Data from six studies indicated that probiotics plus prebiotics (Synbiotics) are effective against eczema, also known as atopic dermatitis. The data revealed no preventative role for synbiotics, however.
Writing in JAMA Pediatrics the authors note that this is the first meta-analysis of randomized control trials of synbiotics for the treatment and prevention of eczema.
Atopic dermatitis
Atopic dermatitis is one of the first signs of allergy during the early days of life and is said to be due to delayed development of the immune system. It is a common inflammatory skin disorder, which occurs in early childhood and may persists into adult life. According to the American Academy of Dermatologists it affects between 10 to 20% of all infants, but almost half of these kids will 'grow out' of eczema between the ages of five and 15.
Current treatments focus on alleviating symptoms, but probiotics have been studied for over 20 years for their therapeutic benefits for the condition, with numerous studies identifying significant strain-specific benefits.
Meta-analysis
Led by Dr Yung-Sen Chang from the National Yang-Ming University in Taipei, Taiwan, the authors assessed data from six treatment trials including 369 children aged between 0 and 14 years, and two prevention trials including 1,320 children aged from 0-6 months.
“In our pooled analysis, synbiotics significantly reduced the Severity Scoring Atopic Dermatitis (SCORAD) index […] after 8 weeks of treatment,” wrote the researchers. “The beneficial effect of synbiotics seems greater than the pooled effect of probiotics in [a] previous meta-analysis.
A greater effect was observed when the authors considered mixed-strain bacterial species products versus single strain products. “There could be a possible synergistic effect of mixed strains of bacteria in regulating the gut microbiota and thus the immune system, and further research is needed,” they wrote.
“We also found that synbiotics significantly improved the SCORAD index for children aged 1 year or older with AD but did not have a significant effect when infants were also included. This is consistent with previous findings of probiotics [in another paper] suggesting that benefit from probiotics or prebiotics is limited in infants younger than 1 year.
The authors also reported that, while the synbiotics performed better than probiotics, there was no significant difference between synbiotics and prebiotics. “However, only 2 studies with small sample sizes used prebiotics as the control, and it has been shown that prebiotics might by themselves have a possible beneficial effect for the treatment of AD. Therefore, these findings should be interpreted with caution as we might not have had enough power to detect a difference.
They called for more studies to elucidate if there are any difference in efficacy when considering the strains of probiotics and type of prebiotics used.
“Also, further larger studies are needed to address the efficacy of synbiotics for the prevention of this common pediatric disease,” they concluded.
The authors were affiliated with the National Yang-Ming University (Taipei, Taiwan), Massachusetts General Hospital for Children, Brigham and Women’s Hospital, Kanawha-Charleston Health Department (West Virginia), Harvard T. H. Chan School of Public Health, and the National Institute of Pediatrics in Mexico City.
Source: JAMA Pediatrics
Volume 170, Number 3, Pages 236-242, doi: 10.1001/jamapediatrics.2015.3943
“Synbiotics for Prevention and Treatment of Atopic Dermatitis: A Meta-analysis of Randomized Clinical Trials”
Authors: Y.S. Chang at al.