{"title":"博氏酵母CNCM I-745治疗中国儿童急性腹泻的疗效和安全性:一项系统综述和荟萃分析","authors":"Lynne V McFarland, Tong Li","doi":"10.3389/fcimb.2025.1587792","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pediatric acute gastroenteritis (PAGE) is a common cause of morbidity and mortality, especially in children under five years old. Therapeutic strategies including probiotics have been investigated, but trials from non-English speaking countries may not be easily accessible.</p><p><strong>Aim: </strong>To determine the efficacy of <i>Saccharomyces boulardii</i> compared to controls for treating PAGE in children receiving standard rehydration therapy in trials conducted in China.</p><p><strong>Methods: </strong>Systematic review and meta-analysis using literature search with Google Scholar, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and China Biology Medicine disc (from inception to June 30, 2024) of randomized, controlled trials comparing <i>S. boulardii</i> CNCM I-745 to controls for the treatment of PAGE in children conducted in China. Independent data extraction by two reviewers. Standard meta-analysis methods were applied and random-effect or fixed-effects models were used depending upon the degree of heterogeneity using standardized mean differences for continuous data and relative risk estimates for dichotomous outcomes. The risk of bias for each study was determined and heterogeneity was measured by I<sup>2</sup>.</p><p><strong>Results: </strong>Of 851 articles screened, 10 RCTs (1125 participants) met the inclusion criteria, and none were found in non-Chinese databases. <i>S. boulardii</i> CNCM I-745 was found to significantly reduce the duration of PAGE (SMD=-1.63 days, 95% CI -2.08, -1.18), improve the total effectiveness rating (RR=1.22, 95% CI 1.16, 1.28) and significantly more participants were cured (RR=1.47, 95% CI 1.30, 1.67). The finding that <i>S. boulardii</i> significantly reduced the levels of two pro-inflammatory cytokines (TNF-α and IL8) has not been reported in previous meta-analyses of PAGE.</p><p><strong>Conclusion: </strong><i>S. boulardii</i> CNCM I-745 is an effective treatment for PAGE and was well tolerated in trials done in China.</p><p><strong>Systematic review registration: </strong>www.crd.york.ac.uk/PRSPERO, identifier CRD 42024567537.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"15 ","pages":"1587792"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174131/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of <i>Saccharomyces boulardii</i> CNCM I-745 for the treatment of pediatric acute diarrhea in China: a systematic review and meta-analysis.\",\"authors\":\"Lynne V McFarland, Tong Li\",\"doi\":\"10.3389/fcimb.2025.1587792\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pediatric acute gastroenteritis (PAGE) is a common cause of morbidity and mortality, especially in children under five years old. Therapeutic strategies including probiotics have been investigated, but trials from non-English speaking countries may not be easily accessible.</p><p><strong>Aim: </strong>To determine the efficacy of <i>Saccharomyces boulardii</i> compared to controls for treating PAGE in children receiving standard rehydration therapy in trials conducted in China.</p><p><strong>Methods: </strong>Systematic review and meta-analysis using literature search with Google Scholar, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and China Biology Medicine disc (from inception to June 30, 2024) of randomized, controlled trials comparing <i>S. boulardii</i> CNCM I-745 to controls for the treatment of PAGE in children conducted in China. Independent data extraction by two reviewers. Standard meta-analysis methods were applied and random-effect or fixed-effects models were used depending upon the degree of heterogeneity using standardized mean differences for continuous data and relative risk estimates for dichotomous outcomes. The risk of bias for each study was determined and heterogeneity was measured by I<sup>2</sup>.</p><p><strong>Results: </strong>Of 851 articles screened, 10 RCTs (1125 participants) met the inclusion criteria, and none were found in non-Chinese databases. <i>S. boulardii</i> CNCM I-745 was found to significantly reduce the duration of PAGE (SMD=-1.63 days, 95% CI -2.08, -1.18), improve the total effectiveness rating (RR=1.22, 95% CI 1.16, 1.28) and significantly more participants were cured (RR=1.47, 95% CI 1.30, 1.67). The finding that <i>S. boulardii</i> significantly reduced the levels of two pro-inflammatory cytokines (TNF-α and IL8) has not been reported in previous meta-analyses of PAGE.</p><p><strong>Conclusion: </strong><i>S. boulardii</i> CNCM I-745 is an effective treatment for PAGE and was well tolerated in trials done in China.</p><p><strong>Systematic review registration: </strong>www.crd.york.ac.uk/PRSPERO, identifier CRD 42024567537.</p>\",\"PeriodicalId\":12458,\"journal\":{\"name\":\"Frontiers in Cellular and Infection Microbiology\",\"volume\":\"15 \",\"pages\":\"1587792\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174131/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Cellular and Infection Microbiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fcimb.2025.1587792\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cellular and Infection Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcimb.2025.1587792","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:儿童急性胃肠炎(PAGE)是一种常见的发病和死亡原因,特别是在5岁以下儿童中。已经研究了包括益生菌在内的治疗策略,但非英语国家的试验可能不容易获得。目的:在中国进行的试验中,与对照组相比,确定博氏酵母菌治疗接受标准补液治疗的儿童PAGE的疗效。方法:利用谷歌Scholar、PubMed、Embase、Cochrane Library、中国国家知识基础设施和中国生物医学光盘(从成立到2024年6月30日)的文献检索,对在中国进行的比较博氏弓索菌CNCM I-745与对照组治疗儿童PAGE的随机对照试验进行系统回顾和meta分析。由两位审稿人独立提取数据。采用标准荟萃分析方法,根据连续数据的标准化平均差异和二分类结果的相对风险估计的异质性程度,使用随机效应或固定效应模型。确定每项研究的偏倚风险,并通过I2测量异质性。结果:在筛选的851篇文献中,有10篇rct(1125名受试者)符合纳入标准,未在非中文数据库中找到。发现博氏弧菌CNCM I-745显著缩短PAGE持续时间(SMD=-1.63天,95% CI -2.08, -1.18),提高总有效率(RR=1.22, 95% CI 1.16, 1.28),显著增加了治愈的参与者(RR=1.47, 95% CI 1.30, 1.67)。先前的PAGE荟萃分析未报道博氏沙门氏菌显著降低两种促炎细胞因子(TNF-α和il - 8)水平的发现。结论:博氏沙门氏菌CNCM I-745是治疗PAGE的有效药物,在中国进行的试验中耐受性良好。系统评审注册:www.crd.york.ac.uk/PRSPERO,标识符CRD 42024567537。
Efficacy and safety of Saccharomyces boulardii CNCM I-745 for the treatment of pediatric acute diarrhea in China: a systematic review and meta-analysis.
Background: Pediatric acute gastroenteritis (PAGE) is a common cause of morbidity and mortality, especially in children under five years old. Therapeutic strategies including probiotics have been investigated, but trials from non-English speaking countries may not be easily accessible.
Aim: To determine the efficacy of Saccharomyces boulardii compared to controls for treating PAGE in children receiving standard rehydration therapy in trials conducted in China.
Methods: Systematic review and meta-analysis using literature search with Google Scholar, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and China Biology Medicine disc (from inception to June 30, 2024) of randomized, controlled trials comparing S. boulardii CNCM I-745 to controls for the treatment of PAGE in children conducted in China. Independent data extraction by two reviewers. Standard meta-analysis methods were applied and random-effect or fixed-effects models were used depending upon the degree of heterogeneity using standardized mean differences for continuous data and relative risk estimates for dichotomous outcomes. The risk of bias for each study was determined and heterogeneity was measured by I2.
Results: Of 851 articles screened, 10 RCTs (1125 participants) met the inclusion criteria, and none were found in non-Chinese databases. S. boulardii CNCM I-745 was found to significantly reduce the duration of PAGE (SMD=-1.63 days, 95% CI -2.08, -1.18), improve the total effectiveness rating (RR=1.22, 95% CI 1.16, 1.28) and significantly more participants were cured (RR=1.47, 95% CI 1.30, 1.67). The finding that S. boulardii significantly reduced the levels of two pro-inflammatory cytokines (TNF-α and IL8) has not been reported in previous meta-analyses of PAGE.
Conclusion: S. boulardii CNCM I-745 is an effective treatment for PAGE and was well tolerated in trials done in China.
期刊介绍:
Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.