中华皮肤科杂志 ›› 2026, e20240514.doi: 10.35541/cjd.20240514
代盈盈,王莲,蒋献
收稿日期:2024-09-26
修回日期:2026-06-23
发布日期:2026-09-22
通讯作者:
蒋献
E-mail:jiangxian@scu.edu.cn
基金资助:Dai Yingying, Wang Lian, Jiang Xian
Received:2024-09-26
Revised:2026-06-23
Published:2026-09-22
Contact:
Jiang Xian
E-mail:jiangxian@scu.edu.cn
Supported by:摘要: 【摘要】 肠道菌群与皮肤健康密切相关,补充益生菌有助于调节肠道菌群,维持肠道微生态稳态。已有研究表明,乳杆菌属、双歧杆菌属等益生菌通过调节短链脂肪酸等代谢产物介导的免疫反应、神经内分泌功能和屏障结构等多种机制,对治疗皮肤疾病产生积极影响。本文综述口服益生菌改善皮肤健康的作用机制和其在特应性皮炎、银屑病、寻常痤疮等特定皮肤疾病治疗中的应用进展。
代盈盈 王莲 蒋献. 口服益生菌治疗皮肤疾病的作用机制与应用进展[J]. 中华皮肤科杂志, 2026,e20240514. doi:10.35541/cjd.20240514
Ying-Ying DAI Lian Wang XIAN JIANG. Oral probiotics in the treatment of skin diseases: mechanisms of action and advances in their application[J]. Chinese Journal of Dermatology,2026,e20240514. doi:10.35541/cjd.20240514
| [1] | Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing[J]. Nature, 2010,464(7285):59⁃65. DOI: 10.1038/nature08821. |
| [2] | Fan Y, Pedersen O. Gut microbiota in human metabolic health and disease[J]. Nat Rev Microbiol, 2021,19(1):55⁃71. DOI: 10. 1038/s41579⁃020⁃0433⁃9. |
| [3] | Park YM, Lee SY, Kang MJ, et al. Imbalance of gut Streptococcus, Clostridium, and Akkermansia determines the natural course of atopic dermatitis in infant[J]. Allergy Asthma Immunol Res, 2020,12(2):322⁃337. DOI: 10.4168/aair. 2020.12.2.322. |
| [4] | Zhao H, Shang L, Zhang Y, et al. IL⁃17A inhibitors alleviate psoriasis with concomitant restoration of intestinal/skin microbiota homeostasis and altered microbiota function[J]. Front Immunol, 2024,15:1344963. DOI: 10.3389/fimmu.2024.1344963. |
| [5] | Deng Y, Wang H, Zhou J, et al. Patients with acne vulgaris have a distinct gut microbiota in comparison with healthy controls[J]. Acta Derm Venereol, 2018,98(8):783⁃790. DOI: 10. 2340/00015555⁃2968. |
| [6] | Mahmud MR, Akter S, Tamanna SK, et al. Impact of gut microbiome on skin health: gut⁃skin axis observed through the lenses of therapeutics and skin diseases[J]. Gut Microbes, 2022,14(1):2096995. DOI: 10.1080/19490976.2022.2096995. |
| [7] | Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic[J]. Nat Rev Gastroenterol Hepatol, 2014,11(8):506⁃514. DOI: 10.1038/nrgastro.2014.66. |
| [8] | Varela⁃Trinidad GU, Domínguez⁃Díaz C, Solórzano⁃Castanedo K, et al. Probiotics: protecting our health from the gut[J]. Microorganisms, 2022, 10(7):1428. DOI: 10.3390/microorganisms 10071428. |
| [9] | Aburto MR, Cryan JF. Gastrointestinal and brain barriers: unlocking gates of communication across the microbiota⁃gut⁃brain axis[J]. Nat Rev Gastroenterol Hepatol, 2024,21(4):222⁃247. DOI: 10.1038/s41575⁃023⁃00890⁃0. |
| [10] | Stec A, Sikora M, Maciejewska M, et al. Bacterial Metabolites: a link between gut microbiota and dermatological diseases[J]. Int J Mol Sci, 2023, 24(4):3494. DOI: 10.3390/ijms24043494. |
| [11] | Xie L, Alam MJ, Marques FZ, et al. A major mechanism for immunomodulation: dietary fibres and acid metabolites[J]. Semin Immunol, 2023,66:101737. DOI: 10.1016/j.smim.2023. 101737. |
| [12] | Barman M, Gio⁃Batta M, Andrieux L, et al. Short⁃chain fatty acids (SCFA) in infants' plasma and corresponding mother's milk and plasma in relation to subsequent sensitisation and atopic disease[J]. EBioMedicine, 2024,101:104999. DOI: 10. 1016/j.ebiom.2024.104999. |
| [13] | Li D, Luo ZB, Zhu J, et al. Ginsenoside F2⁃mediated intestinal microbiota and its metabolite propionic acid positively impact the gut⁃skin axis in atopic dermatitis mice[J]. J Agric Food Chem, 2024,72(1):339⁃350. DOI: 10.1021/acs.jafc.3c06015. |
| [14] | Zhu L, Jian X, Zhou B, et al. Gut microbiota facilitate chronic spontaneous urticaria[J]. Nat Commun, 2024,15(1):112. DOI: 10.1038/s41467⁃023⁃44373⁃x. |
| [15] | Sanchez HN, Moroney JB, Gan H, et al. B cell⁃intrinsic epigenetic modulation of antibody responses by dietary fiber⁃derived short⁃chain fatty acids[J]. Nat Commun, 2020,11(1):60. DOI: 10.1038/s41467⁃019⁃13603⁃6. |
| [16] | Lu W, Deng Y, Fang Z, et al. Potential role of probiotics in ameliorating psoriasis by modulating gut microbiota in imiquimod⁃induced psoriasis⁃like mice[J]. Nutrients, 2021, 13(6):2010. DOI: 10.3390/nu13062010. |
| [17] | Schwarz A, Bruhs A, Schwarz T. The short⁃chain fatty acid sodium butyrate functions as a regulator of the skin immune system[J]. J Invest Dermatol, 2017,137(4):855⁃864. DOI: 10. 1016/j.jid.2016.11.014. |
| [18] | Schwarz A, Philippsen R, Schwarz T. Induction of regulatory T cells and correction of cytokine disbalance by short⁃chain fatty acids: implications for psoriasis therapy[J]. J Invest Dermatol, 2021,141(1):95⁃104.e2. DOI: 10.1016/j.jid.2020. 04.031. |
| [19] | Szelest M, Walczak K, Plech T. A new insight into the potential role of tryptophan⁃derived AhR ligands in skin physiological and pathological processes[J]. Int J Mol Sci, 2021, 22(3):1104. DOI: 10.3390/ijms22031104. |
| [20] | Brown J, Robusto B, Morel L. Intestinal dysbiosis and tryptophan metabolism in autoimmunity[J]. Front Immunol, 2020,11:1741. DOI: 10.3389/fimmu.2020.01741. |
| [21] | Ferreira Branquinho MS, Silva M, Castilho GA, et al. Kynurenine inhibits melanogenesis in human melanocyte⁃keratinocyte co⁃cultures and in a reconstructed 3D skin model[J]. Exp Dermatol, 2022,31(3):427⁃432. DOI: 10.1111/exd.14486. |
| [22] | Fang Z, Pan T, Li L, et al. Bifidobacterium longum mediated tryptophan metabolism to improve atopic dermatitis via the gut⁃skin axis[J]. Gut Microbes, 2022,14(1):2044723. DOI: 10.1080/19490976.2022.2044723. |
| [23] | Yang L, Li D, Sun S, et al. Dupilumab therapy improves gut microbiome dysbiosis and tryptophan metabolism in Chinese patients with atopic dermatitis[J]. Int Immunopharmacol, 2024,131:111867. DOI: 10.1016/j.intimp.2024.111867. |
| [24] | Collins SL, Stine JG, Bisanz JE, et al. Bile acids and the gut microbiota: metabolic interactions and impacts on disease[J]. Nat Rev Microbiol, 2023,21(4):236⁃247. DOI: 10.1038/s41579⁃022⁃00805⁃x. |
| [25] | 王凯丽. 从次级胆汁酸调控Th17/Treg免疫平衡探讨解毒祛瘀滋阴方治疗SLE的作用机制[D]. 杭州: 浙江中医药大学, 2023. DOI: 10.27465/d.cnki.gzzyc.2023.000212. |
| [26] | Chen X, Chen Y, Stanton C, et al. Dose⁃response efficacy and mechanisms of orally administered bifidobacterium breve CCFM683 on IMQ⁃induced psoriasis in mice[J]. Nutrients, 2023, 15(8):1952. DOI: 10.3390/nu15081952. |
| [27] | Xiao W, Chen M, Peng Q, et al. Lithocholic acid promotes rosacea⁃like skin inflammation via G protein⁃coupled bile acid receptor 1[J]. Biochim Biophys Acta Mol Basis Dis, 2022,1868(12):166563. DOI: 10.1016/j.bbadis.2022.166563. |
| [28] | Pessôa R, Clissa PB, Sanabani SS. The interaction between the host genome, epigenome, and the gut⁃skin axis microbiome in atopic dermatitis[J]. Int J Mol Sci, 2023, 24(18):14322. DOI: 10.3390/ijms241814322. |
| [29] | Sikora M, Kiss N, Stec A, et al. Trimethylamine N⁃oxide, a gut microbiota⁃derived metabolite, is associated with cardiovascular risk in psoriasis: a cross⁃sectional pilot study[J]. Dermatol Ther (Heidelb), 2021,11(4):1277⁃1289. DOI: 10.1007/s13555⁃021⁃00547⁃3. |
| [30] | Barrea L, Muscogiuri G, Pugliese G, et al. Association of trimethylamine N⁃oxide (TMAO) with the clinical severity of hidradenitis suppurativa (acne inversa)[J]. Nutrients, 2021, 13(6):1997. DOI: 10.3390/nu13061997. |
| [31] | Li Y, Liang L, Deng X, et al. Lipidomic and metabolomic profiling reveals novel candidate biomarkers in active systemic lupus erythematosus[J]. Int J Clin Exp Pathol, 2019,12(3):857⁃866. |
| [32] | Verde L, Frias⁃Toral E, Cacciapuoti S, et al. Very low⁃calorie ketogenic diet (VLCKD): a therapeutic nutritional tool for acne?[J]. J Transl Med, 2024,22(1):322. DOI: 10.1186/s12967⁃024⁃05119⁃5. |
| [33] | Verde L, Cacciapuoti S, Caiazzo G, et al. Very low⁃calorie ketogenic diet (VLCKD) in the management of hidradenitis suppurativa (acne inversa): an effective and safe tool for improvement of the clinical severity of disease. Results of a pilot study[J]. J Transl Med, 2024,22(1):149. DOI: 10.1186/s12967⁃024⁃04853⁃0. |
| [34] | Chen G, Chen ZM, Fan XY, et al. Gut⁃Brain⁃skin axis in psoriasis: a review[J]. Dermatol Ther (Heidelb), 2021,11(1):25⁃38. DOI: 10.1007/s13555⁃020⁃00466⁃9. |
| [35] | Ralvenius WT, Neumann E, Pagani M, et al. Itch suppression in mice and dogs by modulation of spinal α2 and α3GABAA receptors[J]. Nat Commun, 2018,9(1):3230. DOI: 10.1038/s41467⁃018⁃05709⁃0. |
| [36] | Thirion F, Guilly S, Fromentin S, et al. Changes in gut microbiota of patients with atopic dermatitis during balneotherapy[J]. Clin Cosmet Investig Dermatol, 2022,15:163⁃176. DOI: 10.2147/CCID. S342104. |
| [37] | Uehara E, Hokazono H, Sasaki T, et al. Effects of GABA on the expression of type I collagen gene in normal human dermal fibroblasts[J]. Biosci Biotechnol Biochem, 2017,81(2):376⁃379. DOI: 10.1080/09168451.2016.1238296. |
| [38] | Wang X, Su Y, Cai Z, et al. γ⁃Aminobutyric acid promotes the inhibition of hair growth induced by chronic restraint stress[J]. Life Sci, 2023,317:121439. DOI: 10.1016/j.lfs.2023.121439. |
| [39] | Wardhana M, Windari M, Puspasari N, et al. Role of serotonin and dopamine in psoriasis: a case⁃control study[J]. Open Access Maced J Med Sci, 2019,7(7):1138⁃1142. DOI: 10.3889/oamjms. 2019.267. |
| [40] | Keren A, Gilhar A, Ullmann Y, et al. Instantaneous depolarization of T cells via dopamine receptors, and inhibition of activated T cells of psoriasis patients and inflamed human skin, by D1⁃like receptor agonist: fenoldopam[J]. Immunology, 2019,158(3):171⁃193. DOI: 10.1111/imm.13109. |
| [41] | Vijay A, Kouraki A, Gohir S, et al. The anti⁃inflammatory effect of bacterial short chain fatty acids is partially mediated by endocannabinoids[J]. Gut Microbes, 2021,13(1):1997559. DOI: 10.1080/19490976.2021.1997559. |
| [42] | Varian BJ, Poutahidis T, DiBenedictis BT, et al. Microbial lysate upregulates host oxytocin[J]. Brain Behav Immun, 2017,61:36⁃49. DOI: 10.1016/j.bbi.2016.11.002. |
| [43] | Woo YR, Kim HS. Interaction between the microbiota and the skin barrier in aging skin: a comprehensive review[J]. Front Physiol, 2024,15:1322205. DOI: 10.3389/fphys.2024.1322205. |
| [44] | Tang X. Probiotic Roles of Clostridium butyricum in piglets: considering aspects of intestinal barrier function[J]. Animals (Basel), 2024, 14(7):1069. DOI: 10.3390/ani14071069. |
| [45] | Polak K, Bergler⁃Czop B, Szczepanek M, et al. Psoriasis and gut microbiome⁃current state of art[J]. Int J Mol Sci, 2021, 22(9):4529. DOI: 10.3390/ijms22094529. |
| [46] | Drago F, De Col E, Agnoletti AF, et al. The role of small intestinal bacterial overgrowth in rosacea: a 3⁃year follow⁃up[J]. J Am Acad Dermatol, 2016,75(3):e113⁃e115. DOI: 10.1016/j.jaad.2016.01.059. |
| [47] | Woo YR, Han YJ, Kim HS, et al. Updates on the risk of neuropsychiatric and gastrointestinal comorbidities in rosacea and its possible relationship with the gut⁃brain⁃skin axis[J]. Int J Mol Sci, 2020, 21(22):8427. DOI: 10.3390/ijms21228427. |
| [48] | Yang Z, Zhou Y, Han Z, et al. The effects of probiotics supplementation on Helicobacter pylori standard treatment: an umbrella review of systematic reviews with meta⁃analyses[J]. Sci Rep, 2024,14(1):10069. DOI: 10.1038/s41598⁃024⁃59399⁃4. |
| [49] | Liang B, Yuan Y, Peng XJ, et al. Current and future perspectives for Helicobacter pylori treatment and management: from antibiotics to probiotics[J]. Front Cell Infect Microbiol, 2022,12:1042070. DOI: 10.3389/fcimb.2022.1042070. |
| [50] | Wiese⁃Szadkowska M, Helmin⁃Basa A, Eljaszewicz A, et al. Selected commensal bacteria change profiles of Helicobacter pylori⁃induced T cells via dendritic cell modulation[J]. Helicobacter, 2019,24(6):e12614. DOI: 10.1111/hel.12614. |
| [51] | Boyanova L, Gergova G, Markovska R, et al. Bacteriocin⁃like inhibitory activities of seven Lactobacillus delbrueckii subsp. bulgaricus strains against antibiotic susceptible and resistant Helicobacter pylori strains[J]. Lett Appl Microbiol, 2017,65(6):469⁃474. DOI: 10.1111/lam.12807. |
| [52] | Augusto de Oliveira MF, Agne DB, Bastos L, et al. Atopic dermatitis pediatric patients show high rates of nasal and intestinal colonization by methicillin⁃resistant Staphylococcus aureus and coagulase⁃negative staphylococci[J]. BMC Microbiol, 2024,24(1):42. DOI: 10.1186/s12866⁃023⁃03165⁃5. |
| [53] | Piewngam P, Zheng Y, Nguyen TH, et al. Pathogen elimination by probiotic Bacillus via signalling interference[J]. Nature, 2018,562(7728):532⁃537. DOI: 10.1038/s41586⁃018⁃0616⁃y. |
| [54] | Trompette A, Pernot J, Perdijk O, et al. Gut⁃derived short⁃chain fatty acids modulate skin barrier integrity by promoting keratinocyte metabolism and differentiation[J]. Mucosal Immunol, 2022,15(5):908⁃926. DOI: 10.1038/s41385⁃022⁃00524⁃9. |
| [55] | Li W, Wang Z, Cao J, et al. Melatonin improves skin barrier damage caused by sleep restriction through gut microbiota[J]. J Pineal Res, 2023,75(1):e12874. DOI: 10.1111/jpi.12874. |
| [56] | Lee K, Kim HJ, Kim SA, et al. Exopolysaccharide from Lactobacillus plantarum HY7714 protects against skin aging through skin⁃gut axis communication[J]. Mol Basel Switz, 2021, 26(6):1651. DOI: 10.3390/molecules26061651. |
| [57] | Seo E, Song HH, Kim H, et al. Oral administration of mixed probiotics improves photoaging by modulating the cecal microbiome and MAPK pathway in UVB⁃irradiated hairless mice[J]. Mol Nutr Food Res, 2023,67(12):e2200841. DOI: 10.1002/mnfr.202200841. |
| [58] | Ai J, Ma W, Pan Z, et al. Ameliorative effect of Lactobacillus plantarum CCFM8661 on oleic acid⁃induced acne: integrated gut microbiota link to acne pathogenesis[J]. J Sci Food Agric, 2024,104(1):328⁃339. DOI: 10.1002/jsfa.12921. |
| [59] | Rybak I, Haas KN, Dhaliwal SK, et al. Prospective placebo⁃controlled assessment of spore⁃based probiotic supplementation on sebum production, skin barrier function, and acne[J]. J Clin Med, 2023, 12(3):895. DOI: 10.3390/jcm12030895. |
| [60] | Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto⁃oligosaccharides in the prevention of allergic diseases: a randomized, double⁃blind, placebo⁃controlled trial[J]. J Allergy Clin Immunol, 2007, 119(1):192⁃198. DOI: 10. 1016/j.jaci.2006.09.009. |
| [61] | Voigt J, Lele M. Lactobacillus rhamnosus used in the perinatal period for the prevention of atopic dermatitis in infants: a systematic review and meta⁃analysis of randomized trials[J]. Am J Clin Dermatol, 2022,23(6):801⁃811. DOI: 10.1007/s40257⁃022⁃00723⁃x. |
| [62] | Navarro⁃López V, Martínez⁃Andrés A, Ramírez⁃Boscá A, et al. Efficacy and safety of oral administration of a mixture of probiotic strains in patients with psoriasis: a randomized controlled clinical trial[J]. Acta Derm Venereol, 2019,99(12):1078⁃1084. DOI: 10.2340/00015555⁃3305. |
| [63] | Atefi N, Mohammadi M, Bodaghabadi M, et al. Evaluating the effectiveness of probiotic supplementation in combination with doxycycline for the treatment of moderate acne: a randomized double⁃blind controlled clinical trial[J]. J Cosmet Dermatol, 2025,24(1):e16614. DOI: 10.1111/jocd.16614. |
| [64] | Yu J, Duan Y, Zhang M, et al. Effect of combined probiotics and doxycycline therapy on the gut⁃skin axis in rosacea[J]. mSystems, 2024,9(11):e0120124. DOI: 10.1128/msystems.01201⁃24. |
| [65] | 张红燕, 李丽, 王明霞, 等. 益生菌在痤疮治疗中的应用进展[J]. 中华皮肤科杂志, 2023,56(3):283⁃285. DOI: 10.35541/cjd.20200657. |
| [66] | Gao YW, Yao X, Yang XY. Application of bioengineered bacteria in allergic diseases[J]. Int J Dermatol Venereol, 2023, 6(1):43. DOI: 10.1097/JD9.0000000000000242. |
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