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Probiotic administration in early life, atopy, and asthma: a meta-analysis of clinical trials.
Pediatrics. 2013 Sep; 132(3):e666-76.Ped

Abstract

BACKGROUND AND OBJECTIVE

Probiotics may reduce the risk of atopy and asthma in children. However, results from clinical trials have been conflicting, and several of them may have been underpowered. We performed a meta-analysis of randomized, placebo-controlled trials to assess the effects of probiotic supplementation on atopic sensitization and asthma/wheeze prevention in children.

METHODS

Random-effects models were used to calculate pooled risk estimates. Meta-regression was conducted to examine the effect of potential factors on probiotics efficacy.

RESULTS

Probiotics were effective in reducing total immunoglobulin E (IgE) (mean reduction: -7.59 U/mL [95% confidence interval (CI): -14.96 to -0.22]; P = .044). Meta-regression showed that the reduction in IgE was more pronounced with longer follow-up. Probiotics significantly reduced the risk of atopic sensitization when administered prenatally (relative risk: 0.88 [95% CI: 0.78 to 0.99]; P = .035 for positive result on the skin prick test and/or elevated specific IgE to common allergens) and postnatally (relative risk: 0.86 [95% CI: 0.75 to 0.98]; P = .027 for positive result on skin prick test). Administration of Lactobacillus acidophilus, compared with other strains, was associated with an increased risk of atopic sensitization (P = .002). Probiotics did not significantly reduce asthma/wheeze (relative risk: 0.96 [95% CI: 0.85 to 1.07]).

CONCLUSIONS

Prenatal and/or early-life probiotic administration reduces the risk of atopic sensitization and decreases the total IgE level in children but may not reduce the risk of asthma/wheeze. Follow-up duration and strain significantly modified these effects. Future trials for asthma prevention should carefully select probiotic strain and consider longer follow-up.

Authors+Show Affiliations

Division of Pediatric Pulmonology, Department of Pediatrics, University of Miami, Miami, FL, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

23958764

Citation

Elazab, Nancy, et al. "Probiotic Administration in Early Life, Atopy, and Asthma: a Meta-analysis of Clinical Trials." Pediatrics, vol. 132, no. 3, 2013, pp. e666-76.
Elazab N, Mendy A, Gasana J, et al. Probiotic administration in early life, atopy, and asthma: a meta-analysis of clinical trials. Pediatrics. 2013;132(3):e666-76.
Elazab, N., Mendy, A., Gasana, J., Vieira, E. R., Quizon, A., & Forno, E. (2013). Probiotic administration in early life, atopy, and asthma: a meta-analysis of clinical trials. Pediatrics, 132(3), e666-76. https://doi.org/10.1542/peds.2013-0246
Elazab N, et al. Probiotic Administration in Early Life, Atopy, and Asthma: a Meta-analysis of Clinical Trials. Pediatrics. 2013;132(3):e666-76. PubMed PMID: 23958764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Probiotic administration in early life, atopy, and asthma: a meta-analysis of clinical trials. AU - Elazab,Nancy, AU - Mendy,Angelico, AU - Gasana,Janvier, AU - Vieira,Edgar R, AU - Quizon,Annabelle, AU - Forno,Erick, Y1 - 2013/08/19/ PY - 2013/8/21/entrez PY - 2013/8/21/pubmed PY - 2013/10/31/medline KW - atopic sensitization KW - childhood asthma KW - childhood atopy KW - intestinal microbiome KW - meta-analysis KW - probiotics KW - total IgE SP - e666 EP - 76 JF - Pediatrics JO - Pediatrics VL - 132 IS - 3 N2 - BACKGROUND AND OBJECTIVE: Probiotics may reduce the risk of atopy and asthma in children. However, results from clinical trials have been conflicting, and several of them may have been underpowered. We performed a meta-analysis of randomized, placebo-controlled trials to assess the effects of probiotic supplementation on atopic sensitization and asthma/wheeze prevention in children. METHODS: Random-effects models were used to calculate pooled risk estimates. Meta-regression was conducted to examine the effect of potential factors on probiotics efficacy. RESULTS: Probiotics were effective in reducing total immunoglobulin E (IgE) (mean reduction: -7.59 U/mL [95% confidence interval (CI): -14.96 to -0.22]; P = .044). Meta-regression showed that the reduction in IgE was more pronounced with longer follow-up. Probiotics significantly reduced the risk of atopic sensitization when administered prenatally (relative risk: 0.88 [95% CI: 0.78 to 0.99]; P = .035 for positive result on the skin prick test and/or elevated specific IgE to common allergens) and postnatally (relative risk: 0.86 [95% CI: 0.75 to 0.98]; P = .027 for positive result on skin prick test). Administration of Lactobacillus acidophilus, compared with other strains, was associated with an increased risk of atopic sensitization (P = .002). Probiotics did not significantly reduce asthma/wheeze (relative risk: 0.96 [95% CI: 0.85 to 1.07]). CONCLUSIONS: Prenatal and/or early-life probiotic administration reduces the risk of atopic sensitization and decreases the total IgE level in children but may not reduce the risk of asthma/wheeze. Follow-up duration and strain significantly modified these effects. Future trials for asthma prevention should carefully select probiotic strain and consider longer follow-up. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/23958764/Probiotic_administration_in_early_life_atopy_and_asthma:_a_meta_analysis_of_clinical_trials_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=23958764 DB - PRIME DP - Unbound Medicine ER -