Original Article
Probiotics to Reduce the Severity of Atopic Dermatitis in Pediatric Patients: A Systematic Review and Meta-Analysis
Uso de probióticos para disminuir la gravedad de la dermatitis atópica en población pediátrica: revisión sistemática y metaanálisis
A.F. Pachacama López, M.F. Tapia Portilla
, F. Moreno-Piedrahíta Hernández, S. Palacios-Álvarez
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Pontificia Universidad Católica del Ecuador, Quito, Ecuador
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Pachacama López, M.F. Tapia Portilla, F. Moreno-Piedrahíta Hernández, S. Palacios-Álvarez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A.F." "apellidos" => "Pachacama López" ] 1 => array:4 [ "nombre" => "M.F." "apellidos" => "Tapia Portilla" "email" => array:2 [ 0 => "mafernanda1196@outlook.es" 1 => "mafernanda1196@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Moreno-Piedrahíta Hernández" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Palacios-Álvarez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Pontificia Universidad Católica del Ecuador, Quito, Ecuador" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso de probióticos para disminuir la gravedad de la dermatitis atópica en población pediátrica: revisión sistemática y metaanálisis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3894 "Ancho" => 1583 "Tamanyo" => 583217 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Risk-of-bias assessment: review based on the judgement of the authors of the risk of each one of the articles included.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic dermatitis (AD) is a chronic, recurring disease of the skin, associated with abnormal barrier function of the skin, immunologic sensitization, and other mechanisms.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The general prevalence of this disease has increased between 2-fold and 3-fold in recent decades. The disease manifests during the 1<span class="elsevierStyleSup">st</span> year of life in approximately 60% of cases but may appear at any age. Its course may be continuous for long periods or may be recurrent. AD is mild in approximately 80% of children affected<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Probiotics are defined by the WHO as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Multiple mechanisms have been proposed for how probiotics reduce atopy, including shifting the Th1/Th2 balance toward Th1 by inhibiting Th2 cytokines or increasing production of regulatory cytokines such as IL-10 through maturation of dendritic cells or their receptors<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The objective of this study is to perform a systematic review and meta-analysis to determine whether oral administration of probiotics reduces the severity of atopic dermatitis based on the <span class="elsevierStyleItalic">Scoring Atopic Dermatitis</span> (SCORAD) scale in patients under 18 years of age with an established diagnosis of AD.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We performed a systematic review that included randomized clinical trials published to 2020. The studies had to compare the effect of probiotics with a placebo in reducing the severity of atopic dermatitis. The study population was patients under 18 years of age with an established diagnosis of atopic dermatitis, the severity of which was measured using the SCORAD scale.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies that did not meet the inclusion criteria, inconclusive studies, those that presented conflicts of interest, narrative reviews, studies with results other than those sought, studies carried out on animals, studies with interventions other than the clinical interest of this study, and those with a population over 18 year of age were excluded.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The search was performed in the following databases: MEDLINE, Web Of Science (WOS), Scopus, ClinicalTrials.gov, Epistemonikos, Trip medical database, and Biblioteca virtual in salud (BVS). The search string was as follows: (((«Dermatitis, Atopic»[Majr]) AND «Probiotics»[Majr])) AND (((«Child»[Mesh]) OR «Child, Preschool»[Mesh]) OR «Adolescent»[Mesh]).</p><p id="par0045" class="elsevierStylePara elsevierViewall">A total of 2566 articles were found and after eliminating duplicates, we obtained 2412 articles, of which, when the inclusion criteria were applied, 29 articles were obtained, and 2392 records were excluded. The authors MFT and AFPL evaluated the 29 articles based on their level of evidence and discarded 9: 2 were excluded because they did not meet the inclusion criteria, 6 did not specify important data, and 1 did not include the necessary statistical results. Finally, 20 studies were included in the systematic review and 17 studies in the meta-analysis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical Analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">The information was extracted into databases using the programs Microsoft Excel and Review Manager (Rev Man), version 5.4. The results of studies were selected that made it possible to obtain the difference of means as a measure of the size of the continuous effect and its standard deviation with 95% confidence intervals (CI). Where possible, data was taken directly and in other cases, they were calculated using the Rev Man version 5.4 calculator. Clinical outcome was taken as the difference between the baseline SCORAD score and SCORAD score at the end of follow-up.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The χ<span class="elsevierStyleSup">2</span> test was used to determine heterogeneity, which was considered for <span class="elsevierStyleItalic">P</span> < .05, and the coefficient of inconsistency between studies (I<span class="elsevierStyleSup">2</span>), considering heterogeneity if this coefficient is > 40%. The random effects model was used to carry out the meta-analysis and a funnel plot was drawn up to assess the risk of publication bias.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Risk-of-Bias Assessment</span><p id="par0060" class="elsevierStylePara elsevierViewall">The risk of selection, performance, detection, attrition, and notification bias was analyzed for each study based on the criteria proposed by the Cochrane Handbook for Systematic Reviews of Interventions. This analysis can be seen in <a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>, which show the individual risks of bias based on the criteria of both researchers.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">Twenty studies included in the systematic review were analyzed (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), of which 16 supported the use of probiotics to reduce the SCORAD severity in atopic dermatitis. With regard to the type of probiotic, 7 studies used combinations of strains and 13 used single strains; the most commonly used genus was <span class="elsevierStyleItalic">Lactobacillus</span>, species <span class="elsevierStyleItalic">rhamnosus</span>. The frequency of administration of the probiotic varied from 1 to 2 times per day and duration of treatment in the studies varied between 4 and 12 weeks.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The meta-analysis included 17 studies and the global result found a difference in measurement of –0.38, with a 95% CI of –0.63 to –0.14, in favor of the use of probiotics; however, high heterogeneity was found in the studies due to clinical and methodological variability, with I<span class="elsevierStyleSup">2</span> = 76% and χ<span class="elsevierStyleSup">2</span> with <span class="elsevierStyleItalic">P</span> = .00001 (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Subgroup analyses were performed according to type of strain (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>) and follow-up time (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>) for the use of probiotics to reduce the SCORAD; nevertheless, high heterogeneity was found in both analyses. With regard to the strain, greater benefit was not found with the use of <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> in comparison with the other probiotic strains. Based on the time of administration, a greater benefit was found after administration of probiotics for 12 weeks.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Analysis of Sensitivity and Reporting Bias</span><p id="par0080" class="elsevierStylePara elsevierViewall">A sensitivity analysis was performed, and no variations were found after repeatedly reviewing the data, and the results suggested no important changes. Reporting bias was assessed using a funnel plot (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>) and was corroborated using the trim-and-fill method<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>, where a symmetric distribution of the studies can be observed, approaching a funnel shape, which makes it possible to rule out publication bias.</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">The results of this systematic review indicated that probiotics have a beneficial effect in pediatric patients with atopic dermatitis.</p><p id="par0090" class="elsevierStylePara elsevierViewall">These results are supported by the results obtained in the meta-analysis, in which the global results support the use of probiotics to reduce the SCORAD. The heterogeneity of the studies, however, does not make it possible to determine the real magnitude of the degree to which the probiotics reduce the severity of AD as measured by SCORAD.</p><p id="par0095" class="elsevierStylePara elsevierViewall">This heterogeneity is due to the different interventions in each study, resulting from the use of different strains, the doses of probiotics, different duration of the treatments, and the subjectivity of the SCORAD scale for evaluating the severity of the AD.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Given the heterogeneity of the characteristics of the populations between the different studies, the analysis by subgroups does not show potentially real results, except for follow-up, in which case it was established that the efficacy of the use of probiotics is observed following administration for more than 12 weeks.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Makrgeorgou et al<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> performed an update of a systematic review similar to ours, based on a previous review carried out in 2017. That review included 39 articles that, although they provided a significant sample, did not specifically analyze the pediatric population and included the use of symbiotics. The study concluded that probiotics reduce SCORAD severity but with a very low score for determining a significant change in the symptoms of atopic dermatitis.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The systematic review carried out by Huang et al<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> found that more evidence was required to recommend probiotics in a generalized manner. This is because the articles included covered small and heterogeneous populations, which reduced the power of evidence of the review, unlike this review, which includes a larger number of studies and with larger populations.</p><p id="par0115" class="elsevierStylePara elsevierViewall">The limitations of this systematic review include the use of different strains of probiotic, which may lead to different results and individual conclusions in each study. Moreover, several major differences exist between the participants in the clinical trials: in some, it was established that the participants should follow a strict diet with no fermented foods, restriction of the use of antibiotics, and other requirements that were not present in all the clinical trials.</p><p id="par0120" class="elsevierStylePara elsevierViewall">In the statistical analysis for the meta-analysis, heterogeneity was found between the populations of the different studies. This constituted a limitation when analyzing the results, as it made it impossible to determine the reduction in the SCORAD score expected in patients with AD following administration of the probiotic. Another limiting factor involves the association of pharmaceutical companies and food manufacturers in the manufacture of probiotics for the trials, which may be a potential source of conflicts of interest.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The use of probiotics has been studied for several years, with a particular focus on diseases linked to the digestive system. Given that a wide range of probiotics exists on the market in our country, we may begin to use them as coadjuvant treatment in AD.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0130" class="elsevierStylePara elsevierViewall">Oral probiotics, especially strains of bacteria of the genus <span class="elsevierStyleItalic">Lactobacillus</span>, are useful for reducing the severity of atopic dermatitis but more homogeneous studies are required to determine the magnitude of this benefit.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of Interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1606485" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1437802" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1606484" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1437801" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical Analysis" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Risk-of-Bias Assessment" ] ] ] 6 => array:3 [ "identificador" => "sec0025" "titulo" => "Results" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Analysis of Sensitivity and Reporting Bias" ] ] ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of Interest" ] 10 => array:2 [ "identificador" => "xack566196" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-12-14" "fechaAceptado" => "2021-06-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1437802" "palabras" => array:7 [ 0 => "Atopic dermatitis" 1 => "Probiotics" 2 => "Children" 3 => "Adolescents" 4 => "Scoring Atopic Dermatitis (SCORAD) tool" 5 => "Meta-analysis" 6 => "Therapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1437801" "palabras" => array:6 [ 0 => "Dermatitis atópica" 1 => "Probióticos" 2 => "Niño" 3 => "SCORAD" 4 => "Metaanálisis" 5 => "Terapia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Probiotics, defined as live microbial dietary supplements that provide health benefits for the host, have been suggested as a treatment for atopic dermatitis based on a variety of proposed mechanisms of action. We analyzed evidence for the efficacy of probiotics to attenuate the severity of atopic dermatitis in pediatric patients younger than the age of 18 years.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Systematic review of trials of probiotics that included patients under the age of 18 years with a confirmed diagnosis of atopic dermatitis scored for severity using the Scoring Atopic Dermatitis SCORAD) tool. We performed a meta-analysis of the randomized placebo controlled trials. The following databases were searched: MEDLINE, Web of Science, Scopus, ClinicalTrials.gov, Epistemonikos, Trip Medical Database, and the Spanish Virtual Health Library.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Twenty trials were retrieved and included in the systematic review. Sixteen supported the use of probiotics to attenuate SCORAD-evaluated severity. Meta-analysis found an overall mean difference in effect between probiotics and placebo of −0.38 (95% CI, −0.63 to −0.14) in favor of probiotics. However, trial heterogeneity was high (I<span class="elsevierStyleSup">2</span> statistic, 76%) due to clinical and methodological variability.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">In spite of clinical heterogeneity in trials attributable to different types of probiotic products and doses, and to the subjective variability of the SCORAD scale, we conclude that probiotics are beneficial for reducing the severity of atopic dermatitis as reflected by the SCORAD index.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Los probióticos, definidos como microorganismos vivos que proveen un beneficio para la salud del huésped, se han propuesto como una opción terapéutica para la dermatitis atópica (DA), habiéndose identificado varios mecanismos de acción. Se evaluó la eficacia del uso de probióticos para disminuir la gravedad de dermatitis atópica en pacientes pediátricos menores de 18 años.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y métodos</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se realizó una revisión sistemática y metaanálisis que incluyó ensayos clínicos aleatorizados en pacientes menores de 18 años con diagnóstico establecido de dermatitis atópica, cuya gravedad estuvo medida por el Scoring Atopic Dermatitis (SCORAD) comparando el efecto de probióticos con el placebo, mediante la investigación en bases de datos MEDLINE, Web Of Science (WOS), Scopus, ClinicalTrials.gov, Epistemonikos, Trip medical database, Biblioteca virtual en salud (BVS).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron 20 estudios que fueron incluidos en la revisión sistemática, de los cuales 16 apoyan el uso de probióticos para reducir la gravedad del SCORAD en la dermatitis atópica. En el metaanálisis se obtuvo como resultado global una diferencia de medias de −0,38, con un IC 95% de −0,63 a −0,14, a favor del uso de probióticos; sin embargo, se encontró una alta heterogeneidad en los estudios debido a la variabilidad clínica y metodológica, con un I<span class="elsevierStyleSup">2</span> = 76%.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">El uso de probióticos es beneficioso para reducir la gravedad de la DA medida según SCORAD, a pesar de la presencia de una alta heterogeneidad clínica, derivada de sus diferentes tipos, dosis y variabilidad de una escala subjetiva como es el SCORAD.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pachacama López AF, Tapia Portilla MF, Moreno-Piedrahíta Hernández F, Palacios-Álvarez S. Uso de probióticos para disminuir la gravedad de la dermatitis atópica en población pediátrica: revisión sistemática y metaanálisis. Actas Dermosifiliogr. 2021;112:881–890.</p>" ] ] "multimedia" => array:8 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2383 "Ancho" => 2500 "Tamanyo" => 326324 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flow chart of results.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 915 "Ancho" => 2167 "Tamanyo" => 204135 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Risk-of-bias assessment: review based on the judgement of the authors of the risk of bias, presented as a percentage of all the articles included.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3894 "Ancho" => 1583 "Tamanyo" => 583217 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Risk-of-bias assessment: review based on the judgement of the authors of the risk of each one of the articles included.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1716 "Ancho" => 3167 "Tamanyo" => 531049 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Forest plot: efficacy of probiotics vs. placebo in reducing the severity of AD measured by SCORAD.</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1885 "Ancho" => 3167 "Tamanyo" => 499751 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Forest plot: efficacy of <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> and other probiotics vs. placebo in reducing the severity of AD measured by SCORAD.</p>" ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 2178 "Ancho" => 3167 "Tamanyo" => 597084 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Forest plot: efficacy of probiotics vs. placebo in reducing the severity of AD by follow-up time.</p>" ] ] 6 => array:8 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 2595 "Ancho" => 2083 "Tamanyo" => 208453 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Funnel plot: use of probiotics vs. placebo to reduce the SCORAD score.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: B indicates <span class="elsevierStyleItalic">Bifidobacterium</span>; AD, atopic dermatitis; IgE, immunoglobulin E; L, <span class="elsevierStyleItalic">Lactobacillus;</span> SCORAD, Scoring Atopic Dermatitis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Population \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Probiotics (Genus, Species, Strain) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Duration \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study Conclusion \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Navarro-López et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>, 2018 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 children aged 4 to 17 years with AD, moderate SCORAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Bifidobacterium lactis</span> CECT 8145, <span class="elsevierStyleItalic">B longum</span> CECT 7347, and <span class="elsevierStyleItalic">Lactobacillus casei</span> CECT 9104 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Use of probiotics is useful in reducing SCORAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prakoeswa et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>, 2017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 children aged 0 to 14 years with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus plantarum</span> IS-10506 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The use of probiotics is a potential treatment for AD in children \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wang y Wang<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>, 2015 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">212 children aged 1 to 18 years AD and at least 1 positive skin prick or IgE antibody test specific to common allergens \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus paracasei</span> GMNL-133, <span class="elsevierStyleItalic">Lactobacillus fermentum</span> GM090 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The mix of probiotics is associated with clinical improvement of AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wu et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>, 2017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 children aged 4 to 48 months AD, SCORAD ≥ 15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> (MP108) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The use of probiotics reduces all SCORAD parameters in children with AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Han et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 children aged 1 to 13 years with AD, SCORAD between 20 and 50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus plantarum</span> CJLP133 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Probiotic supplements are beneficial for the treatment of AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gore et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">137 children aged 3 to 6 months with AD, SCORAD ≥ 10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus paracasei</span> CNCM I-2116 or <span class="elsevierStyleItalic">Bifidobacterium lactis</span> CNCM I-3446 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No benefit was found for the use of probiotics in the treatment of AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Woo et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>, 2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 children aged 2 to 10 years with AD, SCORAD > 25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus sakei</span> KCTC 10755BP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The use of probiotics is associated with clinical improvement of AD in children \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weston<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>, 2005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 children with a diagnosis of AD and SCORAD ≥ 25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus fermentum</span> VRI-033 PCC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The probiotic supplement is beneficial in reducing the extension and severity of SCORAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sistek et al.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>, 2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 children aged 1 to 10 years and at least 1 positive skin prick or specific IgE antibody test, or a RAST test positive for common allergens \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> and <span class="elsevierStyleItalic">Bifidobacterium lactis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Probiotics improved clinical signs and symptoms of AD only in patients with food sensitivities \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Grüber et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>, 2007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 children aged 3 to 12 months with AD, moderate to severe SCORAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> GG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No therapeutic effect for reducing the severity of AD was found \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brouwer et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>, 2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 children aged under 5 months with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> (NP-Lrh), <span class="elsevierStyleItalic">Lactobacillus</span> GG (NP-LGG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No statistically significant effect of probiotic supplements on SCORAD, inflammatory parameters, or cytokine production \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fölster-Holst et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>, 2006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54 children aged 1 to 55 months with moderate to severe AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> strain GG (LGG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No significant differences were found between the groups in terms of clinical symptoms (SCORAD, pruritus, sleep loss) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rosenfeldt et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>, 2003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 children aged 1 to 13 years with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lyophilized <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> (19070-2) and <span class="elsevierStyleItalic">Lactobacillus reuteri</span> (DSM 122460) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A combination of probiotics was beneficial in the treatment of AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yeşilova et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 children aged 1 to 13 years with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Bifidobacterium bifidum</span>, <span class="elsevierStyleItalic">Lactobacillus acidophilus</span>, <span class="elsevierStyleItalic">L casei</span>, <span class="elsevierStyleItalic">L salivarius</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The use of probiotics is effective in reducing the SCORAD score in patients with AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nakata et al.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>, 2019 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 children aged 10 months to 3 years with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus acidophilus</span> L-92 (L-92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Consuming a specific quantity of L-92 functions as a complementary treatment for AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Han et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">124 children aged 2 to 13 years with mild to moderate AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus pentosus</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The SCORAD scores for the probiotics group improved significantly compared to the placebo group in AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gøbel et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>, 2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 children aged 7 to 24 months with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus acidophilus</span> NCFM, <span class="elsevierStyleItalic">Bifidobacterium animalis</span> ssp. <span class="elsevierStyleItalic">lactis</span> Bi-07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No clinical or general immunologic effect was shown by probiotic supplements in children with AD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chernyshov<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>, 2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 children aged 2 months to 4 years with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> R0011, <span class="elsevierStyleItalic">L helveticus</span> R0052 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The use of the probiotic <span class="elsevierStyleItalic">Lactobacillus acidophilus</span> is associated with a larger number of patients who achieved marked clinical improvement and a greater corticosteroid-saving effect \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Isolauri et al.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>, 2000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 children with a mean age of 4.6 months with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Bifidobacterium lactis</span> Bb-12, <span class="elsevierStyleItalic">Lactobacillus</span> strain GG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A significant improvement occurred in the general condition of the skin in patients who received formulae supplemented with probiotics, compared to the non-supplemented group \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Viljanen et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>, 2005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">230 children aged 1.4 to 11.9 months with AD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lactobacillus</span> GG (LGG), <span class="elsevierStyleItalic">L rhamnosus</span> LC705 (LC705), <span class="elsevierStyleItalic">Bifidobacterium breve</span> Bbi99, <span class="elsevierStyleItalic">Propionibacterium freudenreichii</span> ssp. <span class="elsevierStyleItalic">shermanii</span> JS (<span class="elsevierStyleItalic">Propionibacterium</span> JS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 wk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Treatment with LGG shows a greater reduction of the SCORAD score than the placebo group in infants suffering from AD associated with IgE \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2740425.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Studies Included.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatitis atópica (eccema atópico)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Leung" 1 => "L. Eichenfield" 2 => "M. Boguniewicz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "8th ed." "titulo" => "Fitzpatrick Dermatología En Medicina General" "fecha" => "2014" "paginaInicial" => "165" "paginaFinal" => "182" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Weidinger" 1 => "N. Novak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(15)00149-X" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2016" "volumen" => "387" "paginaInicial" => "1109" "paginaFinal" => "1122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26377142" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recent advances in epidemiology and prevention of atopic eczema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Cipriani" 1 => "A. Dondi" 2 => "G. Ricci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pai.12309" "Revista" => array:6 [ "tituloSerie" => "Pediatr Allergy Immunol" "fecha" => "2014" "volumen" => "25" "paginaInicial" => "630" "paginaFinal" => "638" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25406640" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of oral administration of a mixture of probiotic strains on SCORAD index and use of topical steroids in young patients with moderate atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Navarro-López" 1 => "A. Ramírez-Boscá" 2 => "D. Ramón-Vidal" 3 => "B. Ruzafa-Costas" 4 => "S. Genovés-Martínez" 5 => "E. Chenoll-Cuadros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2017.3647" "Revista" => array:5 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2018" "volumen" => "154" "paginaInicial" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29117309" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manual Cochrane de Revisiones Sistemáticas de Intervenciones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Higgins" 1 => "S. Green" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Barcelona Cent Cochrane Iberoam" "fecha" => "2012" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lactobacillus plantarum</span> IS-10506 supplementation reduced SCORAD in children with atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.R.S. Prakoeswa" 1 => "N. Herwanto" 2 => "R. Prameswari" 3 => "L. Astari" 4 => "S. Sawitri" 5 => "A.-N. Hidayati" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3920/BM2017.0011" "Revista" => array:5 [ "tituloSerie" => "Benef Microbes" "fecha" => "2017" "volumen" => "8" "paginaInicial" => "833" "paginaFinal" => "840" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Children with atopic dermatitis show clinical improvement after <span class="elsevierStyleItalic">Lactobacillus exposure</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I.-J. Wang" 1 => "J.-Y. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cea.12489" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "2015" "volumen" => "45" "paginaInicial" => "779" "paginaFinal" => "787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25600169" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of efficacy and safety of <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> in children aged 4-48 months with atopic dermatitis: An 8-week, double-blind, randomized, placebo-controlled study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.-J. Wu" 1 => "W.-F. Wu" 2 => "C.-W. Hung" 3 => "M.S. Ku" 4 => "P.-F. Liao" 5 => "H.-L. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jmii.2015.10.003" "Revista" => array:6 [ "tituloSerie" => "J Microbiol Immunol Infect" "fecha" => "2017" "volumen" => "50" "paginaInicial" => "684" "paginaFinal" => "692" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26733351" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized trial of <span class="elsevierStyleItalic">Lactobacillus plantarum</span> CJLP133 for the treatment of atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Han" 1 => "B. Kim" 2 => "J. Ban" 3 => "J. Lee" 4 => "B.-J. Kim" 5 => "B. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pai.12010" "Revista" => array:5 [ "tituloSerie" => "Pediatr Allergy Immunol" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "667" "paginaFinal" => "673" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment and secondary prevention effects of the probiotics <span class="elsevierStyleItalic">Lactobacillus paracasei</span> or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Gore" 1 => "A. Custovic" 2 => "G.W. Tannock" 3 => "K. Munro" 4 => "G. Kerry" 5 => "K. Jhonson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2222.2011.03885.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "2012" "volumen" => "42" "paginaInicial" => "112" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22092692" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of <span class="elsevierStyleItalic">Lactobacillus sakei</span> supplementation in children with atopic eczema-dermatitis syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.-I. Woo" 1 => "J.-Y. Kim" 2 => "Y.-J. Lee" 3 => "N.-S. Kim" 4 => "Y.-S. Hahn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.anai.2010.01.020" "Revista" => array:6 [ "tituloSerie" => "Ann Allergy Asthma Immunol" "fecha" => "2010" "volumen" => "104" "paginaInicial" => "343" "paginaFinal" => "348" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20408346" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of probiotics on atopic dermatitis: A randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Weston" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2004.060673" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2005" "volumen" => "90" "paginaInicial" => "892" "paginaFinal" => "897" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15863468" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the effect of probiotics on atopic dermatitis confined to food sensitized children?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Sistek" 1 => "R. Kelly" 2 => "K. Wickens" 3 => "T. Stanley" 4 => "P. Fitzharris" 5 => "J. Crane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2222.2006.02485.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "2006" "volumen" => "36" "paginaInicial" => "629" "paginaFinal" => "633" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16650048" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized, placebo-controlled trial of <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> GG as treatment of atopic dermatitis in infancy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Grüber" 1 => "M. Wendt" 2 => "C. Sulser" 3 => "S. Lau" 4 => "M. Kulig" 5 => "U. Wuahn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2007.01543.x" "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "2007" "volumen" => "62" "paginaInicial" => "1270" "paginaFinal" => "1276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17919141" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "No effects of probiotics on atopic dermatitis in infancy: A randomized placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.L. Brouwer" 1 => "S.A.A. Wolt-Plompen" 2 => "A.E.J. Dubois" 3 => "S. Van der Heide" 4 => "D.-F. Jansen" 5 => "M.-A. Hoijer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2222.2006.02513.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "2006" "volumen" => "36" "paginaInicial" => "899" "paginaFinal" => "906" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16839405" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective, randomized controlled trial on <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> in infants with moderate to severe atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Fölster-Holst" 1 => "F. Müller" 2 => "N. Schnopp" 3 => "D. Abeck" 4 => "I. Kreiselmaier" 5 => "T. Lenz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2006.07558.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2006" "volumen" => "155" "paginaInicial" => "1256" "paginaFinal" => "1261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17107398" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of probiotic <span class="elsevierStyleItalic">Lactobacillus strains</span> in children with atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Rosenfeldt" 1 => "E. Benfeldt" 2 => "S.D. Nielsen" 3 => "K.F. Michaelsen" 4 => "D.L. Jeppesen" 5 => "N.H. Valerius" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mai.2003.389" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2003" "volumen" => "111" "paginaInicial" => "389" "paginaFinal" => "395" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12589361" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of probiotics on the treatment of children with atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Yeşilova" 1 => "Ö. Çalka" 2 => "N. Akdeniz" 3 => "M. Berktaş" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5021/ad.2012.24.2.189" "Revista" => array:5 [ "tituloSerie" => "Ann Dermatol" "fecha" => "2012" "volumen" => "24" "paginaInicial" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22577270" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Additive effect of <span class="elsevierStyleItalic">Lactobacillus acidophilus</span> L-92 on children with atopic dermatitis concomitant with food allergy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Nakata" 1 => "T. Hirota" 2 => "H. Umemura" 3 => "T. Nakagawa" 4 => "N. Kando" 5 => "M. Futamura" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5415/apallergy.2019.9.e18" "Revista" => array:5 [ "tituloSerie" => "Asia Pac Allergy" "fecha" => "2019" "volumen" => "9" "paginaInicial" => "E18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31089460" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probiotics to young children with atopic dermatitis: A randomized placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Gøbel" 1 => "N. Larsen" 2 => "C. Mølgaard" 3 => "M. Jakobsen" 4 => "K.F. Michaelsen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Probiotics Prebiotics" "fecha" => "2010" "volumen" => "5" "paginaInicial" => "53" "paginaFinal" => "59" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized, placebo-controlled trial on clinical and immunologic effects of probiotic containing <span class="elsevierStyleItalic">Lactobacillus rhamnosus</span> R0011 and <span class="elsevierStyleItalic">L. helveticus</span> R0052 in infants with atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.V. Chernyshov" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/08910600903444234" "Revista" => array:5 [ "tituloSerie" => "Microb Ecol Health Dis" "fecha" => "2009" "volumen" => "21" "paginaInicial" => "228" "paginaFinal" => "232" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probiotics in the management of atopic eczema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Isolauri" 1 => "T. Arvola" 2 => "Y. Sutas" 3 => "E. Moilanen" 4 => "S. Salminen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2222.2000.00943.x" "Revista" => array:5 [ "tituloSerie" => "Clin Exp Allergy" "fecha" => "2000" "volumen" => "30" "paginaInicial" => "1605" "paginaFinal" => "1610" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Viljanen" 1 => "E. Savilahti" 2 => "T. Haahtela" 3 => "K. Juntunen-Backman" 4 => "R. Korpela" 5 => "T. Poussa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2004.00514.x" "Revista" => array:5 [ "tituloSerie" => "Allergy" "fecha" => "2005" "volumen" => "60" "paginaInicial" => "494" "paginaFinal" => "500" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Linyu" 1 => "L. Lifeng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0000000000015987" "Revista" => array:2 [ "tituloSerie" => "The trim-and-fill method for publication bias: practical guidelines and recommendations based on a large database of meta-analyses" "fecha" => "2019" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probiotics for treating eczema" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Makrgeorgou" 1 => "J. Leonardi-Bee" 2 => "F.J. Bath-Hextall" 3 => "D.F. Murrell" 4 => "M. Tang" 5 => "A. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD006135.pub3" "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2018" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probiotics for the treatment of atopic dermatitis in children: A systematic review and meta-analysis of randomized controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Huang" 1 => "H. Ning" 2 => "M. Shen" 3 => "J. Li" 4 => "J. Zhang" 5 => "X. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fcimb.2017.00392" "Revista" => array:4 [ "tituloSerie" => "Front Cell Infect Microbiol" "fecha" => "2017" "volumen" => "7" "paginaInicial" => "392" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack566196" "titulo" => "Acknowledgments" "texto" => "<p id="par0140" class="elsevierStylePara elsevierViewall">The authors would like to thank the Pontificada Universidad Católica del Ecuador for encouraging this study.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000010/v1_202111080506/S1578219021002973/v1_202111080506/en/main.assets" "Apartado" => array:4 [ "identificador" => "6155" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011200000010/v1_202111080506/S1578219021002973/v1_202111080506/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002973?idApp=UINPBA000044" ]
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