Zhang Guo-Qiang, Hu Hua-Jian, Liu Chuan-Yang, Zhang Qiao, Shakya Shristi, Li Zhong-Yue
From the Department of Gastroenterology (G-QZ, H-JH, QZ, SS, Z-YL) and Department of Nephrology (C-YL), Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Children's Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2016 Feb;95(8):e2562. doi: 10.1097/MD.0000000000002562.
Most studies investigated probiotics on food hypersensitivity, not on oral food challenge confirmed food allergy in children. The authors systematically reviewed the literature to investigate whether probiotic supplementation prenatally and/or postnatally could reduce the risk of atopy and food hypersensitivity in young children.PubMed, Embase, the Cochrane Central Register of Controlled Trials, and 4 main Chinese literature databases (Wan Fang, VIP, China National Knowledge Infrastructure, and SinoMed) were searched for randomized controlled trials regarding the effect of probiotics on the prevention of allergy in children. The last search was conducted on July 11, 2015.Seventeen trials involving 2947 infants were included. The first follow-up studies were analyzed. Pooled analysis indicated that probiotics administered prenatally and postnatally could reduce the risk of atopy (relative risk [RR] 0.78; 95% confidence interval [CI] 0.66-0.92; I = 0%), especially when administered prenatally to pregnant mother and postnatally to child (RR 0.71; 95% CI 0.57-0.89; I = 0%), and the risk of food hypersensitivity (RR 0.77; 95% CI 0.61-0.98; I = 0%). When probiotics were administered either only prenatally or only postnatally, no effects of probiotics on atopy and food hypersensitivity were observed.Probiotics administered prenatally and postnatally appears to be a feasible way to prevent atopy and food hypersensitivity in young children. The long-term effects of probiotics, however, remain to be defined in the follow-up of existing trials. Still, studies on probiotics and confirmed food allergy, rather than surrogate measure of food hypersensitivity, are warranted.
大多数研究调查的是益生菌对食物过敏反应的影响，而非对经口服食物激发试验确诊的儿童食物过敏的影响。作者系统回顾了文献，以研究产前和/或产后补充益生菌是否可降低幼儿患特应性疾病和食物过敏反应的风险。检索了PubMed、Embase、Cochrane对照试验中心注册库以及4个主要的中文文献数据库（万方、维普、中国知网和中国生物医学文献数据库），查找关于益生菌对儿童过敏预防作用的随机对照试验。最后一次检索于2015年7月11日进行。纳入了17项涉及2947名婴儿的试验。对首次随访研究进行了分析。汇总分析表明，产前和产后使用益生菌可降低患特应性疾病的风险（相对危险度[RR] 0.78；95%置信区间[CI] 0.66 - 0.92；I² = 0%），尤其是在孕妇产前和婴儿产后使用时（RR 0.71；95% CI 0.57 - 0.89；I² = 0%），以及降低食物过敏反应的风险（RR 0.77；95% CI 0.61 - 0.98；I² = 0%）。当仅在产前或仅在产后使用益生菌时，未观察到益生菌对特应性疾病和食物过敏反应有影响。产前和产后使用益生菌似乎是预防幼儿特应性疾病和食物过敏反应的一种可行方法。然而，益生菌的长期影响仍有待在现有试验的随访中确定。尽管如此，仍有必要开展关于益生菌与确诊食物过敏而非食物过敏反应替代指标的研究。
