The Role of Gut Microbiota in the Pathogenesis and Management of Atopic Dermatitis: A Review of Current Evidence

Abstract Introduction and purpose Atopic dermatitis (AD) is a chronic inflammatory skin disease caused by genetic, immunological, environmental, and microbial factors. Recent studies highlight the gut microbiota's role in AD pathogenesis, particularly through the gut–skin axis and immune modulation. This review summarizes current knowledge on the involvement of gut microbiota in AD and explores microbiota-targeted therapies. Materials and methods A literature review was conducted using PubMed, Google Scholar, and sources by recognized researchers from Poland and abroad. Search terms included: "atopic dermatitis," "gut microbiota," "dysbiosis," "short-chain fatty acids," and "gut-skin axis." Both experimental and clinical studies were analyzed. Description of the state of knowledge The gut microbiota plays a crucial role in immune regulation and maintaining epithelial barriers. Dysbiosis, characterized by reduced microbial diversity and lower levels of SCFA-producing bacteria, leads to increased intestinal permeability, Th2-biased responses, and inflammation—factors linked to AD severity. Butyrate, a key microbial metabolite, improves skin barrier function and modulates inflammation. Therapies such as probiotics, prebiotics, fiber, and fecal microbiota transplantation (FMT) may help restore gut balance and alleviate symptoms. ConclusionGut microbiota is a key factor in AD development and management. Adjusting microbial composition through diet, supplements, and microbiota-based interventions offers promising adjunctive treatment strategies. More clinical trials are needed to standardize protocols and confirm long-term effectiveness and safety.