Emerging research has linked this disease to the gut microbiome in various ways, and research thus far has supported a protective role of probiotic and prebiotic supplementation. Positive effect of probiotics seen in allergic subjects (, Positive effect seen only in IgE-sensitized infants (, No significant difference between synbiotics and placebo, Positive effect seen only in food-sensitized children (, No significant difference between probiotics and placebo, SCORAD decrease in subjects not used topical steroids was shown only in probiotic group (, Clinical improvement seen mostly in children with IgE-dependent atopic eczema. These Tregs could migrate to the site of inflammation and suppress the Th2 and Th17 mediated allergic response or directly reduce the expression of TSLP. Microbiome and Probiotics in Acne Vulgaris-A Narrative Review. Synbiotics could not reduce the scoring of childhood atopic dermatitis (SCORAD): a randomized double blind placebo-controlled trial, A practical overview of pediatric atopic dermatitis, part 3: differential diagnosis, comorbidities, and measurement of disease burden. Sensitivity analyses, also termed uncertainty analyses, were used to explore the extent to which our results and conclusions were altered by changes in the data or analysis approach (Alexander et al., 2016). Hill C., Guarner F., Reid G., Gibson G. R., Merenstein D. J., Pot B., et al. Kim et al. 2022 Apr 27;9:871896. doi: 10.3389/fnut.2022.871896. However, in another trial, neither the frequency nor the severity of AD during the first year of life were significantly different between infants with atopic mothers who received L. acidophilus for the first 6 months of life compared with infants who received placebo.Probiotics, especially L. rhamnosus GG, seem to be effective for the prevention of AD. However, a high degree of heterogeneity was observed across these 14 trials (I2 = 87%). Clinical efficacy and mechanism of probiotics in allergic diseases. Strain-specific sub-analyses indicated that Lactobacillus (LS), Lactobacillus fermentum (LF), and a probiotic mixture reduced SCORAD values in children with AD, while LGG and Lactobacillus plantarum (LP) showed no effect in children with AD. The references listed in each report were examined to allow us to retrieve additional information. Atopic Dermatitis (Eczema) and Food Allergy Prevention for Infants. Conclusions: Modulation of the intestinal microbiota with probiotics may offer a way to prevent or treat allergic diseases, including atopic . (2000). However, the authors did not perform a meta-analysis to obtain further details about the treatment effects of probiotics. 2012 Oct;46 Suppl:S56-63. Stimulated dendritic cell direct differentiation of nave T-cell into Th2 cells and Th17 cells which, are known as the mediators of allergic inflammation in skin. Publication bias was assessed by constructing funnel plots. Palmer C. N., Irvine A. D., Terron-Kwiatkowski A., Zhao Y., Liao H., Lee S. P., et al. Unfortunately, we sent 13 emails and didn't receive any data suitable for inclusion in the meta-analysis. reported that oral probiotics alleviated the clinical symptoms of gastrointestinal inflammation and AD (Pessi et al., 2000). Also, we excluded some RCTs from this meta-analysis, and fewer studies included will reduce the confidence associated with the data interpretation and increase heterogeneity and publication bias. Probiotics: a novel approach in the management of food allergy. Also, in the subgroup analyses, children with AD may have different gut microbiota profiles from those of normal children. Marras L, Caputo M, Bisicchia S, Soato M, Bertolino G, Vaccaro S, Inturri R. Microorganisms. Background Probiotic supplementation in early life may be effective in preventing atopic dermatitis (AD); however, results regarding efficacy have been controversial. Gobel R., Larsen N., Molgaard C., Jakobsen M., Michaelsen K. F. (2010). Investigating international time trends in the incidence and prevalence of atopic eczema 19902010: a systematic review of epidemiological studies. On the other hand, the McMaster University with The WAO . Is the effect of probiotics on atopic dermatitis confined to food sensitized children? Changsha, China, 3Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, sharing sensitive information, make sure youre on a federal Of these meta-analyses, the most recent one concluded that probiotics significantly improved the SCORAD index in patients aged 1 year or older with AD (mean difference, -4.51; [95% CI, -6.78 to -2.24]; Kim et al., 2014), but the clinical significance of these findings has been questioned, and therefore, the role of probiotics in the treatment of AD has not been definitively established. Ultimately, 13 studies involving 1,070 children fulfilled our selection criteria (Table (Table11). Chang performed a meta-analysis of studies in which either prebiotics or probiotics were given and reported that synbiotics may be useful to treat AD (Chang et al., 2017). Figure Figure2A2A shows the risk of bias within all enrolled RCTs, as adjudged by the two reviewers. Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials. An official website of the United States government. 2008;9(2):93-103. doi: 10.2165/00128071-200809020-00002. Morgan A. R., Han D. Y., Wickens K., Barthow C., Mitchell E. A., Stanley T. V., et al. The PRISMA statement published in 2009 aimed to improve the reporting of systematic reviews and meta-analyses. Accessibility Conclusions: Filaggrin loss-of-function mutations predispose to phenotypes involved in the atopic march. However, LF (MD, 11.42; 95%CI, 13.81 to 9.04), LS (MD, 7.21; 95%CI, 9.63 to 4.78), and a mixture of different strains (MD, 3.52; 95%CI, 5.61 to 1.44) showed significant effects on SCORAD values in children (Figure (Figure66). government site. Both figures show that the risks of bias were rather low, because all were RCTs that adhered to high standards. The regular instillation of probiotics in daily use at an early age could help in preventing the initiation of eczema. Iemoli E., Trabattoni D., Parisotto S., Borgonovo L., Toscano M., Rizzardini G., et al. The site is secure. Four studies divided children into probiotic intervention and control groups; two studies created three groups (probiotics, a placebo, and another intervention). MD scoring with probiotics treatment compared to control and placebo interventions by age group. Subgroup analyses showed that in Europe, SCORAD revealed no effect of probiotics, whereas significantly lower SCORAD values were reported in Asia (MD, 5.39; 95%CI, 8.91 to 1.87). Hattori K., Yamamoto A., Sasai M., Taniuchi S., Kojima T., Kobayashi Y., et al. The terms used for the search were 'prebiotic', 'probiotic', 'atopic dermatitis', 'Severity Scoring of Atopic Dermatitis', and 'SCORAD'. Thus, our overall results are affected by these issues, and the data were highly heterogeneous. 2006 Apr;61(4):431-7. doi: 10.1111/j.1398-9995.2005.00956.x. A randomized, double-blind, placebo-controlled study investigated the effects of the use of the L. plantarum CJLP133 strain in the prevention of AD symptoms. Several studies on the benefits of probiotics for pediatric AD patients have appeared over the past decades. However, strong evidence to support the effectiveness of the administration of probiotics at a clinical level remains elusive (Meninghin et al., 2012; Foolad and Armstrong, 2014). All 13 studies reported baseline data including socioeconomic status and mean age; these did not differ significantly among the groups. Sung M., Lee K. S., Ha E. G., Lee S. J., Kim M. A., Lee S. W., et al.. (2017). Wickens K., Black P. N., Stanley T. V., Mitchell E., Fitzharris P., Tannock G. W., et al. Genome wide screens have linked AD to several chromosomal loci, including 3q21, 5q31, and 11q13 (Lee et al., 2000; Bowcock and Cookson, 2004; Haagerup et al., 2004; Hoffjan and Epplen, 2005). However, these uncertainties need to be further clarified before corroborating the preventive impact of probiotics in the prevention and/ or treatment of AD. The An official website of the United States government. Differences in study samples, study populations, and intervention methods contributed to the heterogeneity. Flster-Holst R., Moises H. W., Yang L., Fritsch W., Weissenbach J., Christophers E. (1998). This increased rate of incidence has changed the focus of research on AD toward epidemiology, prevention, and treatment. We contacted the corresponding authors but did not receive useful replies. Comprehensive analysis of the gene encoding filaggrin uncovers prevalent and rare mutations in ichthyosis vulgaris and atopic eczema. (2015) (2) that evaluated the use of any probiotic culture/strain/dose/therapy regimen (including studies on fermented yogurt; all dosage forms including tablets, powders, oil suspensions, and capsules were included). Some reports have explored this topic; however, the utility of probiotics for AD remains to be firmly established. Anania C, Brindisi G, Martinelli I, Bonucci E, D'Orsi M, Ialongo S, Nyffenegger A, Raso T, Spatuzzo M, De Castro G, Zicari AM, Carraro C, Piccioni MG, Olivero F. Int J Mol Sci. The study was performed for a time period of 12 weeks among children who were one and 12 years old. Machura E., Karczewska K., Findysz-Wylag B., Mazur B., Lodwich M. (2008). Probiotics may reduce the incidence of atopic dermatitis in at-risk infants. Matsumoto M., Aranami A., Ishige A., Watanabe K., Benno Y. The reported efficacy of probiotics in children < 1 year old was 1.03 (95%CI, 7.05 to 4.99) and that in children 118 years old was 4.50 (95%CI, 7.45 to 1.54; P < 0.001). Sistek D., Kelly R., Wickens K., Stanley T., Fitzharris P., Crane J. about navigating our updated article layout. 2017 Sep 6;7:392. doi: 10.3389/fcimb.2017.00392. Infants and children with AD are typically treated with topical corticosteroids (TCS), antihistamines, and even antibiotics (Totri et al., 2017). atopic dermatitis, skin diseases, inflammation, clinical trials, probiotics. MeSH And most importantly, should the use of probiotics be personalized? Changsha, China, 2Department of Dermatology, Xiangya Hospital, Central South University, (2013a). Objective: Atopic dermatitis (AD) is a prevalent, burdensome, and psychologically important pediatric concern. Prebiotics and probiotics in atopic dermatitis. Atopic dermatitis is a common skin disease. As the leading non-fatal medical skin disorder, AD imposes severe psychosocial burdens on pediatric patients and their families (Chamlin and Chren, 2010; Silverberg, 2016; Sidbury and Khorsand, 2017). Weston S., Halbert A., Richmond P., Prescott S. L. (2005). Probiotics and prebiotics in preventing food allergy and eczema. The .gov means its official. First, we attempted to minimize heterogeneity and publication bias, but significant heterogeneity among trials remained evident. Hippocrates (460370) stated that All diseases begin in the gut, which is the earliest suggestion that bacteria affect health (Hippocrates, 2002). The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Undeniably, considering the increasing occurrence of eczema and the lack of a definitive cure, patients and parents often go to complementary and alternative medicine treatments when they are dissatisfied by the side effects of allopathic medicine (Astin 1998 ). Totri C. R., Eichenfield L. F., Logan K., Proudfoot L., Schmitt J., Lara-Corrales I., et al.. (2017). The terms used for the search were 'prebiotic', 'probiotic', 'atopic dermatitis', 'Severity Scoring of Atopic Dermatitis', and . Lactobacillus salivarius plus fructo-oligosaccharide is superior to fructo-oligosaccharide alone for treating children with moderate to severe atopic dermatitis: a double-blind, randomized, clinical trial of efficacy and safety. FOIA 2012 Jan;166(1):129-36. doi: 10.1111/j.1365-2133.2011.10596.x. Atopic dermatitis (AD) is a common, recurrent, chronic inflammatory skin disease that is a cause of considerable economic and social burden. FOIA CCL28 cannot replace ige for severity by objective SCORAD index in atopic dermatitis in children. . (2006). However, these medications exert several adverse side effects, and AD symptoms may recur rapidly after treatment is stopped. Chilicka K, Dziedziora-Urbiska I, Szygua R, Asanova B, Nowicka D. Life (Basel). Our meta-analysis had certain limitations. (2007). Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease accompanied with severe itching and skin lesions. We initially screened 392 articles, excluded those that did not meet our inclusion criteria, and finally retained 26 articles. An imbalance in Th1/ Th2 immune response has been related to the pathogenesis of allergic diseases (Romagnani et al., 1991; Romagnani, 2000; Schmidt-Weber and Blaser, 2004). Significant differences in SCORAD values favoring probiotics over the control were observed overall (MD, 3.07; 95%CI, 6.12 to 0.03; P < 0.00001). Zhang J., Guo Z., Xue Z., Sun Z., Zhang M., Wang L., et al.. (2015). Probiotics may reduce the duration and severity of all-cause infectious diarrhea. SCORAD, developed by the European Task Force on AD in 1993 (1993), assesses the AD area, clinical features, visual analog scale data, and clinical symptoms, and it is widely used to evaluate AD severity in children (Machura et al., 2008). Kawashima T., Noguchi E., Arinami T., Yamakawa-Kobayashi K., Nakagawa H., Otsuka F., et al. Probiotics in the treatment and prevention of atopic dermatitis. Atopic dermatitis (AD) has been shown to be closely related to gut dysbiosis mediated through the gut-skin axis, and thus the gut microbiome has recently been explored as a potential therapeutic target for the treatment of AD. atopic dermatitis; chronic ski inflammation; gut microbiome; prebiotics; probiotics; synbiotics. The genuine works of Hippocrates, Positive effect of probiotics on constipation in children: a systematic review and meta-analysis of six randomized controlled trials, Effect of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials. 2015 Dec;42(12):1137-42. doi: 10.1111/1346-8138.13072. Prebiotics and synbiotics: two promising approaches for the treatment of atopic dermatitis in children above 2 years. According to the revised hygiene hypothesis this increase is caused by a changed intestinal colonization pattern during infancy, which has an impact on the immune system. A number of studies on LGG suggest that the combination of probiotic strains and prebiotic mixtures imposes positive effects in terms of preventing the onset of AD (Kukkonen et al., 2007; Mikael, 2013; Foolad and Armstrong, 2014). Probiotics, Prebiotics, and Synbiotics for the Treatment and Prevention of Adult Dermatological Diseases. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The incidence of AD was investigated when the infants who had received probiotic strains of L. salivarius CUL61, L. paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34, and Bifidobacterium bifidum CUL20 reached 2 years of age, and the results were compared to those of toddlers who had not received the placebo. They were also found to reduce the severity of AD in approximately half of the RCTs evaluated, although they were not found to change significantly most of the inflammatory markers measured in the majority of the RCTs evaluated. There are also conflicting data regarding the outcome of these studies; some confirming a positive effect of prebiotics, probiotics or synbiotics and some showing no efficacy at all. 2022 Mar 15;12(3):422. doi: 10.3390/life12030422. In contrast, Gore et al. Lactobacilli and bifidobacteria induce differential interferon- profiles in dendritic cells. Data from 1,070 children (intervention group, 553; control group, 517) were assessed. Epub 2015 Nov 27. Sestito S, D'Auria E, Baldassarre ME, Salvatore S, Tallarico V, Stefanelli E, Tarsitano F, Concolino D, Pensabene L. Front Pediatr. Disclaimer, National Library of Medicine Michail S. K., Stolfi A., Johnson T., Onady G. M. (2008). Cukrowska B., Ceregra A., Klewicka E., Slizewska K., Motyl I., Libudzisz Z. The application of probiotics reduced the inflammation by suppressing the levels of INF-, IL-4, and Th17 cells in splenic CD4 T-cells and increasing the expression of IL-10 and Treg-related cytokines in mesenteric lymph nodes as shown in Figure Figure11 (Jan et al., 2012). PRISMA features both a checklist and a flow diagram. Figure Figure2B2B presents the individual risks of bias, again as perceived by the reviewers. The ePub format is best viewed in the iBooks reader. (2013a,b) confirms the involvement of dendritic cells, following the transfer of mature dendritic cells in mice, in the suppression of allergic disease by probiotics. The immune system in healthy adults and patients with atopic dermatitis seems to be affected differently by a probiotic intervention. Atopic dermatitis (AD) represents a chronic inflammatory skin condition in which the skin barrier is impaired; thus, the permeability is increased. Since this condition is currently increasing among children, it requires further study, as little is known regarding . MD scoring with probiotics treatment compared to control and placebo interventions by location. The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. 2021 Sep 12;22(18):9846. doi: 10.3390/ijms22189846. No effects of probiotics on atopic dermatitis in infancy: a randomized placebo-controlled trial, Quality-of-life outcomes and measurement in childhood atopic dermatitis. Atopic dermatitis, or eczema, is a skin condition common in infants and children. Nowicka D, Chilicka K, Dziedziora-Urbiska I. Pathogens. Microbiome and pediatric atopic dermatitis. Ogden et al. Narrowband ultraviolet B and medium-dose ultraviolet A1 are equally effective in the treatment of moderate to severe atopic dermatitis. Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors. IR and VB designed and wrote the manuscript, JL and WP conception and design the outline, SK and YK did the critical review and approved the manuscript. government site. Pessi T., Sutas Y., Hurme M., Isolauri E. (2000). Before 2014;5(202) doi: 10.4172/2155-9899.1000202. Probiotic bacteria in the management of atopic disease: underscoring the importance of viability. 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