Can Mixed Strains of Lactobacillus and Bifidobacterium Reduce Eczema in Infants under Three Years of Age? A Meta-Analysis

Abstract

(1) Background: Whether early supplementation of probiotics to improve intestinal flora can effectively prevent eczema remains a controversial issue. We aimed to investigate the effect of a mixed strain of Lactobacillus and Bifidobacterium on eczema in infants under three years old at present; (2) Methods: We searched the databases of PubMed, Web of Science, and Cochrane Library, as well as National Knowledge Infrastructure (CNKI), WeiPu (VIP), and WanFang Data (WanFang) for randomized controlled trials (RCTs) of probiotics in the prevention of eczema in infants without language restriction. The main outcome was eczema incidence, while adverse events during the intervention constituted the secondary outcome. The random-/fixed-effects model was utilized to calculate the combined relative risk (RR) and 95% confidence interval (CI). The methodological quality of the study was evaluated using the Cochrane “bias risk” tool. According to the initial intervention time, subgroup analysis was carried out, follow-up time, family history, etc.; (3) Results: Nine articles were selected (2093 infants). The Lactobacillus and Bifidobacterium mixed strain could prevent eczema in infants under three years of age compared to the placebo (RR = 0.60; I2 = 67%; p < 0.001). Subgroup analysis revealed that the mixture of two probiotic strains had preventive effects on both infants with positive (RR = 0.53; I2 = 52%; p < 0.001) and negative (RR = 0.69; I2 = 62%; p = 0.02) family history; The follow-up time for ≤12 months (RR = 0.65; I2 = 12%; p = 0.01) and 12–24 months (RR = 0.60; I2 = 79%; p = 0.003), daily dose of probiotics ≤ 1 × 109 and > 1 × 109 colony forming units all can be effective (p < 0.01); Compared with the intervention of infants alone (RR = 0.63; I2 = 63%; p = 0.29), the effect of probiotics mixture at the beginning of pregnancy was more significant (RR = 0.59; I2 = 71%; p < 0.001); Except for the mixture of Lactobacillus rhamnosusGG (LGG) and Bifidobacterium longum (B. longum) (p = 0.18), other subgroups of intervention group can play a preventive effect (p < 0.05); (4) Conclusions: The mixed strain of Lactobacillus and Bifidobacterium can effectively reduce the incidence of eczema in infants under three years old. However, further research is needed to fully understand the exact mechanism of their effect on infant eczema.

Lactobacillus for the treatment and prevention of atopic dermatitis: Clinical and experimental evidence

“…In addition, the preventive effect of probiotics on pediatric AD is better than that of treatment ( Lee et al., 2008 ). A mixture of Lactobacillus and Bifidobacteria can effectively reduce the incidence of eczema in infants and young children during the first three years of life ( Sun et al., 2021 ). The preventive effects of probiotics on eczema appear to last until age of two ( Dang et al., 2013 ) and extend to the age four years ( Kuitunen, 2013 ).…”

Maternal exposure to antibiotics and risk of atopic dermatitis in childhood: a systematic review and meta-analysis

“…Both Lactobaccillus and Bifidobacterium are probiotics. Recent studies showed that early life exposure to these strains can reduce the risk of AD ( 34 ). However, the results of the studies in support of this hypothesis are still inconclusive.…”

The efficacy and safety of oral microecological agents as add‐on therapy for atopic dermatitis: A systematic review and meta‐analysis of randomized clinical trials

“… 55 discovered that probiotics could relieve AD symptoms, especially using mixed‐strain probiotics ( Lactobacillus and Bifidobacterium). Another meta‐analysis 56 also favored that mixed strains of Lactobacillus and Bifidobacterium could reduce the incidence of AD. Thus, a mixed‐strain probiotic component might be beneficial to patients with AD.…”