According to the American Academy of Dermatology, eczema (atopic dermatitis) is a common skin disease in children. Children often get atopic dermatitis during their first year of life. Dry and scaly patches appear on the skin, and often appear on the scalp, forehead, and face. These patches are very common on the cheeks. No matter where it appears, atopic dermatitis is often very itchy. Infants may rub their skin against bedding or carpeting to relieve the itch. In children of all ages, the itch can be so intense that a child cannot sleep. Scratching can lead to a skin infection. According to a new study, synbiotics can both prevent and treat atopic dermatitis. The findings appear online on January 25 in the journal JAMA Pediatrics.
Synbiotics refer to nutritional supplements that combine probiotics and prebiotics that have greater impact when combined. They are live bacteria, which are intended to colonize the large intestine and confer physiological health benefits to the host. A prebiotic is a food or dietary supplement product that confers a health benefit on the host associated with modifying the intestinal organisms. Prebiotics are not drugs.
The study authors note that atopic dermatitis is a very common condition that may be associated with an altered gastrointestinal microbiota that promotes an immune environment more susceptible to allergic disease. Synbiotics have been used for the prevention and treatment of atopic dermatitis; therefore, the objective of the study was to assess the effectiveness of synbiotics for the primary prevention and treatment of the condition.
The researchers conducted a meta-analysis via data collected from medical databases. (A meta-analysis is a compilation of data from a number of studies to clarify a point.) They included all published randomized clinical trials of synbiotics for prevention and/or treatment of atopic dermatitis. To be included, a publication needed to clearly define the intervention as oral administration of synbiotics and must have included an assessment of atopic dermatitis disease severity, such as the Severity Scoring of Atopic Dermatitis (SCORAD) index, or the incidence of AD as an outcome measure. Only 8 of 257 initially identified studies (3%) met the selection criteria.
The investigators screened 257 abstracts to identify 6 treatment studies (369 children enrolled; aged 0 months to 14 years) and 2 prevention studies (1,320 children enrolled; up to age 6 months in one study and term infants less than 3 days of age in the other). From the 6 treatment studies included, the overall pooled change in SCORAD index in those treated with synbiotics at 8 weeks of treatment was −6.56. The beneficial effect of synbiotics was significant only when using mixed strains of bacteria and when used in children aged 1 year or older. From the 2 prevention studies reviewed, the risk of atopic dermatitis was reduced 54%.
The authors concluded that their meta-analysis provided evidence that supports the use of synbiotics for the treatment of atopic dermatitis, particularly synbiotics with mixed strains of bacteria and for children aged 1 year or older. They recommended that further studies are needed to evaluate the effectiveness of synbiotics for the primary prevention of atopic dermatitis.
The authors are affiliated with: Department of Pediatrics, Taipei City Hospital Renai Branch and National Yang-Ming University, Taipei, Taiwan; 2Massachusetts General Hospital for Children, Boston; Channing Division of Network Science, Brigham and Women’s Hospital, Boston, Massachusetts; Kanawha-Charleston Health Department, Charleston, West Virginia; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; and Department of Dermatology, National Institute of Pediatrics, Mexico City, Mexico.