Liu Yang, Zhang Yuxiao, Li Yingna, Zhang Xiaohu, Xie Liang, Liu Hanmin
Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Front Pediatr. 2025 Apr 24;13:1577152. doi: 10.3389/fped.2025.1577152. eCollection 2025.
Asthma is a common chronic inflammatory disease affecting children worldwide. While probiotics have been proposed as a potential therapy, their efficacy in pediatric asthma management remains controversial.
A systematic search of PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and clinicaltrials.gov was conducted to identify randomized controlled trials (RCTs) from 2014 to 2024 evaluating probiotic interventions in children with asthma. Primary outcomes included asthma exacerbation rates and predicted FEV1%. The risk of bias was assessed using Cochrane guidelines.
Out of 1,361 articles, eight RCTs involving 902 participants were included. Meta-analysis showed probiotics significantly reduced acute asthma episodes with risk ratio of 0.38 (95% CI: 0.26-0.56, < 0.00001) and improved FEV1/FVC ratios (MD = 5.70, 95% CI: 1.93-9.47, < 0.003) compared to the control group. Neither FEV1 levels nor school attendance showed significant changes.
Probiotic supplementation may reduce asthma exacerbations and improve pulmonary function in pediatric asthma. However, heterogeneity across studies suggests the need for further research to determine optimal strains, dosages, and treatment durations. This review establishes groundwork for research and practice by exploring microbial interventions in childhood airway disorders.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024607569, identifier (CRD42024607569).
哮喘是一种影响全球儿童的常见慢性炎症性疾病。虽然益生菌已被提议作为一种潜在的治疗方法，但其在儿童哮喘管理中的疗效仍存在争议。
对PubMed、Web of Science、Embase、Cochrane对照试验中心注册库（CENTRAL）和clinicaltrials.gov进行系统检索，以识别2014年至2024年评估益生菌干预儿童哮喘的随机对照试验（RCT）。主要结局包括哮喘加重率和预测的第一秒用力呼气容积（FEV1）百分比。使用Cochrane指南评估偏倚风险。
在1361篇文章中，纳入了8项涉及902名参与者的RCT。荟萃分析显示，与对照组相比，益生菌显著降低了急性哮喘发作，风险比为0.38（95%置信区间：0.26 - 0.56，P < 0.00001），并改善了FEV1/用力肺活量（FVC）比值（平均差 = 5.70，95%置信区间：1.93 - 9.47，P < 0.003）。FEV1水平和上学出勤率均未显示出显著变化。
补充益生菌可能会减少儿童哮喘的发作并改善肺功能。然而，研究之间的异质性表明需要进一步研究以确定最佳菌株、剂量和治疗持续时间。本综述通过探索儿童气道疾病中的微生物干预为研究和实践奠定了基础。
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024607569，标识符（CRD420246
