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Abstract :

Probiotics are defined as live microorganisms which, when administered in adequate amounts, confer a health benefit on the host. To synthesize the evidence for the effectiveness of probiotics in the treatment or prevention of atopic dermatitis (AD) in children, we reviewed the results of 13 relevant randomized (placebo)-controlled trials (RCTs), 10 of which evaluated probiotics as treatment and 3 for prevention of AD. The main outcome measure in 9 RCTs was the change in SCORAD (SCORing Atopic Dermatitis). Four RCTs suggested that there was a statistically significant decrease in SCORAD after probiotic administration to infants or children with AD for 1 or 2 months compared with that after placebo, while in two RCTs SCORAD was significantly reduced after treatment with lactobacilli only in children with IgE-associated AD. In four of these six RCTs, clinical improvement was associated with a change in some inflammatory markers. In three RCTs, the change in SCORAD was not statistically significant between probiotic- and placebo-treated children, although in one of these trials SCORAD was significantly lower after probiotic than with placebo treatment in food-sensitized children. In most RCTs, probiotics did not cause a statistically significant change in interferon-γ, interleukin-4, tumor necrosis factor-α, eosinophil cationic protein or transforming growth factor-β compared with placebo.