From Probiotic to Prebiotic Using Thermal Spring Water openaccess articles

June 2018 | Volume 17 | Issue 6 | Original Article | 657 | Copyright © 2018

Joshua Zeichner MDa and Sophie Seite PhDb

aMount Sinai Hospital, New York, NY bLa Roche-Posay Dermatological Laboratories, Levallois-Perret, France

figure3figure4bacteria. Several diseases such as atopic dermatitis and psoriasis have been found to be associated with changes in the composition of the skin microbiota.8-11 Balneotherapy using probiotic LRP-TSW water has been shown to improve the skin microbiota in a variety of inflammatory skin conditions.Effect of LRP-TSW on Atopic DermatitisThe effect of LRP-TSW balneotherapy on the microbiome has been evaluated in patients with atopic dermatitis. Microbial samples were taken from 31 patients with atopic dermatitis on both affected and adjacent unaffected skin. Repeat samples were taken after 21 days of balneotherapy to analyze microbiota diversity (Shannon index), bacterial phyla, and genus abundance. At baseline, Shannon diversity was lower in the lesional AD skin as compared to adjacent clinically normal skin. After balneotherapy, Shannon diversity index increased in the lesional areas and became similar to what was observed in the clinically normal appearing skin. In addition, balneotherapy resulted in a reduction of Firmicutes organisms mainly Staphylococci, along with an increase in other bacterial phyla. Additionally, an increase in the amount of Xanthomonas genus was also observed (Figure 4). The increase in bacterial diversity after balneotherapy was correlated with a significant increase in Gram-negative bacteria and a significant decrease of Gram-positive bacteria on the skin (Figure 5).In a 2014 study, 100 patients suffering from chronic AD were treated with LRP-TSW balneotherapy at the LRP Treatment Center.12 After treatment, SCORing Atopic Dermatitis (SCORAD) scores significantly (P less than 0.0001) improved in 90% of subjects, with a mean decrease of 38% from 46.8 (SD±1.9) to 27.8 (SD±1.5). Mean EASI (Eczema Area and Severity Index) scores also significantly (P less than 0.0001) improved in 82% of patients from 9.3 (SD±0.8) to 4.6 (SD±0.6). Clinical efficacy correlated with significant improvements in quality of life measures, as Dermatology Life Quality Index (DLQI) and Children’s DLQI (CDLQI) (both P less than 0.0001). There was a mean reduction in DLQI scores of 8.1 (SD±1.0) to 4.1 (SD±0.7) and a 28% reduction in CDLQI scores of 7.5 (SD±0.7) to 4.5 (SD±0.5). Balneotherapy was reported to provide long-lasting results, with clinical and quality of life improvements maintained for an average of 6 months.12LRP-TSW based skincare products have also been shown to improve the diversity of the skin microbiome in eczema patients, after three months of applying an emollient containing at least a 50% concentration of LRP-TSW12 and a supplement with a

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