Probiotics, prebiotics and food allergy: a review

Background. The prevalence of food allergy (FA) has increased, a possible consequence of intestinal dysbiosis, environmental or genetic factors. Currently, no formal indications exist for probiotic or prebiotic supplementation in FA. This review aims to analyze the role of probiotics and prebiotics in the prevention and treatment of FA. Methods. A PubMed/Medline search was carried out on articles published between 2011 and 2021 with the following query: ("Food Hypersensitivity"[MeshJ) AND (("Probiotics"[MeshJ) OR ("Prebiotics"[MeshJ)). Subsequently, the titles and abstracts were analyzed and selected according to established criteria. After full reading of these articles, 54 were included and a narrative review was performed. Results. The review was structured in the following sections: 1) Cow's Milk Proteins Allergy (CMA), 2) Food Allergy to Peanuts and 3) Prevention of Food Allergy. In CMA, studies indicate that extensively hydrolyzed casein formula supplemented with Lactobacillus Rhamnosus GG aids in acquiring tolerance to cow's milk proteins, resolving gastrointestinal symptoms and preventing of other allergic manifestations. In peanut oral immunotherapy (OI), supplementation with Lactobacillus Rhamnosus CGMCC 1.3724 appears to promote sustained desensitization. However, the evidence supporting probiotics for preventing food allergies lacks robustness. Current evidence supports the use of oligosaccharides from breast milk in the first months of life for preventing atopic dermatitis, FA and asthma. Conclusions. The potential of probiotics to be used as therapeutic adjuvants in CMA and peanut OI is promising. However, there is inconsistency regarding the type of probiotic, the dose and duration of supplementation.