Original Articles: Systemic Allergic DisordersEfficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials
Section snippets
INTRODUCTION
Atopic dermatitis (AD) is the most common chronic skin condition in infants and children, with a prevalence of 10% to 20%.1, 2 Geographic location affects the prevalence of this disease, with the highest prevalence in the United States and Europe.3 Important factors in the susceptibility to develop AD include a genetic basis (82%) and environmental factors (18%).4 In addition, AD has been linked to food hypersensitivity, especially milk and egg proteins.5
There have been several proposed methods
Search Strategy and Selection Criteria
The search included PubMed/MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Library from inception through January 2008. In addition, abstracts presented at major gastrointestinal and allergy meetings were reviewed, including the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; the American Gastroenterological Association; the Society for Pediatric Research; and the American Academy of Allergy, Asthma, and
RESULTS
There are currently 11 RCTs examining the effect of probiotics in infants and children with AD with the SCORAD score as the primary outcome. Some studies suggest a favorable outcome. Summary details of the studies are given in Table 1. Table 2 lists the CONSORT scores for each study identified in this analysis. Based on the CONSORT scale, 7 studies were of high quality and 4 were of intermediate quality.
DISCUSSION
The concept of the ability of ingested probiotic bacteria to exert an effect on a remote organ such as the skin is intriguing. Probiotics have shown a favorable effect on the ailing immune system seen in AD. This meta-analysis describes several RCTs exploring the efficacy of probiotics in AD. The first study18 analyzed suggests a benefit of Lactobacillus GG in mild disease. However, 1 month after therapy, SCORAD scores were comparable with those of placebo. Therefore, the effect of the
ACKNOWLEDGMENTS
We thank Bette Sydelko, MSLS, MEd, AHIP, for her help in performing literature searches for the study and all of the authors of the studies included in this meta-analysis who provided the raw data from their studies.
REFERENCES (37)
- et al.
The prevalence of atopic dermatitis in Oregon schoolchildren
J Am Acad Dermatol.
(2000) - et al.
Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management
J Allergy Clin Immunol.
(1999) - et al.
Revised nomenclature for allergy for global use: report of the Nomenclature Review Committee of the World Allergy Organization, October 2003
J Allergy Clin Immunol.
(2004) - et al.
How atopic is atopic dermatitis?
J Allergy Clin Immunol.
(2004) - et al.
Molecular and cellular basis of microflora-host interactions
J Nutr.
(2007) - et al.
Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial
J Allergy Clin Immunol.
(2007) - et al.
Probiotics: a novel approach in the management of food allergy
J Allergy Clin Immunol.
(1997) - et al.
Effect of probiotic Lactobacillus strains in children with atopic dermatitis
J Allergy Clin Immunol.
(2003) - et al.
What are the best outcome measurements for atopic eczema? a systematic review
J Allergy Clin Immunol.
(2007) - et al.
Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life
J Nutr.
(2008)
Epidemiology of atopic dermatitis
Immunol Allergy Clin North Am.
Treatment principles of atopic dermatitis
J Eur Acad Dermatol Venereol.
Importance of genetic factors in the etiology of atopic dermatitis: a twin study
Allergy Asthma Proc.
the SCORAD index: Consensus Report of the European Task Force on Atopic Dermatitis
Dermatology.
Outcome measures of disease severity in atopic eczema
Arch Dermatol.
Scoring atopic dermatitis in infants and young children: distinctive features of the SCORAD index
Allergy.
Clinical features of atopic dermatitis at two years of age: a prospective, population-based case-control study
Acta Derm Venereol.
Recombinant Lactobacillus plantarum inhibits house dust mite-specific T-cell responses
Clin Exp Immunol.
Cited by (85)
Clinical Features of Atopic Dermatitis
2017, Middleton's Allergy EssentialsAllergic and Immunologic Disorders
2017, The Microbiota in Gastrointestinal Pathophysiology: Implications for Human Health, Prebiotics, Probiotics, and DysbiosisAtopic Dermatitis and Allergic Contact Dermatitis
2017, Middleton's Allergy Essentials: First EditionOral supplements in atopic dermatitis
2018, Clinics in DermatologyCurrent concepts in the prevention of atopic dermatitis
2018, Clinics in DermatologyThe microbiome in dermatology
2018, Clinics in Dermatology
Disclosures: Authors have nothing to disclose.
Disclaimer: The opinions and views contained herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Air Force, the Department of Defense, or the US government.