OPPORTUNITIES FOR GUT-SKIN AXIS MODULATION IN MYELODYSPLASTIC SYNDROME PATIENTS WITH NEUTROPHILIC DERMATOSES

Introduction. Recent studies have consistently confirmed the widely accepted view that neutrophilic dermatoses (ND) associated with myeloid malignancies, particularly myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), are relatively common and are frequently associated with an unfavorable prognosis.Aim. To evaluate the effectiveness of integrating a nutritional probiotic component into the comprehensive management of patients with MDS and ND.Materials and methods. Among 72 patients with MDS under clinical observation, 34 (47.2%) presented with clinical manifestations of neutrophilic dermatoses. As a nutritional adjuvant aimed at reducing systemic inflammation, these patients were recommended to take a dietary probiotic supplement containing five Bacillus strains for 12 weeks. The retrospective comparison group included patients with MDS who received a similar treatment regimen but did not receive probiotic nutritional adjuvants. Clinical manifestations of ND and serum cytokine profiles were assessed before and after treatment.Results. The study group demonstrated a more pronounced reduction in IL-6 and TNF-α levels, indicating the ability of the probiotic to modulate systemic inflammation and reduce circulating inflammatory biomarkers. Following nutritional probiotic supplementation, patients in the study group exhibited a more pronounced regression of ND skin manifestations than those in the retrospective control group, suggesting an indirect beneficial effect of reduced systemic inflammation on skin lesions. In the study group, the proportion of patients with papules decreased by 37.5%, while the number of patients with blisters was reduced by nearly 50%. In the control group, the number of patients with blisters also decreased by approximately 50%, whereas the proportion of patients with papules decreased by only 18.8% (p<0.05).Conclusions. The findings suggest that probiotics may serve as effective nutritional adjuvants by modulating the gut–skin axis and exerting systemic anti-inflammatory effects during the comprehensive management of patients with MDS and clinical manifestations of neutrophilic dermatoses.