Evaluation of Probiotic Use in Children With and Without Allergic Diseases

Year 2024, Volume: 51 Issue: 3, 385 - 392, 19.09.2024

Şule Büyük Yaytokgil , Emine Vezir

https://doi.org/10.5798/dicletip.1552572

Abstract

Aim: Various studies have reported that probiotics play a role in immune modulation and in preventing the development of allergic diseases by affecting the intestinal flora. However, there is no clear consensus on this subject yet. This study aimed to evaluate the usage of probiotics in children with and without allergic diseases.
Method: Probiotic usage of children (<18 years old) with and without allergic disease, who applied to the tertiary care pediatric immunology and allergic diseases clinic between 26,December 2023 and 26,January 2024, was evaluated cross-sectionally. Demographic characteristics of the patients, presence of allergic diseases, exposure to pets and cigarettes, and probiotic use (at any time and during the neonatal period) were recorded.
Results: A total of 381 patients (57.7% male) with a median age of 7,5 years(IQR:5-10,7) were included in the study. Of the children 269 (70.6%) with allergic disease and 112 (29.4%) without allergic disease. A total of 190 (49.8%) patients had used probiotics at any time; of these, 77 (40.5%) used for colic in the neonatal period. When patients with and without allergic diseases were compared, the median age, time of birth, type of birth, frequency of family atopic diseases, smoking exposure, pet exposure and frequency of probiotic usage at any time were similar (p respectively: 0.283, 0.507, 0.909,0.122, 0.308,0.486,0.552). Male gender (62%) was more common in those with allergic diseases,(p:0.008). Probiotic usage during the neonatal period was higher in patients without allergic diseases than in those with allergic diseases (32.1% vs 15.2%; p: <0.001).
Conclusion: Our study found that half of the children had used probiotics at some point in their lives. Notably, probiotic use during the neonatal period was higher among children without allergic diseases compared to those with allergic diseases, supporting the hypothesis that early-life probiotic supplementation may have a protective effect against atopic diseases. However, differences between the type, dose, and duration of probiotics administered in the studies cause difficulties in comparing and generalizing the results. So, standard, molecular level and with longer follow-up periods studies are needed.

Keywords

allergic diseases, allergic rhinitis, asthma, atopic dermatitis, food allergy, probiotics, prophylaxis

References

• 1.Lv JJ, Kong XM, Zhao Y, et al. Global, regional andnational epidemiology of allergic disorders inchildren from 1990 to 2019: findings from theGlobal Burden of Disease study 2019. BMJ Open.2024 Apr 8;14(4):e080612.
• 2.Feleszko W, Jaworska J, Rha RD, et al. Probiotic-induced suppression of allergic sensitization andairway inflammation is associated with an increaseof T regulatory-dependent mechanisms in a murinemodel of asthma. Clin Exp Allergy. 2007;37:498–505.
• 3.Romagnani S. The increased prevalence of allergyand the hygiene hypothesis: missing immunedeviation, reduced immune suppression, or both?Immunology. 2004;112(3):352-63.
• 4.Jakobsson HE, Abrahamsson TR, Jenmalm MC, etal. Decreased gut microbiota diversity, delayedBacteroidetes colonisation and reduced Th1responses in infants delivered by caesarean section.Gut. 2014; 63(4):559-66.
• 5.Kallio S, Jian C, Korpela K, et al. Early-life gutmicrobiota associates with allergic rhinitis during13-year follow-up in a Finnish probioticintervention cohort. Microbiol Spectr.2024;12(6):e0413523.
• 6.Bobrowska-Korzeniowska M, Kapszewicz K,Jerzynska J, et al. Early life environmental exposurein relation to new onset and remission of allergicdiseases in school children: Polish Mother and ChildCohort Study. Allergy Asthma Proc. 2019;40(5):329-37.
• 7.Abrahamsson TR, Jakobsson HE, Andersson AF, etal. Low gut microbiota diversity in early infancyprecedes asthma at school age. Clin Exp Allergy.2014;44(6):842-50.
• 8.Taylor AL, Dunstan JA, Prescott SL. Probioticsupplementation for the first 6 months of life fails toreduce the risk of atopic dermatitis and increasesthe risk of allergen sensitization in high-riskchildren: a randomized controlled trial. J Allergy ClinImmunol. 2007;119(1):184-91.
• 9.Brough HA, Lanser BJ, Sindher SB, et al. Earlyintervention and prevention of allergic diseases.Allergy. 2022;77(2):416-41.
• 10.Irwinda R, Darus F, Maulina P. The role ofobstetrician in reducing the risks of childhoodallergy related to Caesarean birth: A literaturereview. World Nutr Journal. 2020;4(1-2):45.
• 11.Kopp MV, Muche-Borowski C, Abou-Dakn M, etal. S3 guideline Allergy Prevention. Allergol Select.2022;6:61-97.
• 12.Venkatesan P. 2023 GINA report for asthma.Lancet Respir Med. 2023;11(7):589.
• 13.Muraro A, Werfel T, Hoffmann-Sommergruber K,et al. EAACI food allergy and anaphylaxis guidelines:diagnosis and management of food allergy. Allergy.2014; 69:1008-25.
• 14.Scadding GK, Scadding GW. Diagnosing allergicrhinitis. Immunol Allergy Clin N Am. 2016; 36:249-60.
• 15.Eichenfield LF, Tom WL, Chamlin SL, et al.Guidelines of car efor the management of atopicdermatitis. Part1.Diagnosis and assesment of atopicdermatitis. J Am Acad Dermatol. 2014; 70(2):338-51.
• 16.Thantsha MS, Mamvura CI, Booyens J. (2012).Probiotics - What They Are, Their Benefits andChallenges. New advances in the basic and clinicalgastroenterology. In Tech Open. 2012;1-32.
• 17.Rautava S, Kalliomaki M, Isolauri E. Newtherapeutic strategy for combating the increasingburden of allergic disease: Probiotics—A Nutrition,Allergy, Mucosal Immunology and IntestinalMicrobiota (NAMI) Research Group report. J AllergyClin Immunol. 2005;116:31-7.
• 18.Bertelsen RJ, Brantsaeter AL, Magnus MC, et al.Probiotic milk consumption in pregnancy andinfancy and subsequent childhood allergic diseases.J Allergy Clin Immunol. 2014; 133:165-71.e8.
• 19.Navarro-Tapia E, Sebastiani G, Sailer S, et al.Probiotic Supplementation During the Perinatal andInfant Period: Effects on Gut Dysbiosis and Disease.Nutrients. 2020;12(8):2243.
• 20.Hernel O, West CE. Clinical effects of probiotics:scientific evidence from a paediatric perspective.British journal of nutrition. 2013; 109 (s2):70-5.
• 21.West CE. Gut microbiota and allergic disease:new findings. Curr Opin Clin Nutr Metab Care.2014;17(3):261-6.
• 22.Rinninella E, Raoul P, Cintoni M, et al. What is theHealthy Gut Microbiota Composition? A ChangingEcosystem across Age, Environment, Diet, andDiseases. Microorganisms. 2019; 7(1):14
• 23.Matsuzaki T, Chin J. Modulating immuneresponses with probiotic bacteria. Immunol and CellBiol. 2000;78:67–73.
• 24.Fiocchi A, Pawankar R, Cuello-Garcia C, et al.World Allergy Organiza-tion-McMaster UniversityGuidelines for Allergic Disease Prevention (GLAD-P). Probiotics World Allergy Organ J. 2015;8(1):4.
• 25.Beşer ÖF, Tunç T, Ölmez A, et al. Parentalperception and management/intestinal gasproblems in infants in Turkey. Türkiye KlinikleriGold J. 2023; 7 (13):1-15.
• 26.Abrahamsson TR, Jakobsson HE, Andersson AF,et al. Low diversity of the gut microbiota in infantswith atopic eczema. J Allergy Clin Immunol.2012;129(2):434-40.
• 27.Bisgaard H, Li N, Bonnelykke K, et al. Reduceddiversity of the intestinal microbiota during infancyis associated with increased risk of allergic diseaseat school age. J Allergy Clin Immunol.2011;128(3):646-52.
• 28.Kukkonen K, Savilahti E, Haahtela T, et al.Probiotics and prebiotic galacto-oligosaccharides inthe prevention of allergic diseases: a randomized,double-blind, placebo-controlled trial. J Allergy ClinImmunol. 2007;119(1):192-8.
• 29.Morisset M, Aubert-Jacquin C, Soulaines P, et al.A non-hydrolyzed, fermented milk formula reducesdigestive and respiratory events in infants at highrisk of allergy. Eur J Clin Nutr. 2011;65(2):175-83. 30.Zhang C, Li L, Jin B, et al. The Effects of DeliveryMode on the Gut Microbiota and Health: State of Art.Front Microbiol. 2021;12:724449.