1Department of Pediatrics - Division of Allergy - Pediatric Hospital Bambino Gesù - Rome, Vatican City 2Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA 3Department of Pediatrics and Medicine, Section of Allergy and Immunology, Louisiana State University Health Sciences Center, Shreveport, LA 4Department of Medicine, University of Medicine and Dentistry of New Jersey Medical School, Newark, NJ 5Department of Paediatrics, Imperial College London, London, United Kingdom 6Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil 7Department of Pediatric Allergology, Women's and Children's Health, University of Uppsala, Uppsala, Sweden 8Department of Food Science & Technology University of Nebraska, Lincoln, NE, USA 9Skin and Allergy Hospital, University of Helsinki, Helsinki, Finland 10Department of Allergy and Immunology, Royal Children's Hospital, University of Melbourne, Murdoch Childrens Research Institute, Melbourne, Australia 11King's College London, Asthma-UK Centre in Allergic Mechanisms of Asthma, Department of Paediatric Allergy, St Thomas' Hospital, London, United Kingdom 12Sydney Medical School, University of Sydney, New South Wales, Australia 13Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY 14Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand 15Department of Paediatrics, National University of Singapore, Singapore.
World Allergy Organ J. 2012 Nov;5(11):148-67. doi: 10.1097/WOX.0b013e3182784ee0.
: Probiotic administration has been proposed for the prevention and treatment of specific allergic manifestations such as eczema, rhinitis, gastrointestinal allergy, food allergy, and asthma. However, published statements and scientific opinions disagree about the clinical usefulness.
: A World Allergy Organization Special Committee on Food Allergy and Nutrition review of the evidence regarding the use of probiotics for the prevention and treatment of allergy.
: A qualitative and narrative review of the literature on probiotic treatment of allergic disease was carried out to address the diversity and variable quality of relevant studies. This variability precluded systematization, and an expert panel group discussion method was used to evaluate the literature. In the absence of systematic reviews of treatment, meta-analyses of prevention studies were used to provide data in support of probiotic applications.
: Despite the plethora of literature, probiotic research is still in its infancy. There is a need for basic microbiology research on the resident human microbiota. Mechanistic studies from biology, immunology, and genetics are needed before we can claim to harness the potential of immune modulatory effects of microbiota. Meanwhile, clinicians must take a step back and try to link disease state with alterations of the microbiota through well-controlled long-term studies to identify clinical indications.
: Probiotics do not have an established role in the prevention or treatment of allergy. No single probiotic supplement or class of supplements has been demonstrated to efficiently influence the course of any allergic manifestation or long-term disease or to be sufficient to do so. Further epidemiologic, immunologic, microbiologic, genetic, and clinical studies are necessary to determine whether probiotic supplements will be useful in preventing allergy. Until then, supplementation with probiotics remains empirical in allergy medicine. In the future, basic research should focus on homoeostatic studies, and clinical research should focus on preventive medicine applications, not only in allergy. Collaborations between allergo-immunologists and microbiologists in basic research and a multidisciplinary approach in clinical research are likely to be the most fruitful.
益生菌的应用被提议用于预防和治疗特定的过敏表现，如湿疹、鼻炎、胃肠道过敏、食物过敏和哮喘。然而，已发表的声明和科学意见对其临床有效性存在分歧。
世界过敏组织食物过敏和营养特别委员会对益生菌用于预防和治疗过敏的证据进行了审查。
对益生菌治疗过敏疾病的文献进行了定性和叙述性综述，以解决相关研究多样性和质量变化的问题。这种可变性排除了系统化，因此使用专家小组讨论方法来评估文献。由于缺乏对治疗的系统评价，使用预防研究的荟萃分析来提供支持益生菌应用的数据。
尽管文献众多，但益生菌研究仍处于起步阶段。需要对常驻人类微生物群进行基础微生物学研究。在声称能够利用微生物群免疫调节作用的潜力之前，需要从生物学、免疫学和遗传学方面进行机制研究。同时，临床医生必须退后一步，通过精心控制的长期研究尝试将疾病状态与微生物群的改变联系起来，以确定临床适应症。
益生菌在预防或治疗过敏方面没有确立的作用。没有单一的益生菌补充剂或补充剂类别被证明能够有效地影响任何过敏表现或长期疾病的进程，或者足以产生这种影响。需要进一步进行流行病学、免疫学、微生物学、遗传学和临床研究，以确定益生菌补充剂是否有助于预防过敏。在此之前，益生菌补充剂在过敏医学中仍然是经验性的。未来，基础研究应侧重于同型研究，临床研究应侧重于预防医学应用，而不仅仅是在过敏方面。过敏免疫学家和微生物学家在基础研究中的合作以及多学科方法在临床研究中的应用可能是最有成效的。
