Effects of probiotics treatment and the prevention of atopic dermatitis/eczema in children : a systematic review

Background: Atopic dermatitis (AD) is one of the most common skin disorders seen in infants and children, affecting around 20% children worldwide. The frequently relapsing inflammatory condition can have a substantial impact to the quality of life of both patients and their families. Treatment is available to manage the symptoms of AD but there is no curative treatment for the disease currently, therefore the focus should be on AD prevention rather than treatment. Emerging evidence suggested that intestinal microbiota may modulate immunologic and inflammatory responses, which may influence the development of sensitization and allergy. There is increasing interest in the potential benefit of nutritional modulation of microbiota with probiotics supplementation during early infancy and pregnancy in reducing the risk of AD in children. Objective: This systematic review is to investigate the effects of probiotics treatment during pregnancy and early infancy in the prevention of atopic dermatitis/eczema in children. Method: A systematic search was conducted using PubMed and MEDLINE to identify randomized-controlled trials (RCTs) that investigate the effects of probiotics supplementation in the prevention of AD in children. Key words searched were probiotic, children, pediatric, infant, toddler and atopic dermatitis/eczema. Eight RCTs were included in this review. Results: Out of the eight RCTs included in this review, four studies reported to have positive effects of probiotics in lowering the risk of developing eczema and reducing the frequency of eczema. The other four studies reported no effects of probiotics supplementation in AD prevention in children. Conclusion: This review showed promising results towards positive effect of probiotics supplementation in reducing the occurrence and incidence of AD in children. However, there are several limitations which may cause variation in the measure outcome. Further investigation would be needed to determine, with consideration of types, strains and dosage of probiotics administrated, timing of supplementation, mode of delivery and breastfeeding practice in order to draw a definite conclusion to prove the role of probiotics in the prevention of AD in children.published_or_final_versionPublic HealthMasterMaster of Public Healt