Lactiplantibacillus plantarum IS-10506 Supplementation Improves Clinical Outcome and Immunology Markers in Psoriasis Vulgaris Patients: A Randomized Controlled Trial

Menul Ayu Umborowati, Iffa Halimah Hasna, Anang Endaryanto, Ingrid Suryanti Surono, Cita Rosita Sigit Prakoeswa

Abstract


BACKGROUND: Probiotics may modify the gut microbiome and have been proven to improve psoriasis vulgaris. Lactiplantibacillus plantarum IS-10506 is a probiotic strain of Indonesian origin. It offers a safe and effective probiotic for psoriasis patients in Indonesia. This study was conducted to evaluate the effect of L. plantarum IS-10506 on clinical and immunology markers in psoriasis vulgaris.

METHODS: This randomized, placebo-controlled, and double-blind trial compared L. plantarum IS-10506 (2×1010 CFU/day) and placebo in 49 patients mild-moderate psoriasis vulgaris, which were divided into intervention (n=24) and control groups (n=25). The interventions were given twice daily for 12 weeks. Both groups received topical corticosteroid and emollient as standard treatment. Psoriasis area and severity index (PASI), dermatology life quality index (DLQI), interleukin (IL)-10, IL-17, and forkhead box protein (Foxp3) were then assessed.

RESULTS: Mean PASI score for the the subjects in probiotic group was significantly reduced compared to placebo at week-6 (p=0.024), and was sustained until week-12 (p=0.049). At week-12, DLQI scores in the probiotic group were lower than placebo (7.57±5.77 vs. 7.79±5.48). IL-17 level was significantly decreased (p=0.013), while the IL-10 and Foxp3 were significantly increased (p≤0.001 and p=0.048, respectively) in probiotic group. Six months after the completion of study, subjects in probiotic group had a lower probability of flares (52.2%) compared to placebo (79.2%). Two subjects receiving probiotics and one receiving placebo noticed changes in defecation frequency, while another subject in the placebo group complained of mild nausea.

CONCLUSION: L. plantarum IS-10506 might effectively improve clinical outcomes and immune biomarkers in psoriasis vulgaris patients, potentially acting as an adjuvant therapy.

KEYWORDS: psoriasis, probiotic, clinical severity, immune marker, human and health


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References


Sylviningrum T, Putranti IO, Sari OP, Arjadi F, Oktavriana T. HLA-Cw6 allele expression is associated with good narrowband ultraviolet B response in Javanese-Indonesian psoriasis subjects. Indones Biomed J. 2021; 13(3): 324-31, CrossRef.

Boehncke WH, Schön MP. Psoriasis. Lancet. 2015; 386(9997): 983-94, CrossRef.

World Health Organization. Global Report on Psoriasis. Geneva: World Health Organization; 2016, article.

Hsu DK, Fung MA, Chen HL. Role of skin and gut microbiota in the pathogenesis of psoriasis, an inflammatory skin disease. Med Microecol. 2020; 4: 100016, CrossRef.

Amelia VUA, Thaha A, Devi M. Angka kejadian psoriasis vulgaris di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP dr. Mohammad Hoesin Palembang periode Agustus 2008-Juni 2012. Majalah Kedokteran Sriwijaya. 2014; 46(4): 253-8, CrossRef.

Dewi DAPN, Indira IG. Insiden dan profil psoriasis di poliklinik kulit dan kelamin Rumah Sakit Umum Pusat Sanglah Denpasar periode Januari 2012 sampai Desember 2014. E-Jurnal Medika Udayana. 2018; 7(9): 1-7, article.

Setyowatie L, Sukanto H, Murtiastutik D. C-reactive protein pada berbagai derajat keparahan psoriasis vulgaris. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2016; 28(2): 1-9, article.

Fransiska A, Husada MS, Effendy E. The differences of depressive symptoms by gender in people with psoriasis. Asian J Pharm Clin Res. 2018; 11(13): 42-5, CrossRef.

Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021; 397(10281): 1301-15, CrossRef.

Zhong H, Yang H, Mao Z, Chai X, Li S. Impact of moderate-to-severe psoriasis on quality of life in China: A qualitative study. Health Qual Life Outcomes. 2021; 19(1): 271, CrossRef.

Myers B, Brownstone N, Reddy V, Chan S, Thibodeaux Q, Truong A, et al. The gut microbiome in psoriasis and psoriatic arthritis. Best Pract Res Clin Rheumatol. 2019; 33(6): 101494, CrossRef.

Hidalgo‐Cantabrana C, Gómez J, Delgado S, Requena‐López S, Queiro‐Silva R, Margolles A, et al. Gut microbiota dysbiosis in a cohort of patients with psoriasis. Br J Dermatol. 2019; 181(6): 1287-95, CrossRef.

Meiliana A, Wijaya A. Gut microbiota, obesity and metabolic dysfunction. Indones Biomed J. 2011; 3(3): 150-67, CrossRef.

Rowland I, Gibson G, Heinken A, Scott K, Swann J, Thiele I, et al. Gut microbiota functions: Metabolism of nutrients and other food components. Eur J Nutr. 2018; 57(1): 1-24, CrossRef.

DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current understanding of dysbiosis in disease in human and animal models. Inflamm Bowel Dis. 2016; 22(5): 1137-50, CrossRef.

Lu W, Deng Y, Fang Z, Zhai Q, Cui S, Zhao J, et al. Potential role of probiotics in ameliorating psoriasis by modulating gut microbiota in imiquimod-induced psoriasis-like mice. Nutrients. 2021; 13(6): 2010, CrossRef.

Ramírez-Boscá A, Navarro-López V, Martínez-Andrés A, Such J, Francés R, Horga de la Parte J, et al. Identification of bacterial DNA in the peripheral blood of patients with active psoriasis. JAMA Dermatol. 2015; 151(6): 670-1, CrossRef.

Widhiati S, Purnomosari D, Wibawa T, Soebono H. The role of gut microbiome in inflammatory skin disorders: a systematic review. Dermatology Reports. 2021; 14(1): 9188, CrossRef.

Salem I, Ramser A, Isham N, Ghannoum MA. The gut microbiome as a major regulator of the gut-skin axis. Front Microbiol. 2018: 9: 1459, CrossRef.

Adib A, Wahid MH, Sudarmono P, Surono IS. Lactobacillus plantarum pada feses individu dewasa sehat yang mengonsumsi Lactobacillus plantarum IS-10506 dari dadih. Jurnal Teknologi dan Industri Pangan. 2013; 24(2): 154-61, CrossRef.

Dahlan MS. Besar Sampel dan Cara Pengambilan Sampel dalam Penelitian Kedokteran dan Kesehatan. 3rd ed. Jakarta: Salemba Medika; 2010, article.

Prakoeswa CRS, Bonita L, Karim A, Herwanto N, Umborowati MA, Setyaningrum T, et al. Beneficial effect of Lactobacillus plantarum IS-10506 supplementation in adults with atopic dermatitis: A randomized controlled trial. J Dermatol Treat. 2022; 33(3): 1491-8, CrossRef.

Surono IS. Traditional Indonesian dairy foods. Asia Pac J Clin Nutr. 2015; 24(Suppl 1): S26-30, article.

Otero ME, van Geel MJ, Hendriks JCM, van de Kerkhof PCM, Seyger MMB, de Jong EMGJ. A pilot study on the Psoriasis Area and Severity Index (PASI) for small areas: Presentation and implications of the Low PASI score. J Dermatol Treat. 2015; 26(4): 314-7, CrossRef.

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994; 19(3): 210-6, CrossRef.

Szántó M, Dózsa A, Antal D, Szabó K, Kemény L, Bai P. Targeting the gut‐skin axis-Probiotics as new tools for skin disorder management? Exp Dermatol. 2019; 28(11): 1210-8, CrossRef.

Gao T, Wang X, Li Y, Ren F. The role of probiotics in skin health and related gut-skin axis: A review. Nutrients. 2023; 15(14): 3123, CrossRef.

Fetarayani D, Soegiarto G, Surono IS, Endaryanto A, Athiyyah AF, Hernaningsih Y, et al. Lactiplantibacillus plantarum IS-10506 enhances tight junction integrity in bronchial epithelium: An experimental study. Indones Biomed J. 2024; 16(2): 162-71, CrossRef.

Prameswari R, Astari L, Hidayati AN, Sigit Prakoeswa CR. Effect of Lactobacillus plantarum on total immunoglobulin E serum and scoring atopic dermatitis (SCORAD) index in children with atopic dermatitis. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2017; 29(2): 91-7, CrossRef.

Karim A, Setyaningrum T, Prakoeswa CRS. 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. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2019; 31(3): 185-92, CrossRef.

Prakoeswa CRS, Herwanto N, Prameswari R, Astari L, Sawitri S, Hidayati AN, et al. Lactobacillus plantarum IS-10506 supplementation reduced SCORAD in children with atopic dermatitis. Benef Microbes. 2017; 8(5): 833-40, CrossRef.

Zeng L, Yu G, Wu Y, Hao W, Chen H. The effectiveness and safety of probiotic supplements for psoriasis: A systematic review and meta-analysis of randomized controlled trials and preclinical trials. J Immunol Res. 2021; 2021: 7552546, CrossRef.

Moludi J, Khedmatgozar H, Saiedi S, Razmi H, Alizadeh M, Ebrahimi B. Probiotic supplementation improves clinical outcomes and quality of life indicators in patients with plaque psoriasis: A randomized double-blind clinical trial. Clin Nutr ESPEN. 2021; 46: 33-9, CrossRef.

Suriano ES, Souza MDM, Kobata CM, Santos FHY, Mimica MJ. Efficacy of an adjuvant Lactobacillus rhamnosus formula in improving skin lesions as assessed by PASI in patients with plaque psoriasis from a university-affiliated, tertiary-referral hospital in São Paulo (Brazil): A parallel, double-blind, randomized clinical trial. Arch Dermatol Res. 2023; 315(6): 1621-9, CrossRef.

Lanna C, Mancini M, Gaziano R, Cannizzaro MV, Galluzzo M, Talamonti M, et al. Skin immunity and its dysregulation in psoriasis. Cell Cycle. 2019; 18(20): 2581-9, CrossRef.

Zhang L, Li Y, Yang X, Wei J, Zhou S, Zhao Z, et al. Characterization of Th17 and FoxP3+ Treg cells in paediatric psoriasis patients. Scand J Immunol. 2016; 83(3): 174-80, CrossRef.

Ma L, Xue HB, Gao T, Gao ML, Zhang YJ. Notch1 signaling regulates the Th17/treg immune imbalance in patients with psoriasis vulgaris. Mediators Inflamm. 2018: 2018: 3069521, CrossRef.

Tian D, Lai Y. The Relapse of psoriasis: Mechanisms and mysteries. JID Innov. 2022; 2(3): 100116, CrossRef.

Dong C, Lin L, Du J. Characteristics and sources of tissue-resident memory T cells in psoriasis relapse. Curr Res Immunol. 2023; 4: 100067, CrossRef.

Vu TT, Koguchi-Yoshioka H, Watanabe R. Skin-resident memory T cells: Pathogenesis and implication for the treatment of psoriasis. J Clin Med. 2021; 10(17): 3822, CrossRef.




DOI: https://doi.org/10.18585/inabj.v16i4.3155

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