Abstract
Objective: Cow's milk allergy (CMA) is a common allergic disease. Probiotics have been suggested as a treatment for CMA, with Lactobacillus rhamnosus GG (LGG) being one of the important predominant choices. Despite reports on this topic, the effectiveness of application in CMA remains to be firmly established.Methods: To assess the effects of LGG on CMA in children, the PubMed/Medline, Embase, Cochrane Library, and Web of Science databases were searched for studies on LGG in treatment of CMA, which were published in the English language.Results: Ten studies were finally included. Significantly higher tolerability rates favoring LGG over controls were observed [risk ratio (RR), 2.22; 95% confidence interval (CI), 1.86–2.66; I2 = 0.00; moderate-quality evidence]. There were no significant differences in SCORAD values favoring LGG over the placebo (mean difference, 1.41; 95% CI, −4.99–7.82; p = 0.67; very low-quality evidence), and LGG may have improved fecal occult blood (risk ratio, 0.36; 95% CI, 0.14–0.92; p = 0.03; low-quality evidence).Conclusion: We found that LGG may have moderate-quality evidence to promote oral tolerance in children with CMA and may facilitate recovery from intestinal symptoms. However, this finding must be treated with caution, and more gpowerful RCTs are needed to evaluate the most effective dose and treatment time for children with CMA.Registration number: CRD42021237221.
Highlights
Food allergy is common in children and has an increasing prevalence worldwide
Study Types Due to the small number of clinical studies and sample sizes regarding the use LGG treatment on Cow’s milk allergy (CMA), we introduced randomized and quasi-randomized control trials in this review to scientifically expand the number of samples included in the study
As some studies did not express their data as mean ± SD or specific number of patients, we contacted the corresponding authors by e-mail
Summary
Food allergy is common in children and has an increasing prevalence worldwide. It increased significantly from 3.5% in 1999 to 7.7% in 2009 in Chinese children [1] and from 3.4% in 1997– 1999 to 5.1% in 2009–2011 in American young children [2]. Cow’s milk allergy (CMA) is one of the most common immune-mediated allergic diseases in children [3]. Most allergic infants can spontaneously acquire milk tolerance before the age of three [4]. The mechanism of CMA has not been fully elucidated. It may be related to cellular immunity and humoral immunity. Based on the expressions of the serum-specific immunoglobulin E (IgE), CMA
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