{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:51:35Z","timestamp":1785466295314,"version":"3.56.0"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T00:00:00Z","timestamp":1619308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Science Foundation of Hunan Province China","award":["2020JJ4767"],"award-info":[{"award-number":["2020JJ4767"]}]},{"name":"Central South University","award":["2020zzts809"],"award-info":[{"award-number":["2020zzts809"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: Whether early supplementation of probiotics to improve intestinal flora can effectively prevent eczema remains a controversial issue. We aimed to investigate the effect of a mixed strain of Lactobacillus and Bifidobacterium on eczema in infants under three years old at present; (2) Methods: We searched the databases of PubMed, Web of Science, and Cochrane Library, as well as National Knowledge Infrastructure (CNKI), WeiPu (VIP), and WanFang Data (WanFang) for randomized controlled trials (RCTs) of probiotics in the prevention of eczema in infants without language restriction. The main outcome was eczema incidence, while adverse events during the intervention constituted the secondary outcome. The random-\/fixed-effects model was utilized to calculate the combined relative risk (RR) and 95% confidence interval (CI). The methodological quality of the study was evaluated using the Cochrane \u201cbias risk\u201d tool. According to the initial intervention time, subgroup analysis was carried out, follow-up time, family history, etc.; (3) Results: Nine articles were selected (2093 infants). The Lactobacillus and Bifidobacterium mixed strain could prevent eczema in infants under three years of age compared to the placebo (RR = 0.60; I2 = 67%; p &lt; 0.001). Subgroup analysis revealed that the mixture of two probiotic strains had preventive effects on both infants with positive (RR = 0.53; I2 = 52%; p &lt; 0.001) and negative (RR = 0.69; I2 = 62%; p = 0.02) family history; The follow-up time for \u226412 months (RR = 0.65; I2 = 12%; p = 0.01) and 12\u201324 months (RR = 0.60; I2 = 79%; p = 0.003), daily dose of probiotics \u2264 1 \u00d7 109 and &gt; 1 \u00d7 109 colony forming units all can be effective (p &lt; 0.01); Compared with the intervention of infants alone (RR = 0.63; I2 = 63%; p = 0.29), the effect of probiotics mixture at the beginning of pregnancy was more significant (RR = 0.59; I2 = 71%; p &lt; 0.001); Except for the mixture of Lactobacillus rhamnosusGG (LGG) and Bifidobacterium longum (B. longum) (p = 0.18), other subgroups of intervention group can play a preventive effect (p &lt; 0.05); (4) Conclusions: The mixed strain of Lactobacillus and Bifidobacterium can effectively reduce the incidence of eczema in infants under three years old. However, further research is needed to fully understand the exact mechanism of their effect on infant eczema.<\/jats:p>","DOI":"10.3390\/nu13051461","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T22:31:39Z","timestamp":1619389899000},"page":"1461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Can Mixed Strains of Lactobacillus and Bifidobacterium Reduce Eczema in Infants under Three Years of Age? A Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Minghui","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanmei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-1018","authenticated-orcid":false,"given":"Qian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,25]]},"reference":[{"key":"ref_1","first-page":"31","article-title":"Research status of related factors of infantile eczema","volume":"18","author":"Xiaohui","year":"2018","journal-title":"Dig. World Latest Med. Inf."},{"key":"ref_2","unstructured":"Pawankar, R., Canonica, G., Holgate, S., Lockey, R., and Blaiss, M. (2013). World Allergy Organization (WAO) White Book on Allergy, Updat, World Allergy Organization."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.anai.2014.07.003","article-title":"Prevalence and determinants of atopy and allergic diseases among school-age children in rural Saskatchewan, Canada","volume":"113","author":"Chu","year":"2014","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1155\/2010\/913123","article-title":"Asthma and allergic disease prevalence in a diverse sample of Toronto school children: Results from the Toronto Child Health Evaluation Questionnaire (T-CHEQ) Study","volume":"17","author":"Dell","year":"2010","journal-title":"Can. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/pai.12579","article-title":"Role of environmental exposures and filaggrin mutations on associations of ethnic origin with risk of childhood eczema. The Generation R Study","volume":"27","author":"Elbert","year":"2016","journal-title":"Pediatric Allergy Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1740-8709.2008.00169.x","article-title":"Breastfeeding protects against adverse respiratory outcomes at 15 months of age","volume":"5","author":"Silvers","year":"2009","journal-title":"Matern. Child. Nutr."},{"key":"ref_7","first-page":"118","article-title":"Clinical analysis of 222 cases of infantile eczema","volume":"4","author":"Mengzhi","year":"2014","journal-title":"J. Chin. Med. Cosmetol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.anai.2009.10.002","article-title":"From atopic dermatitis to asthma: The atopic march","volume":"105","author":"Spergel","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic","volume":"11","author":"Hill","year":"2014","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jaci.2007.10.043","article-title":"Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis","volume":"121","author":"Lee","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Jin, S., Wang, J., Zhang, L., Mu, Y., Huang, K., Zhao, B., Zhang, K., Cui, Y., and Li, S. (2019). Variations in early gut microbiome are associated with childhood eczema. FEMS Microbiol. Lett., 366.","DOI":"10.1093\/femsle\/fnz020"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/apa.13132","article-title":"Breastfeeding and asthma and allergies: A systematic review and meta-analysis","volume":"104","author":"Lodge","year":"2015","journal-title":"Acta Paediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1111\/pai.12560","article-title":"Neonatal risk factors of atopic dermatitis in Denmark - Results from a nationwide register-based study","volume":"27","author":"Egeberg","year":"2016","journal-title":"Pediatric Allergy Immunol."},{"key":"ref_14","first-page":"29","article-title":"Efficacy and hidden danger of probiotics","volume":"71","author":"Ting","year":"2019","journal-title":"J. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1111\/j.1365-2222.2005.02259.x","article-title":"Fecal microbiota in sensitized wheezy and non-sensitized non-wheezy children: A nested case-control study","volume":"35","author":"Murray","year":"2005","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.jaci.2015.08.021","article-title":"Faecalibacterium prausnitzii subspecies-level dysbiosis in the human gut microbiome underlying atopic dermatitis","volume":"137","author":"Song","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.det.2017.02.006","article-title":"An Update on the Pathophysiology of Atopic Dermatitis","volume":"35","author":"Malik","year":"2017","journal-title":"Dermatol. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"320","DOI":"10.3109\/02770903.2013.862259","article-title":"The immunomodulatory effect of probiotics beyond atopy: An update","volume":"51","author":"Vitaliti","year":"2014","journal-title":"J. Asthma"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Cabana, M.D., McKean, M., Caughey, A.B., Fong, L., Lynch, S., Wong, A., Leong, R., Boushey, H.A., and Hilton, J.F. (2017). Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial. Pediatrics, 140.","DOI":"10.1542\/peds.2016-3000"},{"key":"ref_20","unstructured":"Chenxi, H. (2019). Preventive Effect of Probiotics on Neonatal Eczema. [Master\u2019s Thesis, North China University of Science and Technology]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40413-015-0055-2","article-title":"World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics","volume":"8","author":"Fiocchi","year":"2015","journal-title":"World Allergy Organ. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1111\/all.12398","article-title":"EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"de Silva, D., Halken, S., Singh, C., Antonella, M., Angier, E., Arasi, S., Arshad, H., Beyer, K., Boyle, R., and du Toit, G. (2020). Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials. Pediatric Allergy Immunol.","DOI":"10.1111\/pai.13273"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1111\/cea.12838","article-title":"Pre- and probiotics for allergy prevention: Time to revisit recommendations?","volume":"46","author":"Forsberg","year":"2016","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_25","unstructured":"Zhuoyun, M., Ze, Y., and Jialong, Y. (2020). Application status and efficacy of probiotics in food. J. Mod. Food, 129\u2013131."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1177\/0300060513493692","article-title":"Meta-analysis of probiotics and\/or prebiotics for the prevention of eczema","volume":"41","author":"Dang","year":"2013","journal-title":"J. Int. Med. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3920\/BM2017.0191","article-title":"Eczema-protective probiotic alters infant gut microbiome functional capacity but not composition: Sub-sample analysis from a RCT","volume":"10","author":"Murphy","year":"2019","journal-title":"Benef. Microbes"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"David, M., Alessandro, L., Jennifer, T., Douglas, G.A., and Group, T.P. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gu, S., Yang, A.W., Xue, C.C., Li, C.G., Pang, C., Zhang, W., and Williams, H.C. (2013). Chinese herbal medicine for atopic eczema. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD002291.pub4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1002\/(SICI)1097-0258(19980430)17:8<841::AID-SIM781>3.0.CO;2-D","article-title":"Detecting and describing heterogeneity in meta-analysis","volume":"17","author":"Hardy","year":"1998","journal-title":"Stat. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1136\/archdischild-2013-305799","article-title":"Probiotics in the prevention of eczema: A randomised controlled trial","volume":"99","author":"Allen","year":"2014","journal-title":"Arch. Dis. Child."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1365-2133.2010.09889.x","article-title":"Probiotics in pregnant women to prevent allergic disease: A randomized, double-blind trial","volume":"163","author":"Dotterud","year":"2010","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1111\/j.1365-2222.2008.03008.x","article-title":"Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: A double-blind placebo-controlled study","volume":"38","author":"Huurre","year":"2008","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e386","DOI":"10.1111\/j.1399-3038.2009.00958.x","article-title":"Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: A double-blind, randomized, placebo-controlled trial","volume":"21","author":"Kim","year":"2010","journal-title":"Pediatric Allergy Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.jaci.2012.09.003","article-title":"Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant","volume":"130","author":"Rautava","year":"2012","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1111\/cea.12930","article-title":"Reduced Th22 cell proportion and prevention of atopic dermatitis in infants following maternal probiotic supplementation","volume":"47","author":"Ro","year":"2017","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/pai.13018","article-title":"Probiotics in late infancy reduce the incidence of eczema: A randomized controlled trial","volume":"30","author":"Schmidt","year":"2019","journal-title":"Pediatric Allergy Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13601-016-0119-6","article-title":"Atopic dermatitis prevention in children following maternal probiotic supplementation does not appear to be mediated by breast milk TSLP or TGF-beta","volume":"6","author":"Simpson","year":"2016","journal-title":"Clin. Transl. Allergy"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/j.1365-2222.2008.03133.x","article-title":"Probiotic supplementation in the first 6 months of life in at risk Asian infants\u2014Effects on eczema and atopic sensitization at the age of 1 year","volume":"39","author":"Soh","year":"2009","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_40","first-page":"873","article-title":"Effects of probiotics supplementation during pregnancy and infancy to prevent allergic eczema in children: A meta analysis","volume":"26","author":"Lafang","year":"2018","journal-title":"Chin. J. Child. Health Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1111\/all.12700","article-title":"Probiotics for prevention of atopic diseases in infants: Systematic review and meta-analysis","volume":"70","author":"Zuccotti","year":"2015","journal-title":"Allergy"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/cea.12332","article-title":"The gut microbiota and its role in the development of allergic disease: A wider perspective","volume":"45","author":"West","year":"2015","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."},{"key":"ref_43","first-page":"114","article-title":"Application of probiotics in children with allergic diseases","volume":"32","author":"Yuejie","year":"2017","journal-title":"Chin. J. Pract. Pediatrics"},{"key":"ref_44","first-page":"504","article-title":"Probiotics for prevention of allergic diseases in children: A meta analysis","volume":"50","author":"Lujing","year":"2012","journal-title":"Chin. J. Pediatrics"},{"key":"ref_45","first-page":"1372","article-title":"Probiotics in the prevention of infantile eczema and atopic eczema: A systematic review","volume":"12","author":"Yu","year":"2012","journal-title":"Chin. J. Evid. Based Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1159\/000356338","article-title":"Supplementation with probiotics in the first 6 months of life did not protect against eczema and allergy in at-risk Asian infants: A 5-year follow-up","volume":"163","author":"Loo","year":"2014","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3945\/jn.109.117093","article-title":"Dietary supplementation with lactobacilli and bifidobacteria is well tolerated and not associated with adverse events during late pregnancy and early infancy","volume":"140","author":"Allen","year":"2010","journal-title":"J. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e659","DOI":"10.1111\/j.1399-3038.2010.01061.x","article-title":"Probiotics and allergy in children\u2014An update review","volume":"21","author":"Pan","year":"2010","journal-title":"Pediatric Allergy Immunol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:52:42Z","timestamp":1760161962000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,25]]},"references-count":48,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["nu13051461"],"URL":"https:\/\/doi.org\/10.3390\/nu13051461","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,25]]}}}