Department of Pediatrics, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan.
Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan.
Pediatr Res. 2023 Sep;94(3):1067-1074. doi: 10.1038/s41390-023-02557-7. Epub 2023 Mar 15.
Interventions targeting the gut microbiota for treating food allergy (FA) have been gaining much attention. Although several studies have examined the effects of probiotics, few have verified the effects of prebiotic intervention on FA in humans.
We conducted a preliminary open-label, parallel-group comparison trial in children diagnosed with severe cow's milk allergy (CMA) who were instructed to ingest baked milk (BM; bread or cookies) daily. The subjects either received or did not receive the prebiotic 1-kestose (kestose) daily for 6 months. CMA symptoms and the threshold dose for milk protein were evaluated by oral food challenge with heated milk or BM. Blood and fecal samples were also collected for investigations of the antigen-specific immunoglobulin (Ig) E levels and microbiota composition.
Kestose treatment significantly increased the threshold dose for milk protein, and decreased the milk- and casein-specific IgE levels in serum. In those treated with kestose, the abundance of Fusicatenibacter spp. significantly increased in the feces, and a significant inverse correlation was seen between the abundance of Fusicatenibacter spp. and the milk- and casein-specific IgE levels.
Kestose treatment induced some tolerance to milk protein via changes in the gut microbiota composition in children with FA.
A 6-month treatment with the prebiotic kestose increased the threshold dose for milk protein, and decreased the serum levels of milk- and casein-specific IgE in children diagnosed with cow's milk allergy. The kestose treatment increased the abundance of Fusicatenibacter spp. in the gut, which was inversely correlated with the antigen-specific IgE levels. This is the first study to demonstrate that a prebiotic intervention induced some tolerance to an allergen in children with food allergy.
针对肠道微生物群治疗食物过敏（FA）的干预措施受到了广泛关注。虽然已有多项研究探讨了益生菌的作用，但很少有研究证实益生元干预对人类 FA 的影响。
我们对诊断为严重牛奶过敏（CMA）的儿童进行了初步的开放性、平行组比较试验，这些儿童被指示每天摄入烘焙牛奶（BM；面包或饼干）。其中一组每天接受或不接受 1-蔗果三糖（蔗果三糖）的益生元治疗，为期 6 个月。通过口服热牛奶或 BM 进行食物挑战来评估 CMA 症状和牛奶蛋白的阈值剂量。还采集了血液和粪便样本，用于研究抗原特异性免疫球蛋白（Ig）E 水平和微生物群组成。
蔗果三糖治疗显著增加了牛奶蛋白的阈值剂量，降低了血清中牛奶和酪蛋白特异性 IgE 水平。在接受蔗果三糖治疗的患者中，粪便中 Fuscatinibacter spp. 的丰度显著增加，并且 Fuscatinibacter spp. 的丰度与牛奶和酪蛋白特异性 IgE 水平呈显著负相关。
在 FA 儿童中，通过改变肠道微生物群组成，蔗果三糖治疗诱导了对牛奶蛋白的一些耐受性。
6 个月的益生元蔗果三糖治疗增加了牛奶蛋白的阈值剂量，降低了牛奶过敏儿童的血清牛奶和酪蛋白特异性 IgE 水平。蔗果三糖治疗增加了肠道中 Fuscatinibacter spp. 的丰度，与抗原特异性 IgE 水平呈负相关。这是第一项证明益生元干预在食物过敏儿童中诱导了对过敏原的一些耐受性的研究。
