Probiotics in prevention of the atopic march: Myth or reality?

Abstract

The objective of the paper is to investigate whether probiotic supple-mentation prenatally and/or postnatally could prevent the development of atopic/allergic march after systematically reviewed the litera-ture. The atopic march refers to the natural history of allergic diseases which develop during infancy and childhood. Allergic diseases, including atopic dermatitis, IgE-mediated food allergy, asthma, and allergic rhinitis, have dramatically increased over the last century. It is now known that every fourth child is allergic, but assumed that in 2020 every second child will be allergic. Pub Med were searched for randomized controlled trials regarding the effect of probiotics on the prevention of allergy in children. Type 2 inflammation is the central tenet of the atopic march. Intestinal microflora play an important role in the Th1/Th2 balance. Probiotics are cultures of potentially benefi-cial bacteria that positively affect the host by enhancing the microbial balance and they restore the normal intestinal permeability and gut microecology. Therefore, the use of probiotics prenatally and postna-tally may counterbalance the Th2 immune phenotype, thus preventing the development of the atopic march. Probiotics administration is able to reduce atopic inflammation and to enhance anti-inflammatory markers. Conclusion − The current systemic review suggests that pro-biotics administered prenatally and postnatally could reduce the risk of atopy and food allergy in young children, but they are not helpful in the prevention of asthma. © 2019 by the University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.