{
  "abstract": "Background Gut dysbiosis is associated with atopic eczema pathogenesis through the gut-skin axis. Accumulating evidence suggests the immunomodulatory potential of Bifidobacterium in skin disease management. We investigated whether oral supplementation of a Bifidobacterium-based synbiotic formula (SIM05) improves clinical outcomes of atopic eczema.Methods A pilot, single-arm study in 27 adults with physician-diagnosed atopic eczema (mean age 40.2 ± 10.1 years; 48.1% female) was conducted at a tertiary referral centre. Subjects received SIM05 ( Bifidobacterium breve, Bifidobacterium bifidum, Lactobacillus salivarius, 10 billion CFU in one sachet daily) for 16 weeks. The primary outcome was the change in Eczema Area and Severity Index (EASI) across 16 weeks. Secondary outcomes included EASI response rates, changes in Pruritus Numerical Rating Scale (PNRS), Dermatology Life Quality Index (DLQI), faecal metagenomic profile, and adverse event rate. ClinicalTrials.gov: NCT06230991.Results At 16 weeks, 40.0% of subjects achieved improvement in EASI score from baseline. Overall EASI-50 (≥50% improvement) response rate was 20.0%. Quality of life (DLQI) improved significantly from 9.19 ± 4.99 to 7.44 ± 4.14 at 16 weeks (p=0.043). Domain-specific analysis showed improvement in the symptoms and feelings subdomain (p<0.05). Faecal metagenomics revealed significant enrichment of multiple Bifidobacterium species, including Bifidobacterium breve and Bifidobacterium longum at both 8 and 16 weeks (IDDF2026-ABS-0199 Figure 1), as well as Bifidobacterium kashiwanohense and Bifidobacterium pseudocatenulatum at 16 weeks (all p<0.05). Eubacterium sp. CAG38, a short-chain fatty acid producer, was significantly elevated at both 8 and 16 weeks (p<0.05). Functional analysis of gut microbiome revealed significant enrichment of the L-lysine biosynthesis I pathway (p=0.023). No serious adverse event was reported.Conclusions SIM05 significantly improved the quality of life in adults with atopic eczema, potentially through the enrichment of multiple Bifidobacterium species and anti-inflammatory microbial pathways. Multi-species enrichment may suggest cross-feeding and ecological niche facilitation beyond direct supplementation. Bifidobacterium-mediated mechanisms may be critical for skin health via the gut-skin axis.Abstract IDDF2026-ABS-0199 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Wenye Xu"
    },
    {
      "affiliations": [
        "Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Raphaela Iris Lau"
    },
    {
      "affiliations": [
        "Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Jessica YL Ching"
    },
    {
      "affiliations": [
        "Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Pui-Kuan Cheong"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Lin Zhang"
    },
    {
      "affiliations": [
        "Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China."
      ],
      "name": "Francis KL Chan"
    },
    {
      "affiliations": [
        "Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong"
      ],
      "name": "Siew C Ng"
    }
  ],
  "title": "IDDF2026-ABS-0199 Synbiotic formula (SIM05) enriched multiple bifidobacterium species and significantly improved quality of life in adults with atopic eczema",
  "uid": "5403bc26-9e8a-58f7-86f9-19afc37a1cb2"
}