Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden; inFLAME Global Network (Worldwide Universities Network), West New York, NJ, USA.
inFLAME Global Network (Worldwide Universities Network), West New York, NJ, USA; Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Department of Biotechnology, Unit of Lactic Acid Bacteria and Probiotics, Valencia, Spain.
Allergol Int. 2017 Oct;66(4):529-538. doi: 10.1016/j.alit.2017.08.001. Epub 2017 Sep 1.
Large-scale biodiversity loss and complex changes in social behaviors are altering human microbial ecology. This is increasingly implicated in the global rise in inflammatory diseases, most notably the "allergy epidemic" in very early life. Colonization of human ecological niches, particularly the gastrointestinal tract, is critical for normal local and systemic immune development and regulation. Disturbances in composition, diversity and timing of microbial colonization have been associated with increased allergy risk, indicating the importance of strategies to restore a dysbiotic gut microbiota in the primary prevention of allergic diseases, including the administration of probiotics, prebiotics and synbiotics. Here, we summarize and discuss findings of randomized clinical trials that have examined the effects of these microbiome-related strategies on short and long-term allergy preventative effects - including new guidelines from the World Allergy Organization which now recommend probiotics and prebiotics for allergy prevention under certain conditions. The relatively low quality evidence, limited comparative studies and large heterogeneity between studies, have collectively hampered recommendations on specific probiotic strains, specific timing and specific conditions for the most effective preventive management. At the same time the risk of using available products is low. While further research is needed before specific practice guidelines on supplement probiotics and prebiotics, it is equally important that the underlying dietary and lifestyle factors of dysbiosis are addressed at both the individual and societal levels.
大规模的生物多样性丧失和复杂的社会行为变化正在改变人类的微生物生态。这与全球炎症性疾病的上升，特别是生命早期的“过敏流行”密切相关。人类生态位的定殖，特别是胃肠道，对正常的局部和全身免疫发育和调节至关重要。微生物定植的组成、多样性和时间的紊乱与过敏风险的增加有关，这表明需要采取策略来恢复肠道微生物群的失调，以预防过敏疾病，包括益生菌、益生元和合生菌的应用。在这里，我们总结和讨论了随机临床试验的结果，这些试验研究了这些与微生物组相关的策略对短期和长期预防过敏的影响，包括世界过敏组织的新指南，该指南现在建议在某些情况下使用益生菌和益生元预防过敏。相对较低质量的证据、有限的比较研究以及研究之间的较大异质性，共同阻碍了对特定益生菌株、特定时间和特定条件下最有效预防管理的建议。同时，使用现有产品的风险很低。虽然在制定补充益生菌和益生元的具体实践指南之前还需要进一步研究，但同样重要的是，在个体和社会层面上解决微生物失调的潜在饮食和生活方式因素。
