The impact of prebiotics, probiotics and synbiotics on the prevention and treatment of atopic dermatitis in children: An umbrella meta-analysis

Lifeng Wang ¹ Lijuan Xu ^1,2*

• ¹ Beijing Luhe Hospital, Capital Medical University, Beijing, China
• ² Capital Medical University, Beijing, China

Background: Studies have suggested that the administration of prebiotics, probiotics and synbiotics (pre-, pro-, and synbiotics) may potentially decrease the incidence of atopic dermatitis (AD) and alleviate its severity in children; however, recent studies have yielded inconclusive findings.Objective: This umbrella meta-analysis aimed to comprehensively assess the effect of pre-, pro-, and synbiotics on AD among children.A systematic search was carried out in the PubMed and Scopus databases up to April 2024 to identify relevant meta-analyses. Relative risks (RR) and weighted mean differences (WMD) along with their 95% confidence intervals (CI) were pooled using a random effects model to evaluate the impacts on both the incidence of AD and its severity, as assessed by the Scoring Atopic Dermatitis (SCORAD) index.Results: This umbrella meta-analysis included 38 meta-analyses, with 127,150 participants. The analysis suggested that intervention with pre-, pro-, and synbiotics significantly reduced the incidence of AD (RR=0.74, 95% CI: 0.70-0.79), which was confirmed by subgroup analyses. The treatment significantly reduced SCORAD score (WMD=-3.75, 95% CI: -5.08 to -2.42). In subgroup analysis, multi-strain probiotics, Lactobacillus, synbiotics, and pre-, pro-, and synbiotics mixtures were found to significantly decrease the SCORAD score, while, Bifidobacterium and prebiotics alone did not show a significant effect on the SCORAD score. The treatment resulted in a significant decrease in SCORAD score among children with moderate to severe AD, but not in subjects with mild AD.Conclusions: Probiotics and synbiotics could be promising interventions to reduce the risk of developing AD and alleviate its severity in children.