Prebiotics for the prevention of allergies: A systematic review and meta‐analysis of randomized controlled trials

  title={Prebiotics for the prevention of allergies: A systematic review and meta‐analysis of randomized controlled trials},
  author={Carlos A. Cuello-Garcia and Alessandro Giovanni Fiocchi and Ruby Pawankar and Juan Jos{\'e} Yepes-Nuñez and Gian Paolo Morgano and Y Zhang and Arnav Agarwal and Shreyas P. Gandhi and Luigi M. Terracciano and Holger J. Schünemann and Jan L. Brożek},
  journal={Clinical \& Experimental Allergy},
  pages={1468 - 1477}
Prevalence of allergic diseases in infants is approximately 10% reaching 20 to 30% in those with an allergic first‐degree relative. Prebiotics are selectively fermented food ingredients that allow specific changes in composition/activity of the gastrointestinal microflora. They modulate immune responses, and their supplementation has been proposed as an intervention to prevent allergies. 
Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials
  • D. de SilvaS. Halken G. Roberts
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2020
This systematic review of ways to prevent immediate‐onset/IgE‐mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI).
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Both the mechanisms and the therapeutic evidence from preclinical and clinical studies exploring the role of prebiotics in allergy prevention are described.
Postnatal probiotics administration does not prevent asthma in children, but using prebiotics or synbiotics may be the effective potential strategies to decrease the frequency of asthma in high-risk children - a meta-analysis of clinical trials.
Probiotics supplementation in the first months after birth does not decrease the risk of asthma development in thefirst years of life in high-risk children, although prebiotics and synbiotics may be the potential preventive factors that reduce the incidence of asthma in children.
Effectiveness of an antenatal maternal supplementation with prebiotics for preventing atopic dermatitis in high-risk children (the PREGRALL study): protocol for a randomised controlled trial
This is a randomised, multicentre, double-blind, trial to evaluate the effectiveness of antenatal prebiotic maternal supplementation in pregnant women versus placebo on the occurrence of atopic dermatitis in at-risk children.
What's new in atopic eczema? An analysis of systematic reviews published in 2017. Part 1: treatment and prevention
There is high‐quality evidence to demonstrate that dupilumab is better than placebo for the treatment of AE, is not associated with a higher incidence of adverse effects and does not increase the risk of infection compared with placebo; however, comparison studies with other systemic treatments are necessary.
Dietary and Nutritional Influences on Allergy Prevention
  • B. Gordon
  • Medicine
    Current Treatment Options in Allergy
  • 2018
There is now enough evidence of effects of vitamin D, omega-3 fats, the Mediterranean diet, and antioxidants to recommend their use in routine clinical practice for prevention and treatment of allergic conditions.
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Evidence supports altering the microbiome in infants at high risk of atopy who are not able to breastfeed with Lactobacillus strains when given both prenatally followed by prolonged use (greater than 6 months) postnatally for the primary prevention of eczema.
The Dietary Fiber Pectin: Health Benefits and Potential for the Treatment of Allergies by Modulation of Gut Microbiota
Pectin has shown immunomodulatory effects on allergies, although the underlying mechanisms still need to be elucidated, and the relation of certain pectin structures to allergies is little known.


Prebiotics for the Prevention of Allergies: A Systematic Review and Meta-analysis of Randomized Controlled Trials
A systematic review and meta-analysis was performed of studies in which researchers assessed the effects of prebiotic supplementation on the development of allergies and excluded cointerventions administered with prebiotics.
Prebiotic‐supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high‐risk infants: a randomized controlled trial
Prevention guidelines for infants at high risk of allergic disease recommend hydrolysed formula if formula is introduced before 6 months, but evidence is mixed. Adding specific oligosaccharides may
Probiotics for the prevention of allergy: A systematic review and meta-analysis of randomized controlled trials.
Prebiotics in infants for prevention of allergy.
  • D. OsbornJ. Sinn
  • Medicine, Biology
    The Cochrane database of systematic reviews
  • 2013
There is some evidence that a prebiotic supplement added to infant feeds may prevent eczema, but it is unclear whether the use of prebiotics should be restricted to infants at high risk of allergy or may have an effect in low risk populations.
World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Prebiotics
WAO recommendations about prebiotic supplementation for the prevention of allergy are intended to support parents, clinicians and other health care professionals in their decisions whether or not to use prebiotics for the purpose of preventing allergies in healthy, term infants.
Early neutral prebiotic oligosaccharide supplementation reduces the incidence of some allergic manifestations in the first 5 years of life.
Oligosaccharide prebiotics (scGOS/lcFOS), when started early in life have a protective effect against allergic manifestations in high risk infants, and the protection lasts beyond infancy until 5 y of life, for AD and allergic rhinoconjunctivitis.
A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age
Results show for the first time a beneficial effect of prebiotics on the development of atopic dermatitis in a high risk population of infants and it appears likely that oligosaccharides modulate postnatal immune development by altering bowel flora and have a potential role in primary allergy prevention during infancy.
Prebiotics Do Not Influence the Severity of Atopic Dermatitis in Infants: A Randomised Controlled Trial
Although there is no evidence, that consumption of a hypoallergenic infant formula enriched with prebiotic galacto-oligosaccharides had any effect on SCORAD, it was safe and well tolerated.
Recent developments in prebiotics to selectively impact beneficial microbes and promote intestinal health.
Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life.
The observed dual protection lasting beyond the intervention period suggests that an immune modulating effect through the intestinal flora modification may be the principal mechanism of action.