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

Background 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 s...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2015-10, Vol.136 (4), p.952-961
Main Authors: Cuello-Garcia, Carlos A., MD, Brożek, Jan L., MD, PhD, Fiocchi, Alessandro, MD, Pawankar, Ruby, MD, Yepes-Nuñez, Juan José, MD, MSc(Epi), Terracciano, Luigi, MD, Gandhi, Shreyas, BHSc, Agarwal, Arnav, BHSc, Zhang, Yuan, MD, Schünemann, Holger J., MD, MSc, PhD
Format: Article
Language:English
Subjects:
Age
Allergy
Allergy and Immunology
Animals
Asthma
Bias
Breast Feeding
Breastfeeding & lactation
Clinical trials
Dietary Supplements
Disease prevention
Eczema
Eczema - immunology
Eczema - microbiology
Eczema - prevention & control
Female
Food
Food allergies
Humans
Hypersensitivity - immunology
Hypersensitivity - microbiology
Hypersensitivity - prevention & control
Hypotheses
Infant, Newborn
Maternal-Fetal Exchange
Microbiota - immunology
Population
Pregnancy
prevention
Probiotics
Probiotics - administration & dosage
Probiotics - adverse effects
probiotics systematic reviews
Quality
Randomized Controlled Trials as Topic
Reproducibility of Results
Risk
Studies
Womens health
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Summary:Background 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.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2015.04.031