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Ciencia & Saude Coletiva 2008We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease. Electronic... (Meta-Analysis)
Meta-Analysis Review
We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease. Electronic searches on household intervention and atopic disease were conducted in 2007 in EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials comparing asthma outcomes in a household intervention group with either placebo intervention or no intervention. Meta-analyses on the prevention studies found that the interventions made no difference to the onset of wheeze but made a significant reduction in physician-diagnosed asthma. Meta-analysis of lung function outcomes indicated no improvement due to the interventions but found a reduction in symptom days. Qualitatively, health care was used less in those receiving interventions. However, in one study that compared intervention, placebo, and control arms, the reduction in heath care use was similar in the placebo and intervention arms. This review suggests that there is not sufficient evidence to suggest implementing hygiene measures in an attempt to improve outcomes in existing atopic disease, but interventions from birth in those at high risk of atopy are useful in preventing diagnosed asthma but not parental-reported wheeze.
Topics: Asthma; Child; Dust; Environmental Exposure; Humans; Severity of Illness Index
PubMed: 18833368
DOI: 10.1590/s1413-81232008000600026 -
Asian Pacific Journal of Allergy and... Aug 2023The effect of probiotics in the treatment of atopic dermatitis (AD) is inconclusive, partially due to the heterogeneities of AD.
BACKGROUND
The effect of probiotics in the treatment of atopic dermatitis (AD) is inconclusive, partially due to the heterogeneities of AD.
OBJECTIVE
The aim of the present study was to investigate the efficacy of probiotics in the treatment of AD with a subgroup analysis according to country, severity of AD, duration of supplementation, and probiotic strain.
METHODS
Original articles reporting the therapeutic efficacy of probiotics for AD were identified by searching PubMed, Cochrane Library databases, and Embase from inception to September 30, 2022.
RESULTS
This meta-analysis included 1,382 patients with AD from 25 randomized controlled trials. Probiotic supplementation was effective for the treatment of AD, reflected in a significant decrease in the SCORing Atopic Dermatitis (SCORAD) index (SMD, -4.0; 95%CI, -7.3 to -0.7). The subgroup analysis showed a significant therapeutic effect for AD among patients with mild or moderate AD (SMD, -1.4; 95%CIs -2.2 to -0.7), in those supplemented for more than three months (SMD, -5.1; 95%CIs -9.7 to -0.4), and in those supplemented with a probiotic that contained Lactobacillus spp. strains combined with or without other strains (SMD, -4.4; 95%CIs -8.0 to -0.8). In addition, the therapeutic effects of probiotics showed differences according to country and geographic region.
CONCLUSIONS
Probiotics can be beneficial for the treatment of AD, and their therapeutic effect may be individually tailored to improve it based on the severity of AD, strain of probiotics, duration of supplementation, and geographic region.
PubMed: 37578483
DOI: 10.12932/AP-280323-1576 -
Italian Journal of Pediatrics Apr 2024Evidence about feeding practices' consequences in small for gestational age newborns is not well established because they are less likely to initiate and continue... (Review)
Review
Evidence about feeding practices' consequences in small for gestational age newborns is not well established because they are less likely to initiate and continue breastfeeding than other newborns. Our aim was to study current knowledge about the benefits of exclusive human milk diet after 2 years of age in small for gestational age newborns. A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline criteria. Pubmed and Scopus were searched for studies published from databases inception until June 2, 2023. Included articles were analysed and synthesised. Risk of bias and level of evidence assessments were performed. They were enrolled small for gestational age newborns fed by breastfeeding, breast milk or donor milk. The systematic review included 9 articles which were related to 4 health domains: neurodevelopment, cardiovascular, somatic growth and bone mineralization and atopy. Extracted data support a beneficial effect of breastfeeding on these outcomes. Better quality of evidence and longer follow-up are needed.
Topics: Humans; Milk, Human; Infant, Newborn; Breast Feeding; Infant, Small for Gestational Age
PubMed: 38679716
DOI: 10.1186/s13052-024-01648-3 -
Medical Principles and Practice :... 2018To study the available data on the prevalence of atopic diseases and food allergy in children living on the Arabian Peninsula.
OBJECTIVES
To study the available data on the prevalence of atopic diseases and food allergy in children living on the Arabian Peninsula.
METHODS
A PubMed search for relevant published articles was conducted using the following search terms singly or in combination: "atopy," "atopic disease," "atopic disorder," "International Study of Asthma and Allergies in Childhood," "ISAAC," "asthma," "allergic rhinitis," "eczema," and "food allergy" in combination with the names of countries of the Arabian Peninsula (Kuwait, United Arab Emirates, Bahrain, Qatar, Oman, Kingdom of Saudi Arabia, and Yemen). The search captured studies published up to December 2017.
RESULTS
A total of 8 publications reporting prevalence rates of any type of atopic disease in children in 7 countries of the Arabian Peninsula were retrieved. The prevalence of all atopic disorders was comparable between countries of the Arabian Peninsula. The overall prevalence of asthma ranged from 8 to 23%, while the reported prevalence of eczema ranged from 7.5 to 22.5%. There was great variation in the prevalence rates of rhinoconjunctivitis, which ranged from 6.3 to 30.5%. The prevalence of food allergy (8.1%) was reported for 1 country only, the United Arab Emirates.
CONCLUSIONS
The reported overall rates of atopic disease in countries of the Arabian Peninsula are comparable to those reported in other industrialized countries. This is probably related to the good economic status in the region, which is reflected in the living standards and lifestyle. Further, genetic factors, such as factors related to gene polymorphism, and the high rate of consanguinity in the region may contribute to the higher prevalence of atopic diseases.
Topics: Asthma; Eczema; Food Hypersensitivity; Genetic Predisposition to Disease; Humans; Hypersensitivity; Middle East; Prevalence; Rhinitis, Allergic; Risk Factors; Surveys and Questionnaires
PubMed: 30149382
DOI: 10.1159/000493267 -
The Cochrane Database of Systematic... Jul 2007In infants with a family history of atopy, food allergen avoidance has been advocated as means of preventing the development of atopic disease, when breast-feeding is... (Review)
Review
BACKGROUND
In infants with a family history of atopy, food allergen avoidance has been advocated as means of preventing the development of atopic disease, when breast-feeding is not possible or supplemental feeding is needed. Most infant formulas are based on cow's milk protein. Alternative choices include soya based and hydrolysed cows milk formulas.
OBJECTIVES
To estimate the effect of dietary avoidance of cow's milk protein on the development of asthma or wheeze in children.
SEARCH STRATEGY
We searched the Cochrane database for eligible trials until February 2002. We obtained the full text papers of all abstracts identified as RCTs and two reviewers independently reviewed them.
SELECTION CRITERIA
We included randomised controlled trials involving children with a family history of atopy in at least one first degree relative, if feeding with cow's milk based standard formula was compared to dietary avoidance of cow's milk protein, using soya or other hypoallergenic formula during the initial four months of life or longer.
DATA COLLECTION AND ANALYSIS
Two reviewers extracted data independently. A priori defined subgroups were the types of hypoallergenic artificial feed and dietary restrictions on mother and/or child's diet.
MAIN RESULTS
Six trials used hydrolysed formula for at least four months, in addition to dietary restrictions and in some cases dust-mite reduction measures. The risk of infants experiencing asthma or wheeze during the first year of life was reduced compared to standard cow's milk based formula (Relative Risk 0.40, 95% Confidence Intervals 0.19 to 0.85). Feeding soya-based formula as opposed to standard cow's milk formula did not reduce the risk of having asthma or wheeze at any age.
AUTHORS' CONCLUSIONS
Breast-milk should remain the feed of choice for all babies. In infants with at least one first degree relative with atopy, hydrolysed formula for a minimum of four months combined with dietary restrictions and environment measures may reduce the risk of developing asthma or wheeze in the first year of life. There is insufficient evidence to suggest that soya-based milk formula has any benefit.
Topics: Asthma; Family; Humans; Infant; Infant Food; Infant, Newborn; Milk Hypersensitivity; Milk Proteins; Randomized Controlled Trials as Topic; Respiratory Sounds
PubMed: 17636737
DOI: 10.1002/14651858.CD003795.pub2 -
Clinical and Experimental Allergy :... Sep 2019Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations...
BACKGROUND
Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes.
OBJECTIVE
We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children.
METHODS
Electronic bibliographic databases (MEDLINE, EMBASE and Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist.
RESULTS
A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitization; nine, wheezing/asthma; six, food allergy; three, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias.
CONCLUSION AND CLINICAL RELEVANCE
In contrast with previous findings, we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardized methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required.
Topics: Female; Humans; Infant; Infant, Newborn; Male; Milk Hypersensitivity; Milk Proteins; Milk, Human; Transforming Growth Factor beta1; Transforming Growth Factor beta2
PubMed: 31058363
DOI: 10.1111/cea.13409 -
Journal of Asthma and Allergy 2017For the early identification of persistent asthma symptoms among young children with recurrent wheezing, it would be helpful to identify all available studies that have...
BACKGROUND
For the early identification of persistent asthma symptoms among young children with recurrent wheezing, it would be helpful to identify all available studies that have identified at least one factor for predicting the persistence of early wheezing. The objective of the present study was to perform a systematic review of all studies that have identified factors that predict the persistence of symptoms among young patients with recurring wheezing.
METHODS
A systematic review of relevant studies was conducted through searching in MEDLINE, EMBASE, CINHAL, and SCOPUS databases up to June 2016. Studies that identified predictors of persistence of wheezing illness among young children with recurrent wheezing were retrieved. Two independent reviewers screened the literature and extracted relevant data.
RESULTS
The literature search returned 649 references, 619 of which were excluded due to their irrelevance. Five additional studies were identified from reference lists, and 35 studies were finally included in the review. Among all the identified predictors, the most frequently identified ones were the following: family asthma or atopy; personal history of atopic diseases; allergic sensitization early in life; and frequency, clinical pattern, or severity of wheezing/symptoms.
CONCLUSION
Parental asthma (especially maternal), parental allergy, eczema, allergic rhinitis, persistent wheezing, wheeze without colds, exercise-induced wheeze, severe wheezing episodes, allergic sensitization (especially polysensitization), eosinophils (blood or eosinophil cationic protein in nasal sample), and fraction of exhaled nitric oxide were risk factors predicting persistence of early wheezing through school age. All of them are included in conventional algorithms, for example, Asthma Predictive Index and its modifications, for predicting future asthma.
PubMed: 28392707
DOI: 10.2147/JAA.S128319