The Role of the Gut Microbiome in Cow’s Milk Allergy: A Clinical Approach

Abstract

Cow’s milk allergy (CMA) is the most prevalent food allergy (FA) in infancy and early childhood and can be present with various clinical phenotypes. The significant increase in FA rates recorded in recent decades has been associated with environmental and lifestyle changes that limit microbial exposure in early life and induce changes in gut microbiome composition. Gut microbiome is a diverse community of microbes that colonize the gastrointestinal tract (GIT) and perform beneficial functions for the host. This complex ecosystem interacts with the immune system and has a pivotal role in the development of oral tolerance to food antigens. Emerging evidence indicates that alterations of the gut microbiome (dysbiosis) in early life cause immune dysregulation and render the host susceptible to immune-mediated diseases later in life. Therefore, the colonization of the gut by “healthy” microbes that occurs in the first years of life determines the lifelong health of the host. Here, we present current data on the possible role of the gut microbiome in the development of CMA. Furthermore, we discuss how gut microbiome modification might be a potential strategy for CMA prevention and treatment.

An Extensively Hydrolyzed Formula Supplemented with Two Human Milk Oligosaccharides Modifies the Fecal Microbiome and Metabolome in Infants with Cow’s Milk Protein Allergy

“…The pathophysiology of CMPA is complex and multifactorial [30]. Several studies have highlighted a dysbiotic gut microbiome in infants with CMPA characterized by a reduced microbial diversity, a loss of beneficial bacteria such as bifidobacteria, and the presence of opportunistic pathogens [31]. Dysbiosis is thought to play an important role in the disturbance of early immune development and regulation [32].…”

Molecular Mechanism and Clinical Effects of Probiotics in the Management of Cow’s Milk Protein Allergy

“…CMPA is the most common FA in infancy: it affects approximately 2% of children under 4 years of age and an even higher percentage of infants. Prevalence of CMPA decreases to less than 1% in children over 6 years of age [ 2 , 13 , 14 , 15 ]. Cow’s milk can be divided into two parts: coagulum (curd), which contains 80% of the CMPs, mainly casein (Bos d 8); and lactoserum (whey), which contains 20% of the CMPs, such as α-lactalbumin (Bos d 4) and β-lactoglobulin (Bos d 5) [ 16 ].…”

“…Dysbiosis can occur in three ways: loss of microbial diversity, loss of beneficial bacteria, and expansion of opportunistic pathogens. Gut dysbiosis has proinflammatory effects, can contribute to the breaking of oral tolerance [ 3 ], and may have a role in FA development [ 2 ], including CMPA. Several studies show that the microbiota in infants with CMPA are different from their healthy counterparts [ 82 ].…”

“…Recent studies suggest that the increasing prevalence of FAs in the last half century can be associated with changes in the composition and function of gut microbiota or “dysbiosis” [ 1 ]. Gut dysbiosis has proinflammatory effects and can lead to several disorders including FAs [ 2 ]. Since gastrointestinal (GI) microbiota are important for the development of FAs, GI microbiota modulation could be used as a therapeutic tool for FAs [ 3 ].…”

Food allergy to cow’s milk proteins and meat

“…Часто при этом поражаются кожа, пищеварительная и респираторная системы [9]. Не-IgE-опосредованная молочная аллергия чаще всего связана с нарушениями состава и функционирования кишечной микробиоты и ответственна за развитием таких симптомов, как срыгивания, колики, тошнота, рвота, боли в животе, диарея или запоры, кровь и слизь в кале [10][11][12][13].…”