The role of probiotics in preventing food allergies in pediatrics

Introduction: Food allergy describes an adverse immune response that occurs reproducibly on exposure to a given food. The prevalence of food allergy is increasing worldwide, with the global prevalence approaching 10%. Children have higher rates of food allergy compared to adults. Despite the high burden of disease and potential risk of fatal outcomes, there is still no cure for food allergies. The standard of management is allergen avoidance and symptomatic treatment. Complete elimination of the food allergen is often difficult due to its widespread use in processed food. There is a paucity of well-designed studies examining probiotics, as potential Immuno-modulatingpharmabiotics, with the primary end point of preventing food allergies or inducing tolerance. In this review the effectiveness of probiotics in treatment and prevention of food allergies in pediatrics will be discussed. Methods: We performed a literature review in the English language using PubMed and Scopus database incorporating the terms probiotics , Food allergy , and pediatrics . The studies published in the last 15 years providing relevant data, were considered. The primary outcome of interest was relief of allergic symptoms and the secondary outcome of interest was inducement of tolerance. Results: Clinical studies aiming to evaluate the effect of probiotic administration on the development of food allergies in children demonstrated inconsistent results probably because of the large variability in probiotics and their mixtures used in the studies, the duration of therapy, and the doses administered. On the other hand, host variations like geographical locations, food habits etc. could also affect the expected results from probiotic usage. Cow’s milk, egg, and peanut allergies are the most frequently studied among infants and young children. In one study, co-administration ofLactobacillus rhamnosus CGMCC1.3724 and peanuts led to sustained desensitization and reduced peanut-specific Ig-E levels. Lactobacillus rhamnosus GG administration was more likely to induce tolerance among infants with suspected cow’s milk allergy. Pooled results showed reduction in the scoring index for eczema and inducing tolerance among patients given probiotics. Analysis of available evidence shows moderate certainty that the use of probiotics can relieve symptoms of children with food allergies. So, the evidence for therapeutic and preventive effects of probiotics on food allergy in human subjects is still sparse. Conclusion: Although some studies show promise for the use of probiotics in treating food allergy, the evidence is still conflicting and inconclusive.

Keywords:

Probiotic , Food allergy , Pediatric