medical Academy, Saint Petersburg, Russia.
He has over 120 publications that have been cited over 420 times, and his
publication h-index is 9. He is a pediatrician and gastroenterologist
interested in functional disorders of gastrointestinal tract, SIBO, GERD,
pediatric allergy, obesity, MAFLD with 19 years of experience.
🌍 Join the Global Conversation
Event:
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📅 March
26–28, 2026
📍 Singapore
& Online
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