Preventative Effects of Probiotics for Infantile Eczema and Atopic Eczema: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yu ¹ ,  ZENG Guo ¹ , ZHU Cairong ² , HUANG Lujiao ¹ , LIU Ke ³ , YU Li ¹

1. Department of Nutrition and Food Hygiene, West China School of Public Health, Sichuan University, Chengdu 610041, China; 2. Department of Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, China; 3. Zigong Center for Disease Control and Prevention, Zigong 643000, China;

Corresponding author：

ZENG Guo, Email: zgmu2003@126.com

Keywords：

Probiotic; Infantile eczema; Atopic eczema; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20120214

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Objective 　To systematically evaluate the preventative effect of probiotics for infantile eczema and atopic eczema.
Methods 　Databases including PubMed, EMbase, MEDLINE (Ovid), CENTRAL, CBM and CNKI were searched from inception to February 2012, so as to collect the randomized controlled trials (RCTs) on probiotics in preventing infantile eczema and atopic eczema. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, evaluated quality and cross-checked. Then the meta-analysis was conducted using RevMan 5.0 software.
Result 　A total of 15 RCTs involving 3 179 infants were included. The results of meta-analyses on 8 high quality RCTs showed that: the incidence of infantile eczema was lower in the probiotics group than the placebo group, with a significant difference (RD=–0.06, 95%CI –0.10 to –0.03, P lt;0.05). Probiotics had no preventative effect on infantile atopic eczema (RD=–0.02, 95%CI –0.08 to 0.03, P gt;0.05), and had preventative effects on both high risk population (RD=–0.09, 95%CI –0.15 to –0.03, P lt;0.05) and general population (RD=–0.05, 95%CI –0.10 to 0.00, P lt;0.05) of infantile eczema.
Conclusion 　Probiotics have certain preventative effects on infantile eczema. Due to the differences of probiotics in the aspects such as probiotic strain, dosage, treatment course, etc., its specific effects on infantile eczema and atopic eczema should be further tested.

Citation： WANG Yu,ZENG Guo,ZHU Cairong,HUANG Lujiao,LIU Ke,YU Li. Preventative Effects of Probiotics for Infantile Eczema and Atopic Eczema: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2012, 12(11): 1372-1378. doi: 10.7507/1672-2531.20120214 Copy

1.	Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. Journal of Allergy and Clinical Immunology, 2008, 121(1): 116-121.
2.	Thestrup-Pedersen K. Atopic eczema. What has caused the epidemic in industrialised countries and can early intervention modify the natural history of atopic eczema? Journal of Cosmetic Dermatology, 2003, 2(3-4): 202-210.
3.	van der Aa LB, Heymans HSA, van Aalderen WMC, et al. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatric Allergy and Immunology, 2010, 21(2p2): e355-e367.
4.	West CE, Gothefors L, Granstrom M, et al. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
5.	Larsen N, Vogensen FK, Gøbel R, et al. Predominant genera of fecal microbiota in children with atopic dermatitis are not altered by intake of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07. FEMS Microbiology Ecology, 2011, 75(3): 482-496.
6.	Gore C, Custovic A, Tannock GW, et al. Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years. Clinical and Experimental Allergy, 2012, 42(1): 112-122.
7.	吴红梅, 杨茗. 数据提取. 见: 刘鸣, 主编. 系统评价、Meta分析设计与实施方法. 第1版. 北京: 人民卫生出版社, 2011: 77-83.
8.	Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2008, 122(4): 788-794.
9.	West CE, Hammarstrom ML, Hernell O. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
10.	Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Journal of Allergy and Clinical Immunology, 2002, 109(1): 119-121.
11.	Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 184-191.
12.	Niers L, Martín R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy, 2009, 64(9): 1349-1358.
13.	Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet, 2001, 357(9262): 1076-1079.
14.	Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 192-198.
15.	Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized,double- blind, placebo-controlled trial of probiotics for primary prevention:no clinical effects of Lactobacillus GG supplementation. Pediatrics, 2008, 121(4) : 850-856．.
16.	Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatric Allergy and Immunology, 2010, 21(2 Pt 2): e386-393.
17.	Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clinical and Experimental Allergy, 2008, 38(8): 1342-1348.
18.	Dotterud CK, Storro O, Johnsen R, et al. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. British Journal of Dermatology, 2010, 163(3): 616-623.
19.	Boyle RJ, Ismail IH, Kivivuori S, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy, 2011, 66(4): 509-516.
20.	Bottcher MF, Abrahamsso TR, Fredriksson M, et al. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric Allergy and Immunology, 2008, 19(6): 497-504.
21.	Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(5): 1174-1180.
22.	Soh SE , Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clinical and Experimental Allergy, 2009, 39(4): 571-578.
23.	Jøhnke H, Vach W, Norberg LA, et al. A comparison between criteria for diagnosing atopic eczema in infants. British Journal of Dermatology, 2005, 153(2): 352-358.
24.	安颖, 王世宾. 益生菌LGG的益生功效及在乳制品中的应用. 食品科技, 2006, (7): 271-273.
25.	朱帝玲, 杨文旭, 杨慧明. 乳酸菌对婴幼儿湿疹一级预防的系统评价. 中国当代儿科杂志, 2010, 12(09): 734-739.

1. Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. Journal of Allergy and Clinical Immunology, 2008, 121(1): 116-121.
2. Thestrup-Pedersen K. Atopic eczema. What has caused the epidemic in industrialised countries and can early intervention modify the natural history of atopic eczema? Journal of Cosmetic Dermatology, 2003, 2(3-4): 202-210.
3. van der Aa LB, Heymans HSA, van Aalderen WMC, et al. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatric Allergy and Immunology, 2010, 21(2p2): e355-e367.
4. West CE, Gothefors L, Granstrom M, et al. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
5. Larsen N, Vogensen FK, Gøbel R, et al. Predominant genera of fecal microbiota in children with atopic dermatitis are not altered by intake of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07. FEMS Microbiology Ecology, 2011, 75(3): 482-496.
6. Gore C, Custovic A, Tannock GW, et al. Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years. Clinical and Experimental Allergy, 2012, 42(1): 112-122.
7. 吴红梅, 杨茗. 数据提取. 见: 刘鸣, 主编. 系统评价、Meta分析设计与实施方法. 第1版. 北京: 人民卫生出版社, 2011: 77-83.
8. Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2008, 122(4): 788-794.
9. West CE, Hammarstrom ML, Hernell O. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology, 2009, 20(5): 430-437.
10. Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Journal of Allergy and Clinical Immunology, 2002, 109(1): 119-121.
11. Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 184-191.
12. Niers L, Martín R, Rijkers G, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy, 2009, 64(9): 1349-1358.
13. Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet, 2001, 357(9262): 1076-1079.
14. Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(1): 192-198.
15. Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized,double- blind, placebo-controlled trial of probiotics for primary prevention:no clinical effects of Lactobacillus GG supplementation. Pediatrics, 2008, 121(4) : 850-856．.
16. Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatric Allergy and Immunology, 2010, 21(2 Pt 2): e386-393.
17. Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clinical and Experimental Allergy, 2008, 38(8): 1342-1348.
18. Dotterud CK, Storro O, Johnsen R, et al. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. British Journal of Dermatology, 2010, 163(3): 616-623.
19. Boyle RJ, Ismail IH, Kivivuori S, et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy, 2011, 66(4): 509-516.
20. Bottcher MF, Abrahamsso TR, Fredriksson M, et al. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric Allergy and Immunology, 2008, 19(6): 497-504.
21. Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 2007, 119(5): 1174-1180.
22. Soh SE , Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clinical and Experimental Allergy, 2009, 39(4): 571-578.
23. Jøhnke H, Vach W, Norberg LA, et al. A comparison between criteria for diagnosing atopic eczema in infants. British Journal of Dermatology, 2005, 153(2): 352-358.
24. 安颖, 王世宾. 益生菌LGG的益生功效及在乳制品中的应用. 食品科技, 2006, (7): 271-273.
25. 朱帝玲, 杨文旭, 杨慧明. 乳酸菌对婴幼儿湿疹一级预防的系统评价. 中国当代儿科杂志, 2010, 12(09): 734-739.

Chinese Journal of Evidence-Based Medicine

Preventative Effects of Probiotics for Infantile Eczema and Atopic Eczema: A Systematic Review

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