| Study ID | Sample Size | Age Range (months) | Intervention | Dose | Duration (Days) | Outcome(s) | Findings |
|---|---|---|---|---|---|---|---|
| Probiotics | |||||||
| Baldassarre 2010 | 62 | 0-12 | EHF + Lactobacillus GG vs. EHF alone |
2.5 x 107 (CFU)/g | 28 | • Changes in fecal calprotectin levels • Presence of occult blood in stool |
• Fecal calprotectin decrease among EHF + LGG group was significantly larger than decrease among EHF - LGG group • After 4 weeks, 0/12 patients in EHF + LGG group exhibited occult in blood stool, whereas 5/14 in the EHF - LGG group exhibited occult blood in stool |
| Hol 2008 | 119 | 0-6 | EHF + Lactobacillus casei CRL431 and Bifidobacterium lactis Bb-12 vs. EHF alone |
107 (CFU)/g | 365 | • Development of clinical tolerance to cow's milk • Analysis of T- and B-lymphocyte subsets • Changes in SCORAD index • Effects on wheezing and hospital admissions |
• Tolerance development in probiotic group compared to placebo group after 6 months and 12 months was not significant. • Treatment significantly decreased CD3+ and CD3+CD4+ levels in the probiotic group • SCORAD index significantly improved in probiotic group at 6 months and 12 months, and significantly improved in placebo group at 6 months only. After adjusting for baseline values, there was no significant change from baseline between probiotic and placebo groups. • Treatment had no effect on hospital admissions and wheezing. |
| Isolauri 2000 | 27 | 4.6 | EHF + Bifidobacterium lactis Bb-12 or Lactobacillus GG vs. EHF alone |
LGG: 3 x 108 (CFU)/g Bifidobacterium lactis: 1 x 109 (CFU)/g |
60 | • Extent and severity of atopic eczema • Serum concentrations of soluble cell surface molecules, cytokines/chemokines, and urine concentrations of methyl-histamine and eosinophilic protein |
• After 2 months, there was a significant decrease in SCORAD index for both probiotic groups • After 6 months, the SCORAD index had decreased to 0 in all groups • After 2 months, serum CD4 concentration decreased in both probiotic groups, but not the unsupplemented group • Serum TGF-β1 concentrations decreased in those receiving Bifidobacterium lactis Bb-12, but increased in those receiving Lactobacillus GG • Serum concentrations of IL-1ra, TNFα, GM-CSF, sICAM-1, RANTES and MCP-1α were unaffected by probiotics |
| Kirjavainen 2003 | 35 | 3.5-6.8 | EHF + viable Lactobacillus GG or heat-inactivated Lactobacillus GG vs. EHF alone |
1 x 109 (CFU/g) | 52.5 | • Changes in SCORAD index • Changes in microbial cell counts in feces |
• Adverse gastrointestinal effects were noted among the heat-inactivated LGG group and this intervention was discontinued • Mean decrease in SCORAD index was greater in the viable LGG group than in the placebo group • Treatment groups did not show a significant change in bacterial numbers in fecal samples |
| Majamaa 1997 | 31 | 2.5-15.7 | EHF + Lactobacillus GG vs. EHF alone |
5 x 108 (CFU)/g | 60 | • Changes in severity of atopic eczema • Changes in intestinal inflammation via concentrations of fecal α1-antitrypsin, eosinophil cationic protein (ECP), and tumor necrosis factor-α (TNF-α) • Changes in systemic immune response via concentrations of ECP and cytokine production of peripheral blood mononuclear cells |
• The clinical score of atopic dermatitis (SCORAD) significantly improved within the EHF + LGG group only • Concentrations of fecal α1-antitrypsin and TNF-α significantly decreased among EHF + LGG group only • Fecal ECP concentrations were not affected by treatment |
| Prebiotics | |||||||
| Boženský 2015 | 120 | 1.5-2 | EHF + galacto-oligosaccharides vs. EHF alone |
0.5g / 100ml | 182.5 | • Severity of atopic eczema as measured by SCORAD index • Changes in anthropometric factors, tolerance, and incidence of infection |
• While both groups showed a decrease in SCORAD index, there was no significant difference in reduction between the two groups • There was no significant difference in anthropometry, tolerance, or incidence of infection among the two groups |
| Synbiotics | |||||||
| Burks 2015 | 110 | 0-8 | AAF + oligofructose, long-chain inulin, acidic oligosaccharides, Bifidobacterium breve M-16V vs. AAF alone |
Prebiotic blend: 8 g/l (6.8 g/l oligofructose:inulin 9:1 and 1.2 g/l pAOS) Bifidobacterium breve M-16V: 1.47 x 109 (CFU)/100 ml |
112 | • Changes in growth (weight, length, head circumference) • Allergic symptoms consisting of dermatological (SCORAD index), respiratory, and gastrointestinal • Changes in consistency, frequency, and color of stool • Changes in formula intake • Changes in fecal pH and fecal short-chain fatty acids |
• An increase in weight, length, and head circumference was seen in both groups, but there was no significant difference between the groups • 22% of subjects in the treatment group reported diarrhea, whereas 4% in the control group reported diarrhea • 2% of subjects in the treatment group were treated for infection, whereas 18% in the control group were treated for infection • SCORAD index and severity of other allergy symptoms decreased for both groups but there was no significant decrease between the groups • Flatulence, stool frequency, and stool consistency was not significantly different between both groups • Stool color showed significant improvement in the treatment group • Fecal pH was significantly lower among the treatment group • For the treatment group, acetic acid levels were significantly higher while propionic acid levels were lower |
| Burks 2014 | 110 | 0-8 | AAF + oligofructose, long-chain inulin, acidic oligosaccharides, Bifidobacterium breve M-16V vs. AAF alone |
Prebiotic blend: 8 g/l (6.8 g/l oligofructose:inulin 9:1 and 1.2 g/l pAOS) Bifidobacterium breve M-16V: 1.47 x 109 (CFU)/100 ml |
112 | • Changes in growth (weight, length, head circumference) • Formula tolerance • Changes in SCORAD index • Evidence of respiratory allergic symptoms • Stool consistency, frequency, and color • Incidence of adverse events and medication use |
• Both formulas supported normal growth, there was no significant difference in growth between the two groups • Both formulas were equally tolerated and reduced allergic symptoms with no significant differences between the two groups • SCORAD index decreased in both groups with no significant differences between the two groups • The treatment group reported softer and yellow/brown stools, whereas the control group reported dry and green/dark brown stools • Incidence of infection and antibiotic use was lower in the treatment group |
| Harvey 2014 | 30 | 0-36 | AAF + Bifidobacterium breve M16-V and neutral fructo-oligosaccharides mixture vs. AAF alone |
Prebiotic Mixture: 0.8 g/100 ml Bifidobacterium breve M16-V: 1.47 x 109 CFU/100ml |
7 | •Acceptance of formula • Hypoallergenicity (absence of clinical symptoms) • Incidence of adverse events |
• No serious adverse events were reported upon synbiotic addition • Demonstrated at 95% confidence that at least 90% of infants would have no reaction to synbiotic addition, therefore establishing the formula as hypoallergenic |
| Van Der Aa 2010 | 90 | 0-7 | EHF + Bifidobacterium breve M16-V and short chain galacto-/long chain fructooligosaccharide mixture vs. EHF alone |
Prebiotic Mixture: 0.8 g/100 ml Bifidobacterium breve M-16-V: 1.3 x 109 CFU/100ml |
84 | • Severity of atopic dermatitis measured by SCORAD index • Changes in total and specific IgE and eosinophilic granulocytes |
• SCORAD index decreased for both groups, but there was no significant difference in SCORAD index between the groups at any time • Total and specific serum IgE and eosinophilic granulocytes were unaffected by treatment • In a subgroup of infants with elevated total or specific IgE, there was a significantly greater improvement in SCORAD index in the treatment group than in the control group |
| Van Der Aa 2009 | 90 | 0-7 | EHF + Bifidobacterium breve M16-V and short chain galacto-/long chain fructooligosaccharide mixture vs. EHF |
Prebiotic Mixture: 0.8 g/100 ml Bifidobacterium breve M-16V: 1.3 x 109 CFU/100ml |
84 | • Bacterial composition, pH, lactate, and short-chain fatty acids in fecal samples • Changes in fecal consistency and frequency |
• The treatment group demonstrated a significantly higher detection rate of B. breve M16-V and concentrations of D-lactate and L-lactate than controls. • The treatment group had a significantly lower fecal pH than controls • The treatment group demonstrated higher proportions of acetic acid and lower proportions of butyric when compared to controls • Fecal consistency was reported to be significantly softer and constipation was reported less often in the treatment group |