Probiotics for the prevention of allergy: A systematic review and meta-analysis of randomized controlled trials

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• 作者：Carlos A. Cuello-Garcia ; MD^a ; ^b ; Jan L. Bro偶ek ; MD ; PhD^a ; ^c ; ^{brozekj@mcmaster.ca" class="auth_mail" title="E-mail the corresponding author} ; Alessandro Fiocchi ; MD^d ; Ruby Pawankar ; MD^e ; Juan José ; Yepes-Nuñ ; ez ; MD ; MSc(Epi)^a ; ^f ; Luigi Terracciano ; MD^g ; Shreyas Gandhi ; BHSc^c ; ^h ; Arnav Agarwal ; BHSc^c ; ^h ; Yuan Zhang ; MD^a ; Holger J. Schü ; nemann ; MD ; MSc ; PhD^a ; ^c
• 关键词：Allergy ; prevention ; probiotics systematic reviews
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：136
• 期：4
• 页码：952-961
• 全文大小：486 K

文摘

Allergic diseases are considered a health burden because of their high and constantly increasing prevalence, high direct and indirect costs, and undesirable effects on quality of life. Probiotics have been suggested as an intervention to prevent allergic diseases.

Objective

We sought to synthesize the evidence supporting use of probiotics for the prevention of allergies and inform World Allergy Organization guidelines on probiotic use.

Methods

We performed a systematic review of randomized trials assessing the effects of any probiotic administered to pregnant women, breast-feeding mothers, and/or infants.

Results

Of 2403 articles published until December 2014 identified in Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, 29 studies fulfilled a priori specified inclusion criteria for the analyses. Probiotics reduced the risk of eczema when used by women during the last trimester of pregnancy (relative risk [RR], 0.71; 95% CI, 0.60-0.84), when used by breast-feeding mothers (RR, 0.57; 95% CI, 0.47-0.69), or when given to infants (RR, 0.80; 95% CI, 0.68-0.94). Evidence did not support an effect on other allergies, nutrition status, or incidence of adverse effects. The certainty in the evidence according to the Grading of Recommendation Assessment Development and Evaluation approach is low or very low because of the risk of bias, inconsistency and imprecision of results, and indirectness of available research.

Conclusion

Probiotics used by pregnant women or breast-feeding mothers and/or given to infants reduced the risk of eczema in infants; however, the certainty in the evidence is low. No effect was observed for the prevention of other allergic conditions.