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Cited by 65Probiotics and Fermented FoodsDermatology and Skin DiseasesFood Allergy and Anaphylaxis Research

Comparative effectiveness of probiotic strains on the prevention of pediatric atopic dermatitis: A systematic review and network meta-analysis

Tan‐Lim, Carol Stephanie C., Esteban‐Ipac, Natasha Ann R., Recto, Marysia Stella T., Castor, Mary Anne R., Casis‐Hao, Roxanne J., Nano, Aimee Lou M.·2021·Pediatric Allergy and Immunology
DOI 10.1111/pai.13514
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Abstract

Abstract Background Atopic dermatitis is the most common chronic skin disease affecting the pediatric population. Probiotics have been proposed to be effective in preventing the development of pediatric atopic dermatitis. Although studies show promise for the use of probiotics, the evidence is still inconclusive due to significant heterogeneity and imprecision. Objective To determine the comparative effectiveness of the different types of probiotic strains in preventing the development of atopic dermatitis among pediatric patients. Methodology A systematic search of Cochrane Library, MEDLINE, TRIP Database, and Centre for Research and Dissemination was conducted. Manual search of the reference lists and search for unpublished articles were also done. All randomized controlled trials available from inception until April 12, 2020, on the use of probiotics in the prevention of atopic dermatitis among children were included. The comparator groups considered are other probiotic strains and placebo. The primary outcome of interest was the development of atopic dermatitis. Two authors independently searched for articles, screened the articles for inclusion, appraised the articles using the Cochrane risk of bias tool version 2, and extracted the data. In case of disagreement, the two authors discussed the source of disagreement until consensus was reached. If consensus was not reached, an independent third party reviewer was consulted. Frequentist network meta‐analysis was conducted using STATA 14 software. The ranking probabilities and surface under the cumulative ranking curve (SUCRA) values were obtained to determine ranking of the different probiotic strains based on efficacy and safety data. Results We included 21 original studies represented by 35 records and a total of 5406 children with atopic dermatitis as diagnosed by clinicians or fulfillment of validated diagnostic criteria. All studies were randomized placebo‐controlled trials. The top 3 probiotic preparations in terms of efficacy in reducing the risk of atopic dermatitis are Mix8 ( Lactobacillus paracasei ST11, Bifidobacterium longum BL999), LP ( Lactobacillus paracase i ssp paracasei F19) and Mix3 ( Lactobacillus rhamnosus GG, Bifidobacterium animalis ssp lactis Bb‐12). Mix8 compared with placebo probably reduces the risk of atopic dermatitis based on low‐quality evidence (RR = 0.46, 95% CI 0.25‐0.85). Mix3 compared with placebo also probably reduces the risk of atopic dermatitis based on low‐quality evidence (RR = 0.50, 95% CI 0.27‐0.94). It is uncertain whether LP compared with placebo reduces the risk of atopic dermatitis due to very‐low‐quality certainty of evidence (RR = 0.49, 95% CI 0.20‐1.19). In terms of adverse events, LGG may slightly lead to less adverse events compared with placebo based on low‐quality evidence (RR = 0.70, 95% CI 0.32‐1.52). Mix4 may slightly lead to more adverse events compared with placebo based on low‐quality evidence (RR = 1.06, 95% CI 0.02‐51.88). Based on subgroup analysis of studies involving infants, Mix3 compared with placebo probably reduces the risk of atopic dermatitis based on low‐quality evidence (RR = 0.46, 95% CI 0.22‐0.97). In the subgroup analysis of studies where probiotics were administered to pregnant women and to infants, LRH compared with placebo probably reduces the risk of atopic dermatitis based on moderate‐quality evidence (RR = 0.54, 95% CI 0.26‐1.11). Conclusion Certain probiotic preparations demonstrate efficacy in reducing the risk of developing atopic dermatitis when administered to pregnant women, infants, or both.

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  • Clinical efficacy of probiotics for allergic diseases is inconsistent due to substantial interindividual variability in lifestyle, microbiome composition, health status, gender, and age.

    “Although in vitro and in vivo studies suggest potential benefits, clinical efficacy is inconsistent due to substantial interindividual variability in lifestyle, microbiome composition, health status, gender, and age [89,90,91].”

    From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [91]

  • Only some strains of Lactobacillus spp., Bifidobacterium spp., and Propionibacterium spp. showed beneficial results in reducing the risk of atopic eczema in children, while other strains of the same species did not.

    “Following these studies, it was mentioned that only some strains of Lactobacillus spp., Bifidobacterium spp., and Propionibacterium spp. showed beneficial results, while other strains of the same species did not.”

    From The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties (2024) · cites this paper as [131]

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Authors
Tan‐Lim, C. S. C., Esteban‐Ipac, N. A. R., Recto, M. S. T., Castor, M. A. R., Casis‐Hao, R. J., & Nano, A. L. M.
Affiliations
  • Philippine General Hospital (PH)
  • University of the Philippines Manila (PH)
  • Department of Pediatrics Division of Allergy and Immunology University of the Philippines Manila ‐ Philippine General Hospital Manila Philippines
Corresponding author
Tan‐Lim, Carol Stephanie C.
ORCID
Venue
Pediatric Allergy and Immunology
Publisher
Wiley
Published
2021-05-15
Volume
32
Issue
6
Pages
1255-1270
ISSN
  • 0905-6157 (ISSN-L)
  • 1399-3038
DOI
10.1111/pai.13514
OpenAlex
W4240658500
Cited by
65
References
53
Citations by year
2026: 8 · 2025: 11 · 2024: 14 · 2023: 12 · 2022: 13 · 2021: 7
FWCI
1.05
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
Pediatric Allergy and Immunology (publishedVersion)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
  • Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
Keywords
pediatric atopic dermatitis, probiotics, atopic dermatitis prevention, Lactobacillus rhamnosus GG, Bifidobacterium animalis subsp. lactis BB-12, surface under the cumulative ranking curve

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