Disclosures: Tan-Lim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
August 16, 2021
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Probiotics may reduce risk for atopic dermatitis in pregnant women, infants

Disclosures: Tan-Lim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Certain probiotic strains lowered the risk for developing atopic dermatitis when administered to pregnant women and infants, according to a systematic meta-analysis published in Pediatric Allergy and Immunology.

“After the completion of an earlier study on the comparative effectiveness of probiotics in the treatment of pediatric atopic dermatitis, we were interested to find out its role on prevention,” Carol Stephanie C. Tan-Lim, MD, of the department of clinical epidemiology at the University of the Philippines, told Healio. “Many children are affected by atopic dermatitis, and we wanted to investigate if certain probiotic strains may be of use in the prevention of this disease.”

The researchers reviewed data from 35 fully randomized placebo-controlled trials published through April 12, 2020, that examined probiotic efficacy in pediatric atopic dermatitis prevention, 14 of which were follow-up studies of completed randomized controlled trials. The 21 original studies examined the efficacy of six single probiotic strains and/or nine mixed strains administered orally compared with placebo.

Researchers excluded studies that involved patients with a previous diagnosis of atopic dermatitis or other allergic diseases, that had a primary interest in prebiotics or synbiotics, and that only reported surrogate outcomes.

Two researchers extracted data separately to determine how effectively probiotic strains prevented atopic dermatitis and whether there were adverse events. Lack of treatment response was assumed when patient information was missing.

Mix8 (Lactobacillus paracasei ST11, Bifidobacterium longum BL999) showed the greatest reduction in risk for atopic dermatitis compared with placebo (RR = 0.46; 95% CI, 0.25-0.85), although researchers noted these data were based on low-quality evidence.

Mix3 (L. rhamnosus GG, B. animalis ssp lactis Bb-12; RR = 0.5, 95% CI, 0.27-0.94) and Mix6 (B. longum BL999, L. rhamnosus LPR; RR = 0.58; 95% CI, 0.37-0.92) also lowered the risk for atopic dermatitis, again based on low-quality evidence. The association with LP (L. paracasei ssp paracasei F19) did not reach statistical significance (RR = 0.49; 95% CI, 0.2-1.19).

LGG (L. rhanosus GG) appeared to cause fewer adverse events (RR = 0.7; 95% CI, 0.32-1.52), whereas Mix4 (B. bifidum BGN4, B. lactis AD011, L. acidophilus AD031) appeared to increase likelihood of adverse events (RR = 1.06; 95% CI, 0.02-51.88).

Tan-Lim and colleagues conceded that RR analysis was based on low-quality evidence, thus they could only conclude that Mix8 and Mix3 “probably” reduced risk for atopic dermatitis.

Carol Stephanie C. Tan-Lim

“It is interesting to note that the three probiotic preparations that had statistically significant benefit compared with placebo all contained mixtures of probiotic strains (Mix8, Mix3 and Mix6),” they wrote. “This result suggests the synergistic effect of the probiotic strains included in the mixture.”

Moving forward, comparison of the highest-ranked probiotics and investigation of ideal timing, dosage and duration of administration is needed to appropriately treat pediatric atopic dermatitis, according to the researchers.

For more information:

Carol Stephanie C. Tan-Lim, MD, can be reached at cctan7@up.edu.ph.