Table 3.
Summary of the randomized clinical trials using probiotics to prevent or treat AD.
| Year | Completed Participants | Probiotics Used | Intervention Route and Duration | Results | Reference |
|---|---|---|---|---|---|
| Prevention | |||||
| 2001 | 132 children with high risk of allergy and their mothers; 64 in probiotic group vs. 68 in placebo group | L. rhamnosus GG (ATCC 53103) | Oral/2–4 weeks prenatally + 6 months postnatally (by either mothers or infants) | Probiotic group: ↓incidence of AD in the first year of life and at 4 years of age | [277,278] |
| 2007 | 178 children with atopic mothers; 89 in probiotic group vs. 89 in placebo group | L. acidophilus (LAVRI-A1) | Oral/the first 6 months of life | Probiotic group: no effect on AD in the first year of life, ↑incidence of allergen sensitization | [291] |
| 2008 | 94 children with high risk of allergy and their mothers; 50 in probiotic group vs. 44 in placebo group | LGG | Oral/2–4 weeks prenatally + 6 months postnatally (by either mothers or infants) | Probiotic group: no effect on AD at 2 years of age, ↑incidence of recurrent wheezing bronchitis | [292] |
| 2008 | 474 children with high risk of allergy and their mothers; 157 in HN001 group vs. 158 in HN019 group vs. 159 in placebo group | L. rhamnosus HN001 or B. animalis HN019 | Oral/From 35 weeks gestation until 2 years postnatally (by mothers and children) | HN001 group: ↓incidence of AD at 2 years, 4 years, 6 years, and 11 years of age; HN019 group: no effect | [279,280,281,282] |
| 2009 | 245 Asian infants with high risk of allergy; 124 in probiotics group vs. 121 in placebo group | Bifidobacterium longum BL999, L. rhamnosus | Oral/The first 6 months of life | No effect at 1 year of age | [293] |
| 2010 | 112 children with high risk of allergy and their mothers; 57 in probiotics group vs. 55 in placebo group | B. bifidum BGN4, B. animalis subsp. lactis (B. lactis) AD011, L. acidophilus AD031 | Oral/4–8 weeks prenatally + 6 months postnatally (by either mothers or infants) | Probiotics group: ↓incidence of AD in the first year of life | [289] |
| 2010 | 278 children and their mother; 138 in probiotics group vs. 140 in placebo group | Combination of LGG, L. acidophilus La-5, B. lactis Bb-12 | Oral/From 36 weeks of gestation until 3 months postnatally during breastfeeding by mothers | Probiotics group: ↓incidence of AD at 2 years and 6 years of age, ↓TH22, No adverse effect | [286,287,288] |
| 2011 | 250 children with high risk of allergy and their mothers; 125 in probiotic group vs. 125 in placebo group | LGG | Oral/From 36 weeks of gestation until delivery | Probiotic group: no effect on AD in the first year of life, ↓CD14 and IgA in maternal breast milk | [294] |
| 2014 | 158 children and their mothers; 122 in probiotics group vs. 36 in placebo group | Combination of B. breve M-16V, B. longum BB536 | Oral/1 month prenatally + 6 months postnatally by infants | Probiotics group: ↓incidence of AD at 10 and 18 months of age, ↓fecal Proteobacteria, no adverse effect | [290] |
| 2018 | 423 children with high risk of allergy and their mothers; 212 in HN001 group vs. 211 in placebo group | L. rhamnosus HN001 | Oral/From 14–16 weeks of gestation until 6 years postnatally during breastfeeding by mothers | No effect on infantile AD | [295] |
| Treatment | |||||
| 2000 | 27 infants with AD; 9 in LGG group vs. 9 in Bb-12 group vs. 9 in placebo group | LGG, B. lactis Bb-12 (Bb-12) | Oral/3 months | Probiotic groups: ↓AD symptoms, ↓serum soluble CD4, ↓urine eosinophilic protein X | [313] |
| 2003 | 35 infants with AD; 14 in LGG group vs. 13 in heat-inactivated LGG group vs. 8 in placebo group | LGG | Oral/7.5 weeks | LGG group: ↓AD symptoms | [314] |
| 2003 | 43 children with AD; 20 in placebo→probiotics, 23 in probiotics→placebo | Mixture of L. rhamnosus 19070-2 and L. reuteri DSM 122460 | Oral/First intervention (6 weeks)→Washout (6 weeks)→Second intervention (6 weeks) | Probiotics treatment: ↓AD symptoms, ↓serum eosinophil cationic proteins | [329] |
| 2004 | 80 in LGG group, 76 in mix group, 74 in placebo group | LGG, Mixture of 4 probiotics (Mix, LGG, L. rhamnosus LC705, B. breve Bbi99, Propionibacterium freudenreichii ssp. Shermanii JS) | Oral/4 weeks | Generally, no obvious effect, Probiotics group: ↓IgE sensitized AD | [336] |
| 2005 | 53 children with moderate-severe AD (Topical corticosteroids were permitted); 26 in probiotic group vs. 27 in placebo group | L. fermentum VRI-003 PCC | Oral/8 weeks | Probiotics treatment: ↓AD symptoms | [322] |
| 2006 | 59 children with AD; 29 in probiotics group vs. 30 in placebo group | Mixture of LGG and B. lactis Bb-12 (Bb-12) | Oral/18 weeks | All participants probiotics: ↓AD symptoms (non-significant); within food sensitized participants, probiotics group: ↓AD symptoms (significant) | [337] |
| 2006 | 50 infants with AD; 17 in Lrh group, 16 in LGG group, 17 in placebo group | L. rhamnosus (Lrh), LGG | Oral/3 months | No therapeutic effect and no immune difference | [315] |
| 2006 | 53 infants with moderate-severe AD (Emollients, class I–II topical corticosteroids and antihistamines were permitted); 26 in probiotic group, 27 in placebo group | LGG | Oral/8 weeks | No therapeutic effect | [316] |
| 2007 | 102 infants with mild-moderate AD; 54 in probiotic group, 48 in placebo group | LGG | Oral/12 weeks | No therapeutic effect | [317] |
| 2010 | 88 children with AD; 45 in probiotic group vs. 43 in placebo group | L. sakei KCTC 10755BP | Oral/12 weeks | Probiotic group: ↓AD symptoms, ↓serum CCL17 and CCL27 | [324] |
| 2011 | 141 children with AD; 45 in LP group, 47 in BL group, 47 in placebo group | L. paracasei CNCM I-2116(LP), B. lactis CNCM I-3446 (BL) | Oral/3 months | No therapeutic effect | [328] |
| 2011 | 38 adult AD patients; 19 in probiotic group vs. 19 in placebo group | L. salivarius LS01 (DSM 22775) | Oral/16 weeks | Probiotic group: ↓AD symptoms, ↓fecal load of Staphylococci, ↓plasma LPS, enduring restoration of TH1/TH2 immune balance | [320,321] |
| 2012 | 46 adult AD patients; 31 in probiotics group vs. 15 in placebo group | The combination of L. salivarius LS01, B. breve BR3 | Oral/12 weeks | Probiotics group: ↓AD symptoms, ↓plasma LPS, ↓activated T cells, ↑TH1, ↓TH2, ↓TH17, ↑ Treg cells, ↓fecal Staphylococci | [332] |
| 2012 | 118 children with AD (Emollients were permitted); 58 in probiotic group vs. 60 in placebo group | L. plantarum CJLP133 | Oral/12 weeks | Probiotic group: ↓AD symptoms, ↓total eosinophil count, ↓IL-4 and IFNγ in blood | [326] |
| 2014 | 25 adult AD patients; 13 in probiotics group vs. 12 in placebo group | L. salivarius LS01 (DSM 22775), S. thermophilus ST10 (DSM25246) | Oral/1 month | Probiotic group: ↓AD symptoms | [334] |
| 2014 | 44 adult AD patients (Medications without probiotic effect and corticosteroid application were permitted); 22 in probiotic group vs. 22 in placebo group | B. lactis LKM512 | Oral/8 weeks | Probiotic group: ↓AD symptoms, ↑fecal Lactobacilli, ↑fecal kynurenic acid | [331] |
| 2015 | 212 children with moderate-severe AD; 55 in LP group vs. 53 in LF group vs. 51 in LP + LF group vs. 53 in placebo group | L. paracasei (LP), L. fermentum (LF) and the combination of LP and LF | Oral/3 months | LP group, LF group and LP + LF group: ↓AD symptoms, ↓serum IL-4, IgE, TNF, ↑serum IFN, TGF, ↓urine eosinophilic protein X, 8-OHdG | [323] |
| 2017 | 62 children with AD; 30 in probiotic group vs. 32 in placebo group | L. rhamnosus (MP108) | Oral/8 weeks | Probiotic group: ↓AD symptoms | [318] |
| 2017 | 22 children with AD; 12 in probiotic group vs. 10 in placebo group | L. plantarun IS-10506 | Oral/12 weeks | Probiotic group: ↓AD symptoms, ↓serum IL-4, IFNγ, IL-17, ↑serum IL-10↑, ↑Treg cells in blood | [325] |
| 2018 | 50 children with moderate AD who were prescribed topical steroids; 26 in probiotics group vs. 24 in placebo group | Mixture of B. lactis CECT 8145, B. longum CECT 7347, L. casei CECT 9104 | Oral/12 weeks | Probiotics group: ↓AD symptoms, ↓steroids treatment | [333] |
| 2020 | 109 adult AD patients; 29 in CCFM16 group vs. 43 in CCFM8610 group vs. 11 in oligosaccharide group vs. 26 in placebo group | B. bifidum CCFM16, L. plantarum CCFM8610 | Oral/8 weeks | L. plantarum CCFM8610 group: ↓AD symptoms, ↑serum IL-10, ↓microbial functional genes involving S. aureus infection AD symptoms, ↑steroid hormone biosynthesis | [327] |
| 2020 | 82 children with mild-moderate AD; 41 in probiotic group vs. 41 in placebo group | L. pentosus | Oral/12 weeks | Generally, no obvious effect, probiotic group: ↓IgE sensitized AD, (no difference in cytokine levels and microbial diversities) | [335] |
| 2021 | 134 children with AD; 66 in probiotics group vs. 68 in placebo group | L. rhamnosus ŁOCK 0900, ŁOCK 0908, ŁOCK 0918 | Oral/3 months | Probiotics group: ↓AD symptoms | [319] |
| 2021 | 80 adult AD patients; 40 in Probiotics group vs. 40 in placebo group | L. plantarum PBS067, L. reuteri PBS072 and L. rhamnosus LRH020 | Oral/56 days | Probiotics group: ↓AD symptoms, ↓skin TNF and TSLP | [330] |