SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1637284
A Network Meta-analysis of Probiotics in the Treatment of Childhood Asthma
Provisionally accepted
- 1江西中医药大学, 南昌市, China
- 2江西中医药大学附属医院, 南昌市, China
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Objective: This network meta-analysis aims to explore the efficacy and safety of probiotics in children with asthma and attempts to determine which probiotics are most effective in improving outcomes in children with asthma by ranking methods. Methods: A systematic search of Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, and Web of Science, was conducted from the establishment of the databases until July 2024 to screen for randomized controlled trials of probiotics in the treatment of childhood asthma. Lung function was used as the primary outcome measure, and secondary outcome measures included the total clinical response rate, recurrence rate, immune factors, cytokines, and C-ACT score. Data processing and analysis were performed using Revman 5.4 and Stata 17.0 software. Results: A total of 34 randomized controlled trials (RCTs) were included, involving 3,839 participants and 13 interventions. Our analysis showed that conventional treatment combined with probiotics improved outcome indicators in children with asthma better than conventional treatment. Conventional treatment combined with Bifidobacterium Lactobacillus triplex live bacteria had the highest probability of being the optimal intervention in terms of increasing FEV1% and recurrence rate. Conventional treatment combined with Bifidobacterium adolescentis had the highest probability of being the optimal intervention in increasing FEV1. Conventional treatment combined with Lactobacillus Tablets had the highest probability of being the optimal intervention in increasing PEF. Conventional treatment combined with Bacillus subtilis diplex live bacteria had the highest probability of being the optimal intervention in improving the total clinical response rate. Conventional treatment combined with Bifidobacterium quadruplex live bacteria had the highest probability of being the optimal intervention in reducing IL-4 and IL-33. Conventional treatment combined with Bifidobacterium triplex live bacteria had the highest probability of being the optimal intervention in improving the C-ACT score. Conclusion: Probiotics are effective in treating childhood asthma, and the therapeutic effect of conventional treatment combined with probiotics is superior to that of conventional treatment alone. Therefore, probiotics can be selected as appropriate in clinical treatment of childhood asthma. However, the overall quality of the evidence was at most low or moderate, suggesting that the certainty of the evidence for probiotics in treating.
Keywords: Probiotics, Conventional treatment, Network meta-analysis, childhood, Asthma
Received: 29 May 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Sun, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Di Zhang, 江西中医药大学附属医院, 南昌市, China
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