Wei Xiaochen, Jiang Ping, Liu Jiangbo, Sun Rongfei, Zhu Liqin
Department of Pharmacy, Tianjin First Central Hospital, Tianjin, People's Republic of China.
Department of Respiration, Tianjin First Central Hospital, Tianjin, People's Republic of China.
J Asthma. 2020 Feb;57(2):167-178. doi: 10.1080/02770903.2018.1561893. Epub 2019 Jan 18.
The increased social and economic burdens for asthma in infants make the prevention of asthma a major public health goal. Probiotics may reduce the risk of asthma in infants. However, randomized controlled trials (RCTs) have shown mixed efficacy outcomes. We performed a meta-analysis of RCTs to investigate whether probiotics are associated with a lower asthma incidence in infants. The PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to August 2018. RCTs comparing the effects of probiotic supplements with a placebo for asthma or wheeze incidence in infants were included. A meta-analysis was performed to calculate risk ratio (RR) and 95% confidence interval (CI) using the Mantel-Haenszel statistical method. A total of 19 randomized trials involving 5157 children fulfilled the inclusion criteria. There was no significant association of probiotics with risk of asthma (RR, 0.94 [95% CI, 0.82-1.09]) or wheeze (RR, 0.97 [95% CI, 0.88-1.06]) compared with placebo. Subgroup analysis by asthma risk showed that probiotics significantly reduced wheeze incidence among infants with atopy disease (RR, 0.61 [95% CI, 0.42-0.90]), but no significant associations were found in the other subgroup analyses by participants receiving the intervention, timing of intervention, prevention regimen, probiotic organism, duration of intervention, and duration of follow-up. The use of probiotic supplementation compared with placebo was not associated with a lower risk of asthma in infants. These findings do not support recommendation to use probiotics in the prevention of asthma in infants.
婴儿哮喘所带来的社会和经济负担日益增加，这使得预防哮喘成为一项主要的公共卫生目标。益生菌可能会降低婴儿患哮喘的风险。然而，随机对照试验（RCT）的疗效结果却喜忧参半。我们进行了一项RCT的荟萃分析，以研究益生菌是否与婴儿较低的哮喘发病率相关。从数据库建立之日至2018年8月，我们系统地检索了PubMed、Cochrane图书馆和EMBASE数据库。纳入了比较益生菌补充剂与安慰剂对婴儿哮喘或喘息发病率影响的RCT。使用Mantel-Haenszel统计方法进行荟萃分析，以计算风险比（RR）和95%置信区间（CI）。共有19项涉及5157名儿童的随机试验符合纳入标准。与安慰剂相比，益生菌与哮喘风险（RR，0.94 [95% CI，0.82 - 1.09]）或喘息风险（RR，0.97 [95% CI，0.88 - 1.06]）之间无显著关联。按哮喘风险进行的亚组分析表明，益生菌显著降低了特应性疾病婴儿的喘息发病率（RR，0.61 [95% CI，0.42 - 0.90]），但在其他亚组分析中，包括接受干预的参与者、干预时间、预防方案、益生菌种类、干预持续时间和随访持续时间，均未发现显著关联。与安慰剂相比，补充益生菌与婴儿较低的哮喘风险无关。这些发现不支持在预防婴儿哮喘中使用益生菌的建议。
