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Systematic review and meta-analysis on the use of probiotic supplementation in pregnant mother, breastfeeding mother and infant for the prevention of atopic dermatitis in children.
Amalia, N, Orchard, D, Francis, KL, King, E
The Australasian journal of dermatology. 2020;(2):e158-e173
Abstract
Probiotic supplementation may decrease the risk of allergic disease; however, there are differences between studies, such as the type of probiotic, the route or the duration of supplementation. Therefore, determining the most effective probiotic strain/s, route of administration and duration for clinical recommendation has been difficult. An electronic systematic literature search was undertaken between using Ovid MEDLINE, Embase, PubMed and Cochrane. Risk ratio (RR) and 95% confidence interval (CI) are presented for the studies. PEDro scale and Newcastle-Ottawa Scale were used to assess the quality of the included studies. A total of 21 studies met the inclusion criteria. Strain-specific sub-meta-analyses indicated that single strains are not as effective as probiotic mixtures and administration to a combination of pregnant mothers, breastfeeding mothers and infants had a reduced risk in the onset of atopic dermatitis in children. Our systematic review and meta-analysis showed that a mixture of probiotic supplementation given to the mother in pregnancy and continuing while breastfeeding and also to the infant in children classified as high-risk for atopic dermatitis and non-high-risk groups is the most efficacious in reducing the risk of incidence of atopic dermatitis in children.
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2.
Association between atopic dermatitis and contact sensitization: A systematic review and meta-analysis.
Hamann, CR, Hamann, D, Egeberg, A, Johansen, JD, Silverberg, J, Thyssen, JP
Journal of the American Academy of Dermatology. 2017;(1):70-78
Abstract
BACKGROUND It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk. OBJECTIVE To perform a systematic review and meta-analysis of the association between AD and contact sensitization. METHODS The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on contact sensitization in individuals with and without AD. RESULTS The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in contact sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90). LIMITATIONS Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies. CONCLUSION No overall relationship between AD and contact sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic contact dermatitis is suspected.
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3.
Assisted reproductive technology and risk of asthma and allergy in the offspring: protocol for a systematic review and meta-analysis.
Nwaru, BI, McCleary, N, Erkkola, M, Kaila, M, Virtanen, SM, Sheikh, A
BMJ open. 2016;(4):e010697
Abstract
INTRODUCTION The use of assisted reproductive technology (ART) procedures has increased globally over the last three decades. Recent observational studies suggest that children conceived through ART may be at increased risk of asthma and atopic disease compared with children conceived naturally, but findings are mixed. We aim to synthesise the evidence on the impact of ART on the risk of asthma and atopic disease in the offspring. METHODS AND ANALYSIS We will identify relevant studies by searching MEDLINE, EMBASE, Cochrane Library, ISI Web of Science, CINAHL, Scopus, Google Scholar, AMED, Global Health, PsychINFO, CAB International and the WHO Global Health Library from 1978 to 2016. We will locate additional studies through searching databases of the proceedings of international conferences, contacting international experts in the field, and searching the references cited in identified studies. We will include analytic observational studies (cohort studies, case-control studies and cross-sectional studies) that have investigated the impact of any type of ART on offspring's asthma and atopic disease. Screening of identified records, data extraction from eligible studies and risk of bias assessment of eligible studies will be independently undertaken by two reviewers, with arbitration by a third reviewer. The Effective Public Health Practice Project will be employed for risk of bias assessment. Estimates from studies judged to be clinically, methodologically and statistically homogeneous will be synthesised using random-effects meta-analysis. ETHICS AND DISSEMINATION As this study is based solely on the published literature, no ethics approval is required. We will publish our findings in a peer-reviewed scientific journal and present the results at national and international scientific conferences. PROTOCOL REGISTRATION We will register a detailed protocol for the review with the International Prospective Register of Systematic Reviews (PROSPERO) prior to starting the review.
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4.
Meta-analysis identifies seven susceptibility loci involved in the atopic march.
Marenholz, I, Esparza-Gordillo, J, Rüschendorf, F, Bauerfeind, A, Strachan, DP, Spycher, BD, Baurecht, H, Margaritte-Jeannin, P, Sääf, A, Kerkhof, M, et al
Nature communications. 2015;:8804
Abstract
Eczema often precedes the development of asthma in a disease course called the 'atopic march'. To unravel the genes underlying this characteristic pattern of allergic disease, we conduct a multi-stage genome-wide association study on infantile eczema followed by childhood asthma in 12 populations including 2,428 cases and 17,034 controls. Here we report two novel loci specific for the combined eczema plus asthma phenotype, which are associated with allergic disease for the first time; rs9357733 located in EFHC1 on chromosome 6p12.3 (OR 1.27; P=2.1 × 10(-8)) and rs993226 between TMTC2 and SLC6A15 on chromosome 12q21.3 (OR 1.58; P=5.3 × 10(-9)). Additional susceptibility loci identified at genome-wide significance are FLG (1q21.3), IL4/KIF3A (5q31.1), AP5B1/OVOL1 (11q13.1), C11orf30/LRRC32 (11q13.5) and IKZF3 (17q21). We show that predominantly eczema loci increase the risk for the atopic march. Our findings suggest that eczema may play an important role in the development of asthma after eczema.
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5.
Topical application of Chinese herbal medicine for atopic eczema: a systematic review with a meta-analysis.
Gu, S, Yang, AW, Li, CG, Lu, C, Xue, CC
Dermatology (Basel, Switzerland). 2014;(4):294-302
Abstract
BACKGROUND Atopic eczema (AE) affects 10-20% of children in industrialised countries. OBJECTIVE This review systematically evaluated the effects and safety of topical use of Chinese herbal medicine (CHM) for AE. METHODS Randomised controlled trials on topical use of CHM were identified through searching electronic databases. Their risk of bias was assessed. Meta-analysis was conducted by employing the RevMan 5.2 software. RESULTS Ten studies involving 1,058 participants were included. These studies had high risk of bias in randomisation, blinding and outcome data. Meta-analysis showed that topical applications of CHM were superior to conventional medications in total effectiveness rate (risk ratio 1.19; 95% confidence interval 1.04 to 1.36). No significant difference was observed in overall skin lesion score (standardised mean difference -0.05; 95% confidence interval -0.88 to 0.78) compared to corticosteroid creams. CONCLUSIONS There was no conclusive evidence to demonstrate that topical application of CHM for AE was superior to other control interventions due to methodological weaknesses of the included randomised controlled trials.
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6.
Effect of the use of probiotics in the treatment of children with atopic dermatitis; a literature review.
da Costa Baptista, IP, Accioly, E, de Carvalho Padilha, P
Nutricion hospitalaria. 2013;(1):16-26
Abstract
INTRODUCTION Atopic dermatitis (AD) is a disease that mainly affects the pediatric population involving chronic and repetitive inflammatory skin manifestations. Its evolution is known as atopic march, which is characterized by the occurrence of respiratory and food allergies. AIM: To carry out a classical review of the state-of-theart scientific literature regarding the effect of probiotics on the treatment of children with AD. METHODS Searches were conducted in Medline and Lilacs through the portals PubMed (http://www.ncbi.nlm. nih.gov/pubmed/) and SciELO (http://www.scielo.br). There was a selection of the available publications in the period from 2001 to 2011, using the keywords atopic dermatitis and probiotics (in English and in Portuguese). RESULTS After applying the inclusion and exclusion criterias, we selected 12 case-control studies which were conducted in four European countries and Australia. The methodological quality of the studies was assessed according to the STROBE recommendations. Assessment of agreement among researches in classifying the quality of the articles showed excellent agreement (k = 1.00, 95%) with a total of 9 papers at B level. The majority of the studies (75%) indicated a beneficial biological effect of probiotics on AD, including protection against infections, enhancement of the immune response, inflammation reduction and changes in gut the flora. The remaining studies showed no beneficial effects according to the outcomes of interest. CONCLUSION The majority of the studies in the scientific literature in this review showed improvements in some inflammatory parameters and in intestinal microbiota and not exactly, changes in clinical parameters. However, the biological effects observed in most of them suggest the possibility of benefits of the use of probiotics as an adjuvant in the treatment of AD.
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7.
Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials.
Michail, SK, Stolfi, A, Johnson, T, Onady, GM
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2008;(5):508-16
Abstract
BACKGROUND Several articles describing the efficacy of probiotics in atopic dermatitis (AD) have been published. However, not all studies support a similar outcome. OBJECTIVE To determine whether probiotics are efficacious in treating AD and to explore whether type of probiotic used, duration of therapy, patient age, severity of disease, and IgE sensitization are factors in determining efficacy. METHODS For this meta-analysis of randomized controlled trials describing the efficacy of probiotics in AD, a comprehensive search was performed of databases through January 2008. Three reviewers independently evaluated the studies for methodological qualities. All the data were analyzed, and forest plots were evaluated for the overall efficacy of probiotics in AD and the therapeutic benefit to subgroups of selected patient populations. RESULTS Eleven studies were identified, and data from 10 studies (n = 678) were available to analyze. There was an overall statistically significant difference favoring probiotics compared with placebo in reducing the Scoring of Atopic Dermatitis Severity Index score (mean change from baseline, -3.01; 95% confidence interval, -5.36 to -0.66; P = .01). Children with moderately severe disease were more likely to benefit. Duration of probiotic administration, age, and type of probiotic used did not affect outcome. CONCLUSION Data from this meta-analysis suggest a modestrole for probiotics in pediatric AD. The effect is seen in moderately severe rather than mild disease.