Probiotics and Atopic Dermatitis in Children
Abstract
:1. Introduction
2. Hypothesized Probiotics Mechanisms of Action in Allergic Diseases
3. Probiotics in the Prevention of Pediatric Atopic Dermatitis
4. Probiotics in the Treatment of Pediatric Atopic Dermatitis
Study | Partecipants | Probiotics | Type of study | Duration | Outcome |
---|---|---|---|---|---|
Kalliomäki et al. [22] | 132 high-risk infants for atopy | Lactobacillus rhamnosus GG (1 × 1010 cfu daily) | R, DB, PC | From 2–4 weeks prenatally to 24 weeks postnatally | At 2 years AD frequency halved in probiotic group vs. placebo (23% vs. 46%) |
Kalliomäki et al. [23] | 107 high-risk infants for atopy | Lactobacillus rhamnosus GG | Same cohort of 2001 | Same cohort of 2001 | 4 years follow-up: protective effect against AD still detected in probiotic group |
Kalliomäki et al. [24] | 116 high-risk infants for atopy | Lactobacillus rhamnosus GG | Same cohort of 2001 | Same cohort of 2001 | 7 years follow-up: incidence AD decreased during this period |
Rautava et al. [25] | 57 high-risk infants for atopy | Lactobacillus rhamnosus GG (2 × 1010 cfu daily) | R, DB, PC | Prenatal and 3 months postnatally to breastfeeding mothers | Reduction in AD prevalence in infants brestfed by mothers in probiotic group vs. placebo |
Kopp et al. [26] | 94 high-risk infants for atopy | Lactobacillus rhamnosus GG (5 × 109 cfu twice daily) | R, DB, PC | 4–6 weeks prenatally and 6 months after delivery | No reduced incidence of AD and no modification of severity |
Kukkonen et al. [27] | 925 high-risk infants for atopy | Lactobacillus rhamnosus GG (5 × 109 cfu), L. rhamnosus LC705 (5 × 109 cfu), Bifidobacterium breve Bb99 (2 × 108 cfu), Propionibacterium freudenreichii ssp. Shermanii JS (2 × 109 cfu) twice daily | R, DB, PC | From 2–4 weeks prenatally to 6 months post delivery | Probiotics reduced AD |
Dotterud et al. [28] | 292 infants without risk factor for atopy | Lactobacillus rhamnosus GG (5 × 109 cfu), L. acidophilus La-5 (5 × 109 cfu), Bifidobacterium animalis subsp. lactis (5 × 109 cfu) daily | R, DB, PC | To non-selected (for atopy) mothers from 36 weeks of gestation to 3 months postnatally (all infants breastfed) | Probiotics reduced the cumulative incidence of AD among children at 2 years of age |
Huurre et al. [29] | 140 high-risk infants for atopy | Lactobacillus rhamnosus GG (1 × 1010 cfu) and Bifidobacterium lactis (1 × 1010 cfu) daily | R, DB, PC | To mothers from the 1st trimester of pregnancy to the end of exclusive breastfeeding | Risk of sensitization at 12 months of age for infants of atopic mothers, was reduced by use of probiotics during pregnancy and lactation |
Niers et al. [30] | 102 high-risk infants for atopy | Bifidobacterium Bifidum (1 × 109 cfu), Bifidobacterium lactis (1 × 109 cfu), Lactococcus lactis (1 × 109 cfu) daily | R, DB, PC | To mothers from 6 weeks prenatally and to infants for 12 months postnatally | Probiotics shows a preventive effect of incidence of AD in high-risk infants during the first 2 years of life |
Kim et al. [31] | 112 high-risk infants for atopy | Bifidobacterium Bifidum (1.6 × 109 cfu), Bifidobacterium lactis (1.6 × 109 cfu), Lactobacillus Acidophilus (1.6 × 109 cfu) daily | R, DB, PC | To mothers from 8 weeks prenatally and to mothers/infants for 6 months postnatally | At 6 and 12 months the prevalence of AD in probiotics group was reduced than in placebo group. Cumulative incidence of AD significantly lower in probiotics group at 12 months |
Soh et al. [32] | 253 high-risk infants for atopy | Bifidobacterium longum (1 × 107 cfu), Lactobacillus rhamnosus (2 × 107 cfu) daily | R, DB, PC | To infants from birth to 6 months with milk formula | No effect on prevention of AD in the first year of life |
Kuitunen et al. [33] | 891 high-risk infants for atopy | Lactobacillus rhamnosus GG (5 × 109 cfu), L. rhamnosus LC705 (5 × 109 cfu), Bifidobacterium breve Bb99 (2 × 108 cfu), Propionibacterium freudenreichii ssp. shermanii JS (2 × 109 cfu) twice daily | R, DB, PC | To mothers from 36 weeks of gestation prenatally and to infants postnatally until 6 months of age | At 5 years of age no significant difference appeared in frequencies of AD and IgE associated (atopic) eczema between probiotics and placebo groups. Only cesarean-delivered children had significantly fewer incidence of AD |
Wickens et al. [34] | 474 high-risk infants for atopy | L. rhamnosus (6 × 109 cfu) or Bifidobacterium animalis subsp. lactis (9 × 109 cfu) daily | R, DB, PC | To mothers from 35 weeks prenatally to 6 months if breastfeeding and to infants from birth to 2 years | Only L. rhamnsosus reduced cumulative prevalence of AD by 2 years. No effects for B. animalis |
West et al. [35] | 179 infants | Lactobacillus F19 (1 × 108 cfu daily) | R, DB, PC | To infants during weaning from 4 to 13 months of age | Cumulative incidence of AD at 13 months of life was lower in probiotic group |
Taylor et al. [36] | 178 high-risk infants for atopy | Lactobacillus acidophilus (3 × 109 cfu daily) | R, DB, PC | Newborn of allergic mothers received probiotic or placebo for 6 months | At 6 months or 1 year no reduction in AD in probiotic group vs. placebo |
Abrahamsson et al. [37] | 188 high-risk infants for atopy | Lactobacillus reuteri ATCC (1 × 108 cfu daily) | R, DB, PC | Prenatally to mothers from 36 gestational age and postnatally to infants for 1 year | For AD similar cumulative incidence for probiotic and placebo groups. In probiotic group less IgE-associated eczema during 2 years |
Boyle et al. [38] | 250 pregnant women carrying infants at high risk of atopy | Lactobacillus rhamnosus GG (1.8 × 1010 cfu) daily | R, PC | To pregnant women from the 36th week of gestation until delivery | At 1 year of age, no reduction in incidence of AD and IgE-associated eczema in infants of supplemented mothers |
Study | Partecipants | Probiotics | Type of study | Duration | Outcome |
---|---|---|---|---|---|
Majamaa and Isolauri [47] | 27 infants (1st study) and 11 breastfed infants (2nd study) | Lactobacillus rhamnosus GG (5 × 108 cfu/gm formula or 2 × 1010 cfu twice daily to nursing mothers) | R, DB, PC | 1st: Cow’s milk elimination diet plus formula milk with or without LGG for 4 weeks. 2nd: LGG to mothers during breastfeeding for 4 weeks | After 4 weeks significant SCORAD score reduction (extent, intensity and subjective score) in probiotic group. No difference between groups at 2 months |
Isolauri et al. [48] | 27 infants with AD during breastfeeding | Lactobacillus rhamnosus GG (3 × 108 cfu/g) or Bifidobacterium lactis Bb-12 (1 × 109 cfu/g) | R, DB, PC | 4 weeks | At 2 months, significant improve in SCORAD score in probiotics groups |
Kirjavainen et al. [49] | 21 infants with early onset AD assumed hydrolyzed whey formula | Bifidobacterium lactis Bb-12 (1 × 109 cfu/g) | R, DB, PC | Not specified | Probiotic supplementation modulates composition of gut microbiota and alleviate symptoms of atopy |
Kirjavainen et al. [50] | 35 infants (5.5 months mean age) with AD and suspected (CMA) | Viable Lactobacillus GG (1 × 109 cfu/g) or heat-inactivated LGG | R, DB, PC | Mean length of intervention period of 7.5 weeks | Significant reduction of SCORAD score in viable LGG group |
Weston et al. [51] | 53 children (6–18 months af age) with AD | Lactobacillus fermentum (1 × 109 cfu) twice daily | R, DB, PC | 8 weeks | Probiotic improved severity of AD in children |
Woo et al. [52] | 75 children (2–10 years of age) with AEDS | Lactobacillus sakei (5 × 109 cfu) twice daily | R, DB, PC | 12 weeks | Probiotic supplementation improved clinical severity of AEDS and decreased chemokine levels |
Brouwer et al. [53] | 50 children (<5 months of age) with AD and suspected CMA | Lactobacillus rhamnosus (3 × 108 cfu/g) or Lactobacillus GG (3 × 108 cfu/g) | R, DB, PC | 12 weeks | No clinical or immunological effect of probiotics in children with AD |
Folster-Holst et al. [54] | 54 children (1–55 months of age) with moderate or severe AD | Lactobacillus rhamnosus strain GG (5 × 109 cfu) twice daily | R, DB, PC | 8 weeks | No significant difference in clinical outcome by administration of probiotic |
Gruber et al. [55] | 102 infants (3–12 months of age) with mild to moderate AD | Lactobacillus rhamnosus strain GG (5 × 109 cfu) twice daily | R, DB, PC | 12 weeks | No therapeutic effect of probiotic in mild-to-moderate AD |
Nermes et al. [56] | 37 infants (6.5 months mean age) with AD | Lactobacillus rhamnosus strain GG (3 × 157 cfu/g) daily | R, DB, PC | 12 weeks | SCORAD indices decreased in both probiotic and placebo groups |
Gore et al. [57] | 208 children (3–6 months of age) with AD | Lactobacillus paracasei (1010 cfu) or Bifidobacterium lactis (1010 cfu) daily | R, DB, PC | 12 weeks | No significant difference in SCORAD between all groups at any time-point up to age 3 year |
Rosenfeldt et al. [58] | 43 children with AD 1–13 years old | Lactobacillus rhamnosus (1010 cfu) and L. reuteri (1010 cfu) twice daily | R, DB, PC | 6 weeks | Moderate improvement of clinical severity of AD with administration of probiotics Lactobacillus strains |
Rosenfeldt et al. [59] | 41 children (mean age 4 years) with moderate and severe atopic dermatitis | Lactobacillus rhamnosus (1010 cfu) and L reuteri DSM (1010 cfu) twice daily | R, DB, PC | 6 weeks | Probiotic supplementation may stabilize the intestinal barrier function with an improvement of SCORAD score |
Viljanen et al. [60] | 230 children (mean age 6.4 months) with AD and suspected CMA | LGG (5 × 109 cfu) or mixture: LGG (5 × 109 cfu), L. rhamnosus LC705 (5 × 109 cfu), Bifidobacterium breve (2 × 108 cfu), Propionibacterium freudenreichii ssp. Shermanii JS (2 × 109 cfu) twice daily | R, DB, PC | 4 weeks | Reduction in SCORAD score only in IgE-associated AD in LGG group |
Sistek et al. [61] | 59 children (1–10 years of age) with AD | Lactobacillus rhamnosus (2 × 1010 cfu/g) and Bifidobacterium lactis (2 × 1010 cfu/g) daily | R, DB, PC | 12 weeks and follow-up until 18 weeks | Probiotics improved AD only in food sensitized children |
Gerasimov et al. [62] | 90 children (1–3 years of age) with moderate to severe AD | Lactobacillus acidophilus (5 × 109 cfu) and Bifidobacterium lactis (5 × 109 cfu) twice daily | R, DB, PC | 8 weeks | Probiotics improved significantly clinical severity of AD with a greater decrease in SCORAD score in children supplemented |
Yeşilova et al. [63] | 40 children (1–13 years of age) with moderate to severe AD | B. bifidum (2 × 109 cfu), L. acidophilus (2 × 109 cfu), L. casei (2 × 109 cfu), and L. salivarius (2 × 109 cfu) twice daily | R, DB, PC | 8 weeks | Probiotic in AD patients effectively reduced the SCORAD index |
Passeron et al. [64] | 39 children (>2 years of age) with moderate and severe AD | Lactobacillus rhamnosus Lcr35 (1.2 × 109 cfu) plus prebiotic preparation vs prebiotic alone three times a day | R, DB | 12 weeks | Both synbiotic and prebiotic alone significantly improve the manifestations of AD |
Van der Aa et al. [65] | 82 infants (0–7 months af age) with AD exclusively formula-fed | Bifidobacterium breve (1.3 × 109 cfu/100 mL) plus prebiotic mixture | R, DB, PC | 12 weeks | Probiotic and prebiotic not have beneficial effect on AD severity in infants |
Wu et al. [66] | 54 children (2–14 years of age) with moderate to severe AD | Lactobacillus salivarius (2 × 109 cfu) plus prebiotic vs. prebiotic alone | R, DB | 8 weeks | In probiotic group was seen a significantly lower SCORAD score at 10 weeks |
5. Conclusions
References
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Meneghin, F.; Fabiano, V.; Mameli, C.; Zuccotti, G.V. Probiotics and Atopic Dermatitis in Children. Pharmaceuticals 2012, 5, 727-744. https://doi.org/10.3390/ph5070727
Meneghin F, Fabiano V, Mameli C, Zuccotti GV. Probiotics and Atopic Dermatitis in Children. Pharmaceuticals. 2012; 5(7):727-744. https://doi.org/10.3390/ph5070727
Chicago/Turabian StyleMeneghin, Fabio, Valentina Fabiano, Chiara Mameli, and Gian Vincenzo Zuccotti. 2012. "Probiotics and Atopic Dermatitis in Children" Pharmaceuticals 5, no. 7: 727-744. https://doi.org/10.3390/ph5070727