The role of milk feeds and other dietary supplementary interventions in preventing allergic disease in infants: Fact or fiction?

Vandenplas, Yvan; Chouraqui, J.-P.; Dupont, Christophe; Fiocchi, Alessandro; Salvatore, Silvia; Shamir, Raanan; Szajewska, Hania; Thapar, Nikhil; Venter, Carina; Verhasselt, Valérie

doi:10.1016/j.clnu.2020.10.025

Cited by 20 publications

(24 citation statements)

References 141 publications

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“…Overall, despite some promising results, it is currently not possible to recommend the use of formulas with added probiotics, prebiotics, or symbiotics to favour tolerance acquisition, as the evidence is still scarce and conflicting [ 16 , 69 ].…”

Section: Immune Modulation By Hydrolysed Formulasmentioning

confidence: 99%

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Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips

et al. 2021

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An allergy to cow’s milk requires the avoidance of cow’s milk proteins and, in some infants, the use of a hypoallergenic formula. This review aims to summarize the current evidence concerning different types of hydrolysed formulas (HF), and recommendations for the treatment of IgE- and non-IgE-mediated cow’s milk allergy and functional gastrointestinal disorders in infancy, for which some dietary intervention and HF may be of benefit to both immune and motor mechanisms. Current guidelines recommend cow’s milk protein (i.e., whey or casein) extensively hydrolysed formula (eHF) as the first choice for cow’s milk allergy treatment, and amino acid formulas for more severe cases or those with reactions to eHF. Rice hydrolysed formulas (rHF) have also become available in recent years. Both eHF and rHF are well tolerated by the majority of children allergic to cow’s milk, with no concerns regarding body growth or adverse effects. Some hydrolysates may have a pro-active effect in modulating the immune system due to the presence of small peptides and additional components, like biotics. Despite encouraging results on tolerance acquisition, evidence is still not conclusive, thus hampering our ability to draw firm conclusions. In clinical practice, the choice of hypoallergenic formula should be based on the infant’s age, the severity, frequency and persistence of symptoms, immune phenotype, growth pattern, formula cost, and in vivo proof of tolerance and efficacy.

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Section: Immune Modulation By Hydrolysed Formulasmentioning

confidence: 99%

“…Likewise, the most effective strains, dosages, or optimal duration of treatment are still yet to be determined [ 16 , 69 ].…”

Section: Immune Modulation By Hydrolysed Formulasmentioning

confidence: 99%

Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips

et al. 2021

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“… 93 , 94 Reduced gut microbial diversity and dysbiosis during early life is considered a risk factor for immune-mediated diseases, such as allergy and asthma, through modulation of balance between effector or tolerant responses (activities of Th1 and Th2 cells) that leads to induction of a Th2-skewed immune response, with enhanced IgE responses to food antigens, and/or a defect in mounting proper regulatory T-cell responses. 95 …”

Section: Utility Of Hmo-supplemented Infant Formula In Prevention Of Allergymentioning

confidence: 99%

“…Hence, the manipulation of the microbiota of the infant during pregnancy or after birth, when there is significant immune-plasticity has been suggested to have an impact on allergy prevention. 95 HMO-dependent increase in the growth of Bifidobacterium induces healthy gut microbiota development and contributes to the barrier integrity, while the direct effects of HMOs on the intestinal cell response (ie, reducing the cell growth, inducing differentiation and apoptosis, stimulating SCFA production) are also important for intestinal epithelial cell maturation and a proper intestinal barrier function. 7 , 8 , 66 , 67 , 69–71 …”

Section: Utility Of Hmo-supplemented Infant Formula In Prevention Of Allergymentioning

confidence: 99%

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An Expert Panel Statement on the Beneficial Effects of Human Milk Oligosaccharides (HMOs) in Early Life and Potential Utility of HMO-Supplemented Infant Formula in Cow’s Milk Protein Allergy

Şekerel¹,

Bingöl²,

Çokuğraş³

et al. 2021

JAA

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This review by pediatric gastroenterology and allergy-immunology experts aimed to address the biological roles of human milk oligosaccharides (HMOs) and the potential utility of HMOs in prevention of allergy with particular emphasis on cow ’ s milk protein allergy (CMPA). The participating experts consider HMOs amongst the most critical bioactive components of human milk, which act as antimicrobials and antivirals by preventing pathogen adhesion to epithelial cells, as intestinal epithelial cell modulators by enhancing maturation of intestinal mucosa and intestinal epithelial barrier function, as prebiotics by promoting healthy microbiota composition and as immunomodulators by modulating immune cells indirectly and directly. Accordingly, the participating experts consider the proposed link between HMOs and prevention of allergy to be primarily based on the impact of HMO on gut microbiota, intestinal mucosal barrier, immunomodulation and immune maturation. Along with the lower risk of respiratory and gastrointestinal infections, HMO-supplemented formulas seem to be promising alternatives in the management of CMPA. Nonetheless, the effects of individual as well as complex mixtures of HMO in terms of clear clinical and immunological effects and tolerance development need to be further explored to fully realize the immunomodulatory mechanisms and the potential for HMOs in prevention of allergic diseases and CMPA.

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Prevention of Atopic Dermatitis in Children: Can It be Done?

Kim,

Sandler,

2024

Curr Derm Rep

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The role of milk feeds and other dietary supplementary interventions in preventing allergic disease in infants: Fact or fiction?

Cited by 20 publications

References 141 publications

Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips

Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips

An Expert Panel Statement on the Beneficial Effects of Human Milk Oligosaccharides (HMOs) in Early Life and Potential Utility of HMO-Supplemented Infant Formula in Cow’s Milk Protein Allergy

Prevention of Atopic Dermatitis in Children: Can It be Done?

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