Postnatal probiotic supplementation can prevent and optimize treatment of childhood asthma and atopic disorders: A systematic review of randomized controlled trials

Abstract

BackgroundAlthough several randomized controlled trials (RCTs) published over the past 5 years show that prenatal or postnatal probiotics may prevent or optimize the treatment of childhood asthma and atopic disorders, findings from the systematic reviews and meta-analyses of these studies appear inconsistent. More recent RCTs have focused on postnatal probiotics, and linked specific probiotic strains to better disease outcomes.ObjectiveThis systematic review aimed to determine if postnatal probiotics are as effective as prenatal probiotics in preventing or treating childhood asthma and atopic disorders.MethodsWe searched the PubMed, Medline, Google Scholar, and EMBASE databases for RCTs published within the past 5 years (from 2017 to 2022). We included only full-text RCTs on human subjects published in or translated into the English language. We retrieved relevant data items with a preconceived data-extraction form and assessed the methodological quality of the selected RCTs using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. We qualitatively synthesized the retrieved data to determine any significant differences in study endpoints of the probiotic and placebo groups.ResultsA total of 1,320 participants (688 and 632 in the probiotic and placebo groups) from six RCTs were investigated. One RCT showed that early Lactobacillus rhamnosus GG (LGG) led to a reduction in the cumulative incidence rate of asthma. Another study demonstrated that mixed strains of Lactobacillus paracasei and Lactobacillus fermentum could support clinical improvement in children with asthma while one trial reported a significant reduction in the frequency of asthma exacerbations using a mixture of Ligilactobacillus salivarius and Bifidobacterium breve. Three trials showed that a combination of LGG and Bifidobacterium animalis subsp lactis, Lactobacillus rhamnosus alone, and a probiotic mixture of Lactobacillus ŁOCK strains improved clinical outcomes in children with atopic dermatitis and cow-milk protein allergy.ConclusionsPostnatal strain-specific probiotics (in single or mixed forms) are beneficial in preventing and treating atopic dermatitis and other allergies. Similarly, specific strains are more effective in preventing asthma or improving asthma outcomes. We recommend more interventional studies to establish the most useful probiotic strain in these allergic diseases.

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

“…Jiang et al 54 . and Uwaezuoke et al 55 . discovered that probiotics could relieve AD symptoms, especially using mixed‐strain probiotics ( Lactobacillus and Bifidobacterium).…”

“…With regards to the types of MA, a mixture of probiotics (Lactobacillus and Bifidobacterium combined) was more effective than probiotics alone, which achieved the MCID in SCORAD index. Jiang et al 54 and Uwaezuoke et al 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.…”

Influence of the gut and airway microbiome on asthma development and disease

“…[88][89][90] In pregnant women and newborns (longitudinal), supplementation with these probiotics did not prevent asthma at a later age. [88][89][90] A study in children from 6 to 18 years old who received L. paracasei, L. fermentum or the combination in a mix for 3 months had a lower asthma severity and higher asthma control score (ACT). 91 Children in the same age group who received L. reuteri also had a higher ACT after 8 weeks of probiotic treatment.…”

Bacterial Metabolites: A Link between Gut Microbiota and Dermatological Diseases

“…The mixture of strains Bifidobacterium animalis subsp lactis CECT 8145, Bifidobacterium longum CECT 7347, and Lactobacillus casei CECT 9104 was associated with the best results in the pediatric population, and the mixture of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03 has the best results in adults [ 158 , 159 , 160 ]. Similar to AD, some probiotics may be effective in the prevention and treatment of allergies [ 161 , 162 ].…”