The potential for pre-, pro- and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions

doi:10.1016/j.waojou.2019.100034

Review

. 2019 Jun 4;12(5):100034.

doi: 10.1016/j.waojou.2019.100034. eCollection 2019.

The potential for pre-, pro- and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions

Adam Fox¹, J Andrew Bird², Alessandro Fiocchi³, Jan Knol⁴, Rosan Meyer⁵, Seppo Salminen⁶, Gong Sitang⁷, Hania Szajewska⁸, Nikolaos Papadopoulos⁹

Affiliations

¹ Dept of Paediatric Allergy, Guy's & St Thomas' Hospitals NHS Foundation Trust, Westminster Bridge, London SE1 7EH, United Kingdom.
² University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Allergy and Immunology, 5323 Harry Hines Blvd, Dallas, TX 75390-9063, USA.
³ Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
⁴ Wageningen University, Stippeneng 4, 6708 WE Wageningen, the Netherlands.
⁵ Imperial College, Dept Paediatrics, London, UK.
⁶ Functional Foods Forum, Faculty of Medicine, Itäinen pitkäkatu 4A, 20014 Turku, Finland.
⁷ Guangzhou Women and Children's Medical Center, Tianhe, Guangzhou, 510620, China.
⁸ Department of Paediatrics, The Medical University of Warsaw, 02-091 Warsaw, Zwiriki i Wigury 63A, Poland.
⁹ Professor of Allergy & Paediatric Allergy Division of Infection, Immunity & Respiratory Medicine, University of Manchester, 5th Floor (Research), Royal Manchester Childrens Hospital, Manchester M13 9WL, UK.

PMID: 31194186
PMCID: PMC6555906
DOI: 10.1016/j.waojou.2019.100034

Review

The potential for pre-, pro- and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions

Adam Fox et al. World Allergy Organ J. 2019.

. 2019 Jun 4;12(5):100034.

doi: 10.1016/j.waojou.2019.100034. eCollection 2019.

Authors

Adam Fox¹, J Andrew Bird², Alessandro Fiocchi³, Jan Knol⁴, Rosan Meyer⁵, Seppo Salminen⁶, Gong Sitang⁷, Hania Szajewska⁸, Nikolaos Papadopoulos⁹

Affiliations

¹ Dept of Paediatric Allergy, Guy's & St Thomas' Hospitals NHS Foundation Trust, Westminster Bridge, London SE1 7EH, United Kingdom.
² University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Allergy and Immunology, 5323 Harry Hines Blvd, Dallas, TX 75390-9063, USA.
³ Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
⁴ Wageningen University, Stippeneng 4, 6708 WE Wageningen, the Netherlands.
⁵ Imperial College, Dept Paediatrics, London, UK.
⁶ Functional Foods Forum, Faculty of Medicine, Itäinen pitkäkatu 4A, 20014 Turku, Finland.
⁷ Guangzhou Women and Children's Medical Center, Tianhe, Guangzhou, 510620, China.
⁸ Department of Paediatrics, The Medical University of Warsaw, 02-091 Warsaw, Zwiriki i Wigury 63A, Poland.
⁹ Professor of Allergy & Paediatric Allergy Division of Infection, Immunity & Respiratory Medicine, University of Manchester, 5th Floor (Research), Royal Manchester Childrens Hospital, Manchester M13 9WL, UK.

PMID: 31194186
PMCID: PMC6555906
DOI: 10.1016/j.waojou.2019.100034

Abstract

Cow's milk allergy is one of the most commonly reported childhood food allergies, with increasing incidence, persistence and severity in many countries across the world. The World Allergy Organization Special Committee on Food Allergy has identified cow's milk allergy as an area in need of a rationale-based approach in order to make progress against what it considered an onerous problem, with worldwide public health impact. There is growing interest in the potential role of the gut microbiota in the early programming and development of immune responses and allergy. This discussion paper considers the rationale and available evidence for modulation of the gut microbiota and for the use of synbiotics in the management of infants at risk of, or living with cow's milk allergy and summarizes remaining research questions that need to be answered for the development of evidence-based recommendations.

Keywords: Allergy; Anaphylaxis; Bifidobacteria; Cow's milk allergy; Dysbiosis; IgE; Lactobacilli; Microbiota; Prebiotic; Probiotic; Synbiotic; World Allergy Organization.

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References

1. Schoemaker A.A., Sprikkelman A.B., Grimshaw K.E. Incidence and natural history of challenge-proven cow's milk allergy in European children – EuroPrevall birth cohort. Eur J Allergy Clin Immunol. 2015;70(8):963–972. - PubMed
1. Skripak J.M., Matsui E.C., Mudd K., Wood R.A. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120(5):1172–1177. - PubMed
1. Nocerino R., Leone L., Cosenza L., Canani R.B. Increasing rate of hospitalizations for food-induced anaphylaxis in Italian children: an analysis of the Italian Ministry of Health database. J Allergy Clin Immunol. 2015;135(3):833–835. - PubMed
1. Fiocchi A., Brozek J., Schunemann H. World allergy organization (WAO) diagnosis and rationale for action against cow's milk allergy (DRACMA) guidelines. World Allergy Organization Journal. 2010;21(Suppl):57–161. - PMC - PubMed
1. Koletzko S., Heine R.G., Grimshaw K.E., Beyer K., Grabenhenrich L., Tet T al. Non-IgE mediated cow's milk allergy in EuroPrevall. Eur J Allergy Clin Immunol. 2015;70(12):1679–1680. Available from: - PubMed

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[1] Schoemaker A.A., Sprikkelman A.B., Grimshaw K.E. Incidence and natural history of challenge-proven cow's milk allergy in European children – EuroPrevall birth cohort. Eur J Allergy Clin Immunol. 2015;70(8):963–972. - PubMed

[2] Schoemaker A.A., Sprikkelman A.B., Grimshaw K.E. Incidence and natural history of challenge-proven cow's milk allergy in European children – EuroPrevall birth cohort. Eur J Allergy Clin Immunol. 2015;70(8):963–972. - PubMed

[3] Skripak J.M., Matsui E.C., Mudd K., Wood R.A. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120(5):1172–1177. - PubMed

[4] Skripak J.M., Matsui E.C., Mudd K., Wood R.A. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120(5):1172–1177. - PubMed

[5] Nocerino R., Leone L., Cosenza L., Canani R.B. Increasing rate of hospitalizations for food-induced anaphylaxis in Italian children: an analysis of the Italian Ministry of Health database. J Allergy Clin Immunol. 2015;135(3):833–835. - PubMed

[6] Nocerino R., Leone L., Cosenza L., Canani R.B. Increasing rate of hospitalizations for food-induced anaphylaxis in Italian children: an analysis of the Italian Ministry of Health database. J Allergy Clin Immunol. 2015;135(3):833–835. - PubMed

[7] Fiocchi A., Brozek J., Schunemann H. World allergy organization (WAO) diagnosis and rationale for action against cow's milk allergy (DRACMA) guidelines. World Allergy Organization Journal. 2010;21(Suppl):57–161. - PMC - PubMed

[8] Fiocchi A., Brozek J., Schunemann H. World allergy organization (WAO) diagnosis and rationale for action against cow's milk allergy (DRACMA) guidelines. World Allergy Organization Journal. 2010;21(Suppl):57–161. - PMC - PubMed

[9] Koletzko S., Heine R.G., Grimshaw K.E., Beyer K., Grabenhenrich L., Tet T al. Non-IgE mediated cow's milk allergy in EuroPrevall. Eur J Allergy Clin Immunol. 2015;70(12):1679–1680. Available from: - PubMed

[10] Koletzko S., Heine R.G., Grimshaw K.E., Beyer K., Grabenhenrich L., Tet T al. Non-IgE mediated cow's milk allergy in EuroPrevall. Eur J Allergy Clin Immunol. 2015;70(12):1679–1680. Available from: - PubMed

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The potential for pre-, pro- and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions

Affiliations

The potential for pre-, pro- and synbiotics in the management of infants at risk of cow's milk allergy or with cow's milk allergy: An exploration of the rationale, available evidence and remaining questions

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