The Role of Prebiotics and Probiotics in Prevention of Allergic Diseases in Infants

Abstract

Allergic diseases have been linked to genetic and/or environmental factors, such as antibiotic use, westernized high fat and low fiber diet, which lead to early intestinal dysbiosis, and account for the rise in allergy prevalence, especially in western countries. Allergic diseases have shown reduced microbial diversity, including fewer lactobacilli and bifidobacteria, within the neonatal microbiota, before the onset of atopic diseases. Raised interest in microbiota manipulating strategies to restore the microbial balance for atopic disease prevention, through prebiotics, probiotics, or synbiotics supplementation, has been reported. We reviewed and discussed the role of prebiotics and/or probiotics supplementation for allergy prevention in infants. We searched PubMed and the Cochrane Database using keywords relating to “allergy” OR “allergic disorders,” “prevention” AND “prebiotics” OR “probiotics” OR “synbiotics.” We limited our evaluation to papers of English language including children aged 0–2 years old. Different products or strains used, different period of intervention, duration of supplementation, has hampered the draw of definitive conclusions on the clinical impact of probiotics and/or prebiotics for prevention of allergic diseases in infants, except for atopic dermatitis in infants at high-risk. This preventive effect on eczema in high-risk infants is supported by clear evidence for probiotics but only moderate evidence for prebiotic supplementation. However, the optimal prebiotic or strain of probiotic, dose, duration, and timing of intervention remains uncertain. Particularly, a combined pre- and post-natal intervention appeared of stronger benefit, although the definition of the optimal intervention starting time during gestation, the timing, and duration in the post-natal period, as well as the best target population, are still an unmet need.

Oxidative Stress and Alterations of Paraoxonases in Atopic Dermatitis

“…Parents of children affected by AD often exhibit fear and anxiety about topical treatments [ 51 ]; thus, the recent introduction of nutritional supplements that contain prebiotics and probiotics for prevention and/or being associated with treatments, was viewed with interest [ 52 , 53 ]. On the other hand, the association of oxidative stress in molecular mechanisms involved in the development and maintenance of AD was demonstrated, and it is worthwhile to consider strategies aimed at reducing the oxidative stress of patients.…”

A Journey on the Skin Microbiome: Pitfalls and Opportunities

“…Overall, a combination of prenatal and postnatal probiotics supplementation for allergy prevention (e.g., AD, urticaria) has shown the most consistent benefits, although their routine use cannot be recommended. In most studies, single or multiple strains of lactobacilli and bifidobacteria have been used to treat and prevent allergic diseases; the demonstrated effect of one probiotic strain cannot be extrapolated to another strain [ 201 ].…”

Probiotics and Trained Immunity

“…These observations were linked to the reduction of histone acetylation and NF-kB activity, concomitant with an increase level of DNA methylation [50]. Thus, based on the ability of probiotic bacteria (and/or their metabolites) to favorably modulate different immune and metabolic pathways, other researchers were interested in the study of the probiotics as a dietary supplement with a focus on the therapeutic potential of these microorganisms, especially regarding cancer [51], diabetes [52], and allergy-related diseases [53]. However, in spite of this, the specifics elements used by probiotics to interact with the host remains poorly understood.…”