1.
Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies.
Panduru, M, Panduru, NM, Sălăvăstru, CM, Tiplica, GS
Journal of the European Academy of Dermatology and Venereology : JEADV. 2015;(2):232-242
Abstract
BACKGROUND Atopic Dermatitis (AD) has an increasing incidence and the real cause of the disease is not known yet. Probiotics may be involved in AD prevention, but their role is controversial. OBJECTIVE The purpose of our study was to evaluate the role of probiotics in AD occurrence. METHODS We carried out an extensive search on this topic in the international databases (Pubmed, Scopus,Web of knowledge, EBSCO, ARTO, Google Scholar, ClinicalTrials.gov.) selecting only those studies where the role of probiotics in AD occurrence was analysed. For the selected studies we calculated odds ratio (OR) and 95% confidence interval (CIs). RESULTS Initially, we found 1513 articles, of which only 26 studies fulfilled our criteria. After exclusion of studies on the same populations, 16 studies were included in the final analysis. The meta-analysis of these studies revealed that probiotics administration confers protection against AD occurrence (OR = 0.64, P < 0.001). The subgroup meta-analysis, in general population and population at high risk for allergies, suggested that probiotics administration is protective for AD development in both subgroups (OR = 0.53, P = 0.005; OR = 0.66, P < 0.001). Additional subgroup analysis showed that probiotics prenatal administration followed by postnatal administration was protective (OR = 0.61, P < 0.001) unlike only administration in postnatal period (OR = 0.95, P < 0.82). Finally, the subgroup analysis based on the type of treatment suggested that both Lactobacillus alone and Lactobacillus with Bifidobacterium are protective against AD (OR = 0.70, P = 0.004; OR = 0.62, P < 0.001). CONCLUSION Probiotics seem to have a protective role in AD prevention if there are administration in pre and postnatal period in both general and allergic risk population.
2.
Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials.
Kim, SO, Ah, YM, Yu, YM, Choi, KH, Shin, WG, Lee, JY
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2014;(2):217-26
Abstract
BACKGROUND The effects of probiotics on the treatment of atopic dermatitis (AD) are inconclusive. OBJECTIVE To determine the clinical effect of probiotics in the management of AD overall and in different age groups. METHODS A comprehensive search of databases through December 2013 was performed. For this meta-analysis, randomized controlled trials measuring the treatment effects of probiotics or synbiotics in patients diagnosed with AD were included. The primary outcome was a difference in Scoring of Atopic Dermatitis (SCORAD) values between the treatment and placebo groups overall and in different age populations. RESULTS Twenty-five randomized controlled trials (n = 1,599) were available for this meta-analysis. Significant differences in SCORAD values favoring probiotics over the control were observed overall (mean -4.51, 95% confidence interval -6.78 to -2.24), in children 1 to 18 years old (-5.74, 95% confidence interval -7.27 to -4.20), and in adults (-8.26, 95% confidence interval -13.28 to -3.25). However, the effectiveness of probiotics in infants (<1 year old) with AD was not proved. The effect of synbiotic use was not significantly different from that of probiotic use. Treatment with a mixture of different bacterial species or of Lactobacillus species showed greater benefit than did treatment with Bifidobacterium species alone. CONCLUSION The overall result of this meta-analysis suggests that probiotics could be an option for the treatment of AD, especially for moderate to severe AD in children and adults. However, no evidence was found supporting the beneficial role of probiotics in infants.
3.
Meta-analysis of probiotics and/or prebiotics for the prevention of eczema.
Dang, D, Zhou, W, Lun, ZJ, Mu, X, Wang, DX, Wu, H
The Journal of international medical research. 2013;(5):1426-36
Abstract
OBJECTIVE The efficacy of probiotics and/or prebiotics for preventing eczema in infants remains unclear. This meta-analysis evaluated published studies on pro/prebiotics for eczema prevention, investigating bacterial strain efficacy and changes to the allergy status of the children involved. METHODS Randomized, double-blind, placebo-controlled trials were analysed, irrespective of bacterial strains used in the pro/prebiotics. Studies of pregnant women, nursing mothers and infants receiving pro/prebiotics were included. All infant participants were assessed within 2 years of birth. Incidences of eczema and systemic sensitization were measured by weighted relative risk ratios (RRR). RESULTS The 14 studies on probiotics had a pooled RRR of 0.69 (95% confidence interval [CI]: 0.62, 0.78). Three studies on prebiotic consumption showed a RRR of 0.80 (95% CI: 0.54, 1.18). One study of mixed pro/prebiotic (synbiotic) strains found a RRR ratio of 0.81 (95% CI: 0.66, 0.99). No consistent sensitization changes were found. Only the combination of nonspore lactobacilli and bifidobacteria reduced the incidence of eczema. CONCLUSION This meta-analysis found that probiotics or synbiotics may reduce the incidence of eczema in infants aged <2 years. Systemic sensitization did not change following probiotic administration.