The role of nutrition in the prevention and treatment of atopic dermatitis (literature review)

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Тек жазылушылар үшін

Аннотация

Atopic dermatitis (AD) is a multifactorial chronic inflammatory skin disease with a high prevalence in children and adults. The disease characterized by pruritus, recurrent course is associated with other allergic conditions such as food allergies and asthma, forming the concept of “atopic march”. Genetic mutations affect the barrier function of the skin, creating conditions for allergens to penetrate and inflammation to develop. Environmental factors, including air pollution, nutrition, and microbiota, also play a significant role in the etiology and pathogenesis of AD.

Nutrition during infancy and childhood is a key factor influencing growth and development in childhood, contributing to health and disease prevention throughout life. Breastfeeding and the diversity of the mother’s diet may influence the risk of AD in children. The consumption of certain foods during pregnancy and the specifics of complementary feeding may contribute to the development or decrease the risk of allergy in the child. The gut microbiota plays an important role in modulating immune responses and tolerance to food allergens.

Scopus, Web of Science, Medline, The Cochrane Library, EMBASE, Global Health and RISC databases were used to create this review article. The article analyzes the literature on the peculiarities of the preventive diet in pregnant women, nursing mothers, and children in families with an aggravated hereditary history of atopic dermatitis. The review emphasizes the need for further research to identify the influence of early life nutrition on the risk of allergic diseases. The article discusses current approaches to the prevention and treatment of AD, including the use of probiotics, dietary diversity, and breastfeeding support as meaningful strategies to reduce the risk of AD and allergic diseases in children.

Contribution of the authors:
Yatsyna I.V. — research concept and design, writing the text, editing;
Astakhova I.V. — collection and processing of material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 5, 2024 / Accepted: December 11, 2024 / Published: February 28, 2025

Авторлар туралы

Irina Yatsyna

Federal Scientific Center of Hygiene named after F.F. Erisman

Email: yacyna.iv@fncg.ru
ORCID iD: 0000-0002-8650-8803

MD, Professor, Deputy Director for scientific work, Federal Scientific Center of Hygiene named after F.F. Erisman, Mytishchi, 141014, Russian Federation

e-mail: yacyna.iv@fncg.ru

Irina Astakhova

Federal Scientific Center of Hygiene named after F.F. Erisman

Хат алмасуға жауапты Автор.
Email: astahova.iv@fncg.ru
ORCID iD: 0000-0003-0340-9314

Dermatovenerologist, Federal Scientific Center of Hygiene named after F.F. Erisman, Mytishchi, 141014, Russian Federation

e-mail: astahova.iv@fncg.ru

Әдебиет тізімі

  1. Clinical recommendations: Atopic dermatitis. Moscow; 2021–2023. (in Russian)
  2. Wollenberg A., Barbarot S., Bieber T., Christen-Zaech S., Deleuran M., Fink-Wagner A., et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J. Eur. Acad. Dermatol. Venereol. 2018; 32(5): 657–82. https://doi.org/10.1111/jdv.14891
  3. Macharadze D.Sh., Rassanova E.A., Ruzhentsova T.A., Galanina A.V., Malyshev V.S. Role of nonspecific risk factors in atopic dermatitis. Allergologiya i immunologiya v pediatrii. 2024; (1): 5–11. https://doi.org/10.53529/2500-1175-2024-1-5-11 https://elibrary.ru/rtfhgl (in Russian)
  4. Zhadan I.Yu., Yatsyna I.V., Krasavina E.K., Beshlyy Ya.V. The influence of harmful environmental factors on the dermatological health of the population. Zdravookhranenie Rossiiskoi Federatsii. 2021; 65(4): 342–6. https://doi.org/10.47470/0044-197X-2021-65-4-342-346 https://elibrary.ru/klrklv (in Russian)
  5. Sroka-Tomaszewska J., Trzeciak M. Molecular mechanisms of atopic dermatitis pathogenesis. Int. J. Mol. Sci. 2021; 22(8): 4130. https://doi.org/10.3390/ijms22084130
  6. Mandlik D.S., Mandlik S.K. Atopic dermatitis: new insight into the etiology, pathogenesis, diagnosis and novel treatment strategies. Immunopharmacol. Immunotoxicol. 2021; 43(2): 105–25. https://doi.org/10.1080/08923973.2021.1889583
  7. Strange P., Skov L., Lisby S., Nielsen P.L., Baadsgaard O. Staphylococcal enterotoxin B applied on intact normal and intact atopic skin induces dermatitis. Arch. Dermatol. 1996; 132(1): 27–33.
  8. Brough H.A., Simpson A., Makinson K., Hankinson J., Brown S., Douiri A., et al. Peanut allergy: effect of environmental peanut exposure in children with filaggrin loss-of-function mutations. J. Allergy Clin. Immunol. 2014; 134(4): 867–75.e1. https://doi.org/10.1016/j.jaci.2014.08.011
  9. Eigenmann P.A., Sicherer S.H., Borkowski T.A., Cohen B.A., Sampson H.A. Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998; 101(3): E8. https://doi.org/10.1542/peds.101.3.e8
  10. Burbank A.J., Burks A.W. Natural history of allergic sensitization in infants with early-onset atopic dermatitis: Results from ORCA study. Pediatrics. 2015; 136(6): S331. https://doi.org/10.1542/peds.2015-2776S
  11. Lack G., Fox D., Northstone K., Golding J. Factors associated with the development of peanut allergy in childhood. N. Engl. J. Med. 2003; 348(11): 977–85. https://doi.org/10.1056/NEJMoa013536
  12. Roduit C., Frei R., Depner M., Karvonen A.M., Renz H., Braun-Fahrländer C., et al. Phenotypes of atopic dermatitis depending on the timing of onset and progression in childhood. JAMA Pediatr. 2017; 171(7): 655–62. https://doi.org/10.1001/jamapediatrics.2017.0556
  13. Flohr C., Perkin M., Logan K., Marrs T., Radulovic S., Campbell L.E., et al. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J. Invest. Dermatol. 2014; 134(2): 345–50. https://doi.org/10.1038/jid.2013.298
  14. Sicherer S.H., Sampson H.A. Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management. J. Allergy Clin. Immunol. 1999; 104(3 Pt 2): S114–22. https://doi.org/10.1016/s0091-6749(99)70053-9
  15. Martin P.E., Eckert J.K., Koplin J.J., Lowe A.J., Gurrin L.C., Dharmage S.C., et al. Which infants with eczema are at risk of food allergy? Results from a population-based cohort. Clin. Exp. Allergy. 2015; 45(1): 255–64. https://doi.org/10.1111/cea.12406
  16. Trikamjee T., Comberiati P., D’Auria E., Peroni D., Zuccotti G.V. Nutritional factors in the prevention of atopic dermatitis in children. Front. Pediatr. 2021; 8: 577413. https://doi.org/10.3389/fped.2020.577413
  17. Zhang P. The role of diet and nutrition in allergic diseases. Nutrients. 2023; 15(17): 3683. https://doi.org/10.3390/nu15173683
  18. Acevedo N., Alashkar Alhamwe B., Caraballo L., Ding M., Ferrante A., Garn H., et al. Perinatal and early-life nutrition, epigenetics, and allergy. Nutrients. 2021; 13(3): 724. https://doi.org/10.3390/nu13030724
  19. Willers S.M., Devereux G., Craig L.C., McNeill G., Wijga A.H., Abou El-Magd W., et al. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Thorax. 2007; 62(9): 773–9. https://doi.org/10.1136/thx.2006.074187
  20. Dunstan J.A., Mori T.A., Barden A., Beilin L.J., Taylor A.L., Holt P.G., et al. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J. Allergy Clin. Immunol. 2003; 112(6): 1178–84. https://doi.org/10.1016/j.jaci.2003.09.009
  21. Loo E.X.L., Ong L., Goh A., Chia A.R., Teoh O.H., Colega M.T., et al. Effect of maternal dietary patterns during pregnancy on self-reported allergic diseases in the first 3 years of life: results from the GUSTO study. Int. Arch. Allergy Immunol. 2017; 173(2): 105–13. https://doi.org/10.1159/000475497
  22. Venter C., Greenhawt M., Meyer R.W., Agostoni C., Reese I., du Toit G., et al. EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma. Allergy. 2020; 75(3): 497–523. https://doi.org/10.1111/all.14051
  23. Baïz N., Just J., Chastang J., Forhan A., de Lauzon-Guillain B., Magnier A.M., et al. Maternal diet before and during pregnancy and risk of asthma and allergic rhinitis in children. Allergy Asthma Clin. Immunol. 2019; 15: 40. https://doi.org/10.1186/s13223-019-0353-2
  24. Venter C., Palumbo M.P., Glueck D.H., Sauder K.A., O’Mahony L., Fleischer D.M., et al. The maternal diet index in pregnancy is associated with offspring allergic diseases: the Healthy Start study. Allergy. 2022; 77(1): 162–72. https://doi.org/10.1111/all.14949
  25. Zhang P. The role of diet and nutrition in allergic diseases. Nutrients. 2023; 15(17): 3683. https://doi.org/10.3390/nu15173683
  26. Weidinger S., Novak N. Atopic dermatitis. Lancet. 2016; 387(10023): 1109–22. https://doi.org/10.1016/S0140-6736(15)00149-X
  27. Julia V., Macia L., Dombrowicz D. The impact of diet on asthma and allergic diseases. Nat. Rev. Immunol. 2015; 15(5): 308–22. https://doi.org/10.1038/nri3830
  28. Lin Y.P., Kao Y.C., Pan W.H., Yang Y.H., Chen Y.C., Lee Y.L. Associations between respiratory diseases and dietary patterns derived by factor analysis and reduced rank regression. Ann. Nutr. Metab. 2016; 68(4): 306–14. https://doi.org/10.1159/000447367
  29. Miyake Y., Sasaki S., Tanaka K., Hirota Y. Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants. Eur. Respir. J. 2010; 35(6): 1228–34. https://doi.org/10.1183/09031936.00100609
  30. Kuzume K., Kusu M. Before-birth climatologic data may play a role in the development of allergies in infants. Pediatr. Allergy Immunol. 2007; 18(4): 281–7. https://doi.org/10.1111/j.1399-3038.2006.00526.x
  31. Wei Z., Zhang J., Yu X. Maternal vitamin D status and childhood asthma, wheeze, and eczema: A systematic review and meta-analysis. Pediatr. Allergy Immunol. 2016; 27(6): 612–9. https://doi.org/10.1111/pai.12593
  32. Pacheco-González R.M., García-Marcos L., Morales E. Prenatal vitamin D status and respiratory and allergic outcomes in childhood: A meta-analysis of observational studies. Pediatr. Allergy Immunol. 2018; 29(3): 243–53. https://doi.org/10.1111/pai.12876
  33. Cuello-Garcia C.A., Brożek J.L., Fiocchi A., Pawankar R., Yepes-Nuñez J.J., Terracciano L., et al. Probiotics for the prevention of allergy: A systematic review and meta-analysis of randomized controlled trials. J. Allergy Clin. Immunol. 2015; 136(4): 952–61. https://doi.org/10.1016/j.jaci.2015.04.031
  34. Boyle R.J., Ismail I.H., Kivivuori S., Licciardi P.V., Robins-Browne R.M., Mah L.J., et al. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy. 2011; 66(4): 509–16. https://doi.org/10.1111/j.1398-9995.2010.02507.x
  35. Chu D.K., Koplin J.J., Ahmed T., Islam N., Chang C.L., Lowe A.J. How to prevent atopic dermatitis (eczema) in 2024: theory and evidence. J. Allergy Clin. Immunol. Pract. 2024; 12(7): 1695–704. https://doi.org/10.1016/j.jaip.2024.04.048
  36. Kim J.H. Role of breast-feeding in the development of atopic dermatitis in early childhood. Allergy Asthma Immunol. Res. 2017; 9(4): 285–7. https://doi.org/10.4168/aair.2017.9.4.285
  37. Jiang S., Cai M., Li D., Chen X., Chen X., Huang Q., et al. Association of breast milk-derived arachidonic acid-induced infant gut dysbiosis with the onset of atopic dermatitis. Gut. 2024; 74(1): 45–57. https://doi.org/10.1136/gutjnl-2024-332407
  38. Stephan Y., Müller H.H., Kühnert M., Meinhold-Heerlein I., Ibrahimi G., Reitz M., et al. The effect of early skin-to-skin contact after cesarean section on breastfeeding duration and development of atopic-allergic diseases. Eur. J. Midwifery. 2024; 8. https://doi.org/10.18332/ejm/176213
  39. Luo M., Su H.C., Lin J.E., Zhu C.H., Lin L.H., Han Y. A retrospective analysis of risk factors for atopic dermatitis severity. Dermatitis. 2024; 35(S1): S81–90. https://doi.org/10.1089/derm.2023.0037
  40. Kull I., Böhme M., Wahlgren C.F., Nordvall L., Pershagen G., Wickman M. Breast-feeding reduces the risk for childhood eczema. J. Allergy Clin. Immunol. 2005; 116(3): 657–61. https://doi.org/10.1016/j.jaci.2005.04.028
  41. Gdalevich M., Mimouni D., David M., Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies. J. Am. Acad. Dermatol. 2001; 45(4): 520–7. https://doi.org/10.1067/mjd.2001.114741
  42. Yang Y.W., Tsai C.L., Lu C.Y. Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and meta-analysis of prospective cohort studies. Br. J. Dermatol. 2009; 161(2): 373–83. https://doi.org/10.1111/j.1365-2133.2009.09049.x
  43. Lodge C.J., Tan D.J., Lau M.X., Dai X., Tham R., Lowe A.J., et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatr. 2015; 104(467): 38–53. https://doi.org/10.1111/apa.13132
  44. Kramer M.S., Chalmers B., Hodnett E.D., Sevkovskaya Z., Dzikovich I., Shapiro S., et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001; 285(4): 413–20. https://doi.org/10.1001/jama.285.4.413
  45. Muraro A., Halken S., Arshad S.H., Beyer K., Dubois A.E., Du Toit G., et al. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy. Allergy. 2014; 69(5): 590–601. https://doi.org/10.1111/all.12398
  46. Fleischer D.M., Spergel J.M., Assa’ad A.H., Pongracic J.A. Primary prevention of allergic disease through nutritional interventions. J. Allergy Clin. Immunol. Pract. 2013; 1(1): 29–36. https://doi.org/10.1016/j.jaip.2012.09.003
  47. Neville M.C., Anderson S.M., McManaman J.L., Badger T.M., Bunik M., Contractor N., et al. Lactation and neonatal nutrition: defining and refining the critical questions. J. Mammary Gland Biol. Neoplasia. 2012; 17(2): 167–88. https://doi.org/10.1007/s10911-012-9261-5
  48. Munblit D., Treneva M., Peroni D.G., Colicino S., Chow L.Y., Dissanayeke S., et al. Immune components in human milk are associated with early infant immunological health outcomes: a prospective three-country analysis. Nutrients. 2017; 9(6): 532. https://doi.org/10.3390/nu9060532
  49. Munblit D., Treneva M., Peroni D.G., Colicino S., Chow L., Dissanayeke S., et al. Colostrum and mature human milk of women from London, Moscow, and Verona: determinants of immune composition. Nutrients. 2016; 8(11): 695. https://doi.org/10.3390/nu8110695
  50. Minniti F., Comberiati P., Munblit D., Piacentini G.L., Antoniazzi E., Zanoni L., et al. Breast-milk characteristics protecting against allergy. Endocr. Metab. Immune Disord Drug Targets. 2014; 14(1): 9–15. https://doi.org/10.2174/1871530314666140121145045
  51. Masi A.C., Stewart C.J. Role of breastfeeding in disease prevention. Microb. Biotechnol. 2024; 17(7): e14520. https://doi.org/10.1111/1751-7915.14520
  52. Rajani P.S., Martin H., Groetch M., Järvinen K.M. Presentation and management of food allergy in breastfed infants and risks of maternal elimination diets. J. Allergy Clin. Immunol. Pract. 2020; 8(1): 52–67. https://doi.org/10.1016/j.jaip.2019.11.007
  53. Gelsomino M., Liotti L., Barni S., Mori F., Giovannini M., Mastrorilli C., et al. Elimination diets in lactating mothers of infants with food allergy. Nutrients. 2024; 16(14): 2317. https://doi.org/10.3390/nu16142317
  54. Osborn D.A., Sinn J.K., Jones L.J. Infant formulas containing hydrolysed protein for prevention of allergic disease. Cochrane Database Syst. Rev. 2018; 10(10): CD003664. https://doi.org/10.1002/14651858.CD003664.pub6
  55. Davisse-Paturet C., Raherison C., Adel-Patient K., Divaret-Chauveau A., Bois C., Dufourg M.N., et al. Use of partially hydrolysed formula in infancy and incidence of eczema, respiratory symptoms or food allergies in toddlers from the ELFE cohort. Pediatr. Allergy Immunol. 2019; 30(6): 614–23. https://doi.org/10.1111/pai.13094
  56. Khan A., Adalsteinsson J., Whitaker-Worth D.L. Atopic dermatitis and nutrition. Clin. Dermatol. 2022; 40(2): 135–44. https://doi.org/10.1016/j.clindermatol.2021.10.006
  57. Abrams E.M., Orkin J., Cummings C., Blair B., Chan E.S. Dietary exposures and allergy prevention in high-risk infants. Paediatr. Child Health. 2021; 26(8): 504–5. https://doi.org/10.1093/pch/pxab064
  58. Turati F., Bertuccio P., Galeone C., Pelucchi C., Naldi L., Bach J.F., et al. Early weaning is beneficial to prevent atopic dermatitis occurrence in young children. Allergy. 2016; 71(6): 878–88. https://doi.org/10.1111/all.12864
  59. Chatenoud L., Bertuccio P., Turati F., Galeone C., Naldi L., Chatenoud L., et al. Markers of microbial exposure lower the incidence of atopic dermatitis. Allergy. 2020; 75(1): 104–15. https://doi.org/10.1111/all.13990
  60. Flohr C., Nagel G., Weinmayr G., Kleiner A., Strachan D.P., Williams H.C. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) phase two. Br. J. Dermatol. 2011; 165(6): 1280–9. https://doi.org/10.1111/j.1365-2133.2011.10588.x
  61. Obbagy J.E., English L.K., Wong Y.P., Butte N.F., Dewey K.G., Fleischer D.M., et al. Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. Am. J. Clin. Nutr. 2019; 109(Suppl. 7): 890S–934S. https://doi.org/10.1093/ajcn/nqy220
  62. Savage J.H., Lee-Sarwar K.A., Sordillo J.E., Lange N.E., Zhou Y., O’Connor G.T., et al. Diet during pregnancy and infancy and the infant intestinal microbiome. J. Pediatr. 2018; 203: 47–54.e4. https://doi.org/10.1016/j.jpeds.2018.07.066
  63. Bisgaard H., Li N., Bonnelykke K., Chawes B.L., Skov T., Paludan-Müller G., et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J. Allergy Clin. Immunol. 2011; 128(3): 646–52.e1-5. https://doi.org/10.1016/j.jaci.2011.04.060
  64. Simonyté Sjödin K., Hammarström M.L., Rydén P., Sjödin A., Hernell O., Engstrand L., et al. Temporal and long-term gut microbiota variation in allergic disease: A prospective study from infancy to school age. Allergy. 2019; 74(1): 176–85. https://doi.org/10.1111/all.13485
  65. Venter C., Brown K.R., Maslin K., Palmer D.J. Maternal dietary intake in pregnancy and lactation and allergic disease outcomes in offspring. Pediatr. Allergy Immunol. 2017; 28(2): 135–43. https://doi.org/10.1111/pai.12682
  66. Garcia-Larsen V., Ierodiakonou D., Jarrold K., Cunha S., Chivinge J., Robinson Z., et al. Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLoS Med. 2018; 15(2): e1002507. https://doi.org/10.1371/journal.pmed.1002507
  67. Trompette A., Pernot J., Perdijk O., Alqahtani R.A.A., Domingo J.S., Camacho-Muñoz D., et al. Gut-derived short-chain fatty acids modulate skin barrier integrity by promoting keratinocyte metabolism and differentiation. Mucosal. Immunol. 2022; 15(5): 908–26. https://doi.org/10.1038/s41385-022-00524-9
  68. Du Toit G., Katz Y., Sasieni P., Mesher D., Maleki S.J., Fisher H.R., et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J. Allergy Clin. Immunol. 2008; 122(5): 984–91. https://doi.org/10.1016/j.jaci.2008.08.039
  69. Perkin M.R., Logan K., Marrs T., Radulovic S., Craven J., Flohr C., et al. Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. J. Allergy Clin. Immunol. 2016; 137(5): 1477–86.e8. https://doi.org/10.1016/j.jaci.2015.12.1322
  70. Lundell A.C., Hesselmar B., Nordström I., Adlerberth I., Wold A.E., Rudin A. Higher B-cell activating factor levels at birth are positively associated with maternal dairy farm exposure and negatively related to allergy development. J. Allergy Clin. Immunol. 2015; 136(4): 1074–82.e3. https://doi.org/10.1016/j.jaci.2015.03.022
  71. Du Toit G., Roberts G., Sayre P.H., Bahnson H.T., Radulovic S., Santos A.F., et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N. Engl. J. Med. 2015; 372(9): 803–13. https://doi.org/10.1056/NEJMoa1414850
  72. Moon P.D., Han N.R., Kim H.M., Jeong H.J. High-fat diet exacerbates dermatitis through up-regulation of TSLP. J. Invest. Dermatol. 2019; 139(5): 1198–201. https://doi.org/10.1016/j.jid.2018.11.003
  73. Leung D.Y.M., Berdyshev E., Goleva E. Cutaneous barrier dysfunction in allergic diseases. J. Allergy Clin. Immunol. 2020; 145(6): 1485–97. https://doi.org/10.1016/j.jaci.2020.02.021
  74. Bäck O., Blomquist H.K., Hernell O., Stenberg B. Does vitamin D intake during infancy promote the development of atopic allergy? Acta Derm. Venereol. 2009; 89(1): 28–32. https://doi.org/10.2340/00015555-0541
  75. Flohr C., Mann J. New approaches to the prevention of childhood atopic dermatitis. Allergy. 2014; 69(1): 56–61. https://doi.org/10.1111/all.12343
  76. Tan-Lim C.S.C., Esteban-Ipac N.A.R., Mantaring J.B.V. 3rd., Chan Shih Yen E., Recto M.S.T., Sison O.T., et al. Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: A systematic review and network meta-analysis. Pediatr. Allergy Immunol. 2021; 32(1): 124–36. https://doi.org/10.1111/pai.13305

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