Abstract
(1) Background: Whether early supplementation of probiotics to improve intestinal flora can effectively prevent eczema remains a controversial issue. We aimed to investigate the effect of a mixed strain of Lactobacillus and Bifidobacterium on eczema in infants under three years old at present; (2) Methods: We searched the databases of PubMed, Web of Science, and Cochrane Library, as well as National Knowledge Infrastructure (CNKI), WeiPu (VIP), and WanFang Data (WanFang) for randomized controlled trials (RCTs) of probiotics in the prevention of eczema in infants without language restriction. The main outcome was eczema incidence, while adverse events during the intervention constituted the secondary outcome. The random-/fixed-effects model was utilized to calculate the combined relative risk (RR) and 95% confidence interval (CI). The methodological quality of the study was evaluated using the Cochrane “bias risk” tool. According to the initial intervention time, subgroup analysis was carried out, follow-up time, family history, etc.; (3) Results: Nine articles were selected (2093 infants). The Lactobacillus and Bifidobacterium mixed strain could prevent eczema in infants under three years of age compared to the placebo (RR = 0.60; I2 = 67%; p < 0.001). Subgroup analysis revealed that the mixture of two probiotic strains had preventive effects on both infants with positive (RR = 0.53; I2 = 52%; p < 0.001) and negative (RR = 0.69; I2 = 62%; p = 0.02) family history; The follow-up time for ≤12 months (RR = 0.65; I2 = 12%; p = 0.01) and 12–24 months (RR = 0.60; I2 = 79%; p = 0.003), daily dose of probiotics ≤ 1 × 109 and > 1 × 109 colony forming units all can be effective (p < 0.01); Compared with the intervention of infants alone (RR = 0.63; I2 = 63%; p = 0.29), the effect of probiotics mixture at the beginning of pregnancy was more significant (RR = 0.59; I2 = 71%; p < 0.001); Except for the mixture of Lactobacillus rhamnosus GG (LGG) and Bifidobacterium longum (B. longum) (p = 0.18), other subgroups of intervention group can play a preventive effect (p < 0.05); (4) Conclusions: The mixed strain of Lactobacillus and Bifidobacterium can effectively reduce the incidence of eczema in infants under three years old. However, further research is needed to fully understand the exact mechanism of their effect on infant eczema.
Highlights
Eczema is the most common and the earliest chronic allergic skin disease in infants [1].In recent years, the incidence of eczema in infants has risen twofold to threefold
Studies have shown about 50% of children with eczema continue to suffer from the disease until adulthood and may even develop asthma and allergic rhinitis, which brings a heavy burden to individuals and their families and increases the risk of other allergic diseases [8,9,10]
The results showed that using the above probiotic mixtures as a supplement can avoid infant eczema (RR = 0.60; 95% confidence interval (CI): 0.47–0.78; p < 0.001), which is consistent with the findings of other research [40,41]
Summary
Eczema is the most common and the earliest chronic allergic skin disease in infants [1].In recent years, the incidence of eczema in infants has risen twofold to threefold. The incidence of eczema in the world is 15–30%, and 60% of children develop eczema within the first year after their birth [2]. In developed countries, such as those Europe and America, the incidence of eczema is about 2–35.8% [3,4,5]. Relevant studies have reported that the occurrence of infant eczema is linked to the variation of the intestinal microbiome in the early stage [11], probiotics, breastmilk feeding [12], the birth season ( spring and summer) [13] can reduce the development of eczema
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