• atopic dermatitis;
  • intestinal microflora;
  • probiotics;
  • prebiotics

van der Aa LB, Heymans HSA, van Aalderen WMC, Sprikkelman AB. Probiotics and prebiotics in atopic dermatitis: review of the theoretical background and clinical evidence. Pediatr Allergy Immunol 2010: 21: e355–e367. © 2009 John Wiley & Sons A/S

The prevalence of atopic dermatitis (AD) has risen over the past decades, especially in western societies. According to the revised hygiene hypothesis this increase is caused by a changed intestinal colonization pattern during infancy, which has an impact on the immune system. Manipulating the intestinal microflora with pro-, pre- or synbiotics is an innovative way to prevent or treat AD. This review provides an overview of the theoretical basis for using probiotics and prebiotics in AD and presents the current evidence from randomized controlled trials (RCTs) regarding prevention and treatment of AD and food allergy in children with pro-, pre- and synbiotics. Seven RCTs on prevention and 12 RCTs on treatment were found by searching the Pubmed, Embase and Cochrane databases. Results of these trials are conflicting. In conclusion, at this moment there is not enough evidence to support the use of pro-, pre- or synbiotics for prevention or treatment of AD in children in clinical practice.