The Effect of Probiotics on Atopic Dermatitis in Children (Other (Not Listed) Sample)

Literature Review
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Part 1: Literature Review - The effect of probiotics on atopic dermatitis in children.
Science Direct was used to obtain full text peer reviewed journal articles published in English from 2007 to present, with evidence relating the effect of probiotics on atopic dermatitis in children. Key words: atopic dermatitis, eczema, probiotics, prevention, treatment and children.
Word exclusions: asthma.
Materials used in literature review: 2 double blind placebo controlled studies, 1 prospective cohort study and 1 peer reviewed journal article.
Article 1-Double blind placebo controlled study- Probiotics for the treatment of eczema: a systematic review
The objective of this article is to evaluate the value of probiotics for treating eczema through a systematic review of randomised-controlled trials. Meta-analysis of data showed that there was no significant reduction in eczema symptoms or decreased severity of eczema when compared to placebo. The author´s conclude that probiotics cannot be recommended for treating eczema. It
Includes 12 trials and 781 participants and has 60 references all in recent years- and this makes the research more acceptable.
Strengths and weaknesses: The authors mention that participants taking antibiotics and corticosteroids were not excluded from the review. This could have possibly skewed the outcome of the results. Another weakness is shown as the authors compared the promising results of pimecrolimus, a corticosteroid, to the results of probiotics in a RCT of 4 weeks. One could argue that you cannot compare a suppressive medicine against live bacteria strains as they work differently. A further potential critique is that there are a limited number of probiotic strains used in the studies and this may mean that some less researched probiotic strains may have been overlooked. On the flipside, the authors give an insight on the composition of the intestinal microbiotia and its differentiation in eczema and non- eczema patients.
Article 2 -Peer Reviewed Journal - Probiotics and atopic dermatitis. A new strategy in atopic dermatitis. Positive Treatment
The article portrays an increase in prevalence of atopic dermatitis in the first 5 years of life. It shows a link between eczema and food allergy. The authors take into account other variables besides probiotics, allowing it not to be bias. The paper reveals that probiotics promote homeostasis to intestinal permeability and balances microbiology of the gut; it improves the immunological defense barrier (IgA) of the intestine and reduces pro-inflammatory cytokines and local and systemic inflammation.
Strengths and weaknesses: Although the paper enlightens readers of positive attributes of treatment with probiotics use in eczema, one could argue it is one sided without comparing or contrasting to any negative ways in which the live cultures may not work in some cases. The author also uses outdated sources and this reduces its validity. The authors do not mention if the trials received the same controls and if participants were subjective to variables, which could potentially influence the severity of eczema. One could argue if it is bias by leaving out such important aspects from trials.
In a nutshell, the paper shows probioticsto be a potential promising treatment for patients with eczema by demonstrating how it affects the gut. This is important in understanding of eczema.
Article 3- Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitisation in high-risk children: A randomised controlled trial. Angie L Taylor number :random Negative Prevention:
This paper investigates if Lactobacillus acidophilus can prevent eczema. Newborns were administered the same strain of probiotic or were given a placebo daily for 6 months and assessed at 12 months. 178 infants completed the trial.
Weaknesses:
As not all individuals have a greater significance of eczema in the first year of life, it is possible that they have overlooked some potential future positive results. The author also does not explain what would be the outcome of administering probiotics on pregnant mothers.
Also the study only focuses on Lactobacillus acidophilus- thus limiting possible beneficial outcomes of other strains. The authors do not mention if participants were subjective to variables, which could potentially influence the severity of eczema.
Strengths:
The authors reveal that in caesarean-delivered children, less IgE- associated allergic disease is common, indicating that probiotics have a protective role by having an influence on the gastro-intestinal tract. The author´s portray that bacterial gut colonisation is a critical factor for immune stimulation early in life are thought to stimulate local and systemic immune responses. Contrary to their understanding of probiotics; however, their findings revealed that there was no reduction in the risk of early allergic disease, atopic dermatitis or food allergy from the population sample. This means Naturopaths how gut colonization is important; shows promising hope for future studies based on this information.
Article 4- Probiotics and prebiotics galacto-oligosachharides in the prevention of allergic diseases: A randomized, double- blind, placebo-controlled trial. Positive Prevention:
Kaarina Kukkonen, Erkki Savilahtil number 6,
The authors suggest that rise in eczema cases is largely attributed to poor gut immunity caused by lack of microbial stimulation in infants. The study looks at how a mixture of 4 probiotic strains along with prebiotic galacto-oligosaccharides can prevent eczema. 1223 pregnant women carrying high-risk children were given a treatment and a control of placebo was put in place. This was also given to infants for 6 months and a follow up of 2 years was completed. The results concluded that probiotic treatments significantly prevented eczema. The results also showed an inverse association between atopic diseases and colonization of the gut by probiotics.
Strengths and weaknesses: The authors state that all infants received the same probiotic treatment, and yet probiotic strains vary due to mutation. The paper also did not outline how the probiotics were stored. The authors also failed to mention if the probiotics were administered with or without food as it is questionable whether this affec...