Translational Research in Pediatric Specialities Area, Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Department of Pediatrics, Albert Einstein College of Medicine and the Children's Hospital at Montefiore, Bronx, NY.
J Allergy Clin Immunol Pract. 2022 Sep;10(9):2219-2242. doi: 10.1016/j.jaip.2022.06.038. Epub 2022 Jul 2.
The microbiome plays an important role in the pathogenesis of allergic diseases. This review updates the reader on studies aimed at influencing allergic diseases through modulation of the gut microflora. A nonsystematic review of the literature was performed, focusing on relevant trials evaluating the effect of probiotics/prebiotics/symbiotics in the prevention and treatment of allergic disease. For each allergic disease, we were able to find not only a substantial number of clinical trials but also systematic reviews. Specific guidelines, based on systematic reviews and meta-analyses, are available for the prevention of allergic disease and for the treatment of food allergy. In each of the areas examined-allergic rhinitis, allergic asthma, atopic dermatitis, food allergy, and gastrointestinal allergies-there are substantial uncertainties in the efficacy of gut microflora modulation in prevention and treatment. At present, practicing clinicians can avail themselves of intestinal flora modulators as an adjunct in the prevention of atopic dermatitis but not of other forms of allergic diseases. Their effects on the treatment of allergic diseases remain controversial.
肠道微生物群在过敏性疾病的发病机制中起着重要作用。本综述更新了读者对通过调节肠道微生物群来影响过敏性疾病的研究。对相关文献进行了非系统性回顾，重点关注了评估益生菌/益生元/合生菌在预防和治疗过敏性疾病中的作用的相关试验。对于每种过敏性疾病，我们不仅能够找到大量的临床试验，还能够找到系统评价。基于系统评价和荟萃分析，有针对过敏性疾病预防和食物过敏治疗的具体指南。在检查的各个领域——过敏性鼻炎、过敏性哮喘、特应性皮炎、食物过敏和胃肠道过敏——在预防和治疗中，肠道微生物群调节的疗效存在很大的不确定性。目前，临床医生可以将肠道菌群调节剂作为预防特应性皮炎的辅助手段，但不能用于治疗其他形式的过敏性疾病。它们对治疗过敏性疾病的影响仍存在争议。
