益生菌预防和治疗儿童过敏性疾病的现状

doi:10.12372/jcp.2022.22e0133

摘要/Abstract

摘要：

过敏性疾病的患病率在全球范围内呈上升趋势,严重影响了特应性个体的健康和生活质量。越来越多的证据支持肠道微生态失衡与过敏性疾病的发生、发展和转归有关。益生菌可以通过纠正微生态失衡、维持黏膜屏障、调节免疫功能等机制在过敏性疾病防治方面发挥一定作用。文章对近年来益生菌在儿童食物过敏、特应性皮炎、哮喘和变应性鼻炎等方面的研究和应用现状进行梳理和分析,为临床医师提供参考。

关键词: 益生菌, 微生态失衡, 过敏性疾病, 儿童

Abstract:

The prevalence of allergic diseases is increasing worldwide, which seriously affects the health and quality of life of patients. More and more evidences support that intestinal dysbiosis is related to the occurrence, development and outcome of allergic diseases. Probiotics can play a certain role in the prevention and treatment of allergic diseases by correcting dysbiosis, maintaining mucosal barrier, regulating immune function. This article reviews the research and application status of probiotics in children with food allergy, atopic dermatitis, asthma and allergic rhinitis in recent years, and provides reference for clinicians.

Key words: probiotics, microecological imbalance, allergic disease, child

严永东, 王婷, 滑洁. 益生菌预防和治疗儿童过敏性疾病的现状[J]. 临床儿科杂志, 2022, 40(8): 573-579.

YAN Yongdong, WANG Ting, HUA Jie. Current status of probiotics for prevention and treatment of allergic diseases in children[J]. Journal of Clinical Pediatrics, 2022, 40(8): 573-579.

参考文献 45

[1]	Haspeslagh E, Heyndrickx I, Hammad H, et al. The hygiene hypothesis: immunological mechanisms of airway tolerance[J]. Curr Opin Immunol, 2018, 54: 102-108. doi: S0952-7915(18)30021-9 pmid: 29986301
[2]	Wang HT, Anvari S, Anagnostou K. The role of probiotics in preventing allergic disease[J]. Children (Basel), 2019, 6(2): 24.
[3]	MelliL LC, do Carmo-Rodrigues MS, Araújo-Filho HB, et al. Intestinal microbiota and allergic diseases: a systematic review[J]. Allergol Immunopathol (Madr), 2016, 44(2): 177-188. doi: 10.1016/j.aller.2015.01.013
[4]	Yao TC, Chang CJ, Hsu YH, et al. Probiotics for allergic diseases: realities and myths[J]. Pediatr Allergy Immunol, 2010, 21(6): 900-919. doi: 10.1111/j.1399-3038.2009.00955.x
[5]	Wopereis H, Oozeer R, Knipping K, et al. The first thousand days - intestinal microbiology of early life: establishing a symbiosis[J]. Pediatr Allergy Immunol, 2014, 25(5): 428-438. doi: 10.1111/pai.12232
[6]	Su YJ, Luo SD, Hsu CY, et al. Differences in gut microbiota between allergic rhinitis, atopic dermatitis, and skin urticaria: a pilot study[J]. Medicine, 2021, 100: 9(e25091).
[7]	Durack J, Lynch SV. The gut microbiome: relationships with disease and opportunities for therapy[J]. J Exp Med, 2019, 216(1): 20-40. doi: 10.1084/jem.20180448
[8]	Dang AT, Marsland BJ. Microbes, metabolites, and the gut-lung axis[J]. Mucosal Immunol, 2019, 12(4): 843-850. doi: 10.1038/s41385-019-0160-6 pmid: 30976087
[9]	Trompette A, Gollwitzer ES, Yadava K, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis[J]. Nat Med, 2014, 20(2): 159-166. doi: 10.1038/nm.3444 pmid: 24390308
[10]	O'neill CA, Monteleone G, McLaughlin JT, et al. The gut-skin axis in health and disease: a paradigm with therapeutic implications[J]. Bioessays, 2016, 38(11): 1167-1176. doi: 10.1002/bies.201600008
[11]	De Pessemier B, Grine L, Debaere M, et al. Gut-skin axis: current knowledge of the interrelationship between microbial dysbiosis and skin conditions[J]. Microorganisms, 2021, 9(2): 353. doi: 10.3390/microorganisms9020353
[12]	Ojeda J, Ávila A, Vidal PM. Gut Microbiota interaction with the central nervous system throughout life[J]. J Clin Med, 2021, 10(6): 1299. doi: 10.3390/jcm10061299
[13]	Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics Consensus statement on the scope and appropriate use of the term probiotic[J]. Nat Rev Gastroenterol Hepatol, 2014, 11(8): 506-514. doi: 10.1038/nrgastro.2014.66
[14]	Plaza-Diaz J, Ruiz-Ojeda FJ, Gil-Campos M, et al. Mechanisms of action of probiotics[J]. Adv Nutr, 2019, 10(Suppl 1): S49-S66.
[15]	Stavropoulou E, Bezirtzoglou E. Probiotics in medicine: a long debate[J]. Front Immunol, 2020, 11: 2192. doi: 10.3389/fimmu.2020.02192 pmid: 33072084
[16]	Koplin JJ, Peters RL, Allen KJ. Prevention of food allergies[J]. Immunol Allergy Clin North Am, 2018, 38(1): 1-11. doi: 10.1016/j.iac.2017.09.001
[17]	Zhang GQ, Hu HJ, Liu CY, et al. Probiotics for prevention of atopy and food hypersensitivity in early childhood: a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2016, 95(8): e2562. doi: 10.1097/MD.0000000000002562
[18]	Halken S, Muraro A, de Silva D, et al. EAACI guideline: preventing the development of food allergy in infants and young children (2020 update)[J]. Pediatr Allergy Immunol, 2021, 32(5): 843-858. doi: 10.1111/pai.13496
[19]	Berni Canani R, Di Costanzo M, Bedogni G, et al. Extensively hydrolyzed casein formula containing Lactobacillus rhamnosus GG reduces the occurrence of other allergic manifestations in children with cow's milk allergy: 3-year randomized controlled trial[J]. J Allergy Clin Immunol, 2017, 139(6): 1906-1913. doi: 10.1016/j.jaci.2016.10.050
[20]	Hsiao KC, Ponsonby AL, Axelrad C, et al. Long-term clinical and immunological effects of probiotic and peanut oral immunotherapy after treatment cessation: 4-year follow-up of a randomised, double-blind, placebocontrolled trial[J]. Lancet Child Adolesc Health, 2017, 1(2): 97-105. doi: 10.1016/S2352-4642(17)30041-X
[21]	Santos SCD, Konstantyner T, Cocco RR. Effects of probiotics in the treatment of food hypersensitivity in children: a systematic review[J]. Allergol Immunopathol (Madr), 2020, 48(1): 95-104. doi: 10.1016/j.aller.2019.04.009
[22]	Fang Z, Li L, Zhang H, et al. Gut microbiota, probiotics, and their interactions in prevention and treatment of atopic dermatitis: a review[J]. Front Immunol, 2021, 12: 720393. doi: 10.3389/fimmu.2021.720393
[23]	Li L, Han Z, Niu X, et al. Probiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysis[J]. Am J Clin Dermatol, 2019, 20(3): 367-377. doi: 10.1007/s40257-018-0404-3
[24]	Amalia N, Orchard D, Francis KL, et al. Systematic review and meta-analysis on the use of probiotic supplementation in pregnant mother, breastfeeding mother and infant for the prevention of atopic dermatitis in children[J]. Australas J Dermatol, 2020, 61(2): e158-e173.
[25]	Sun SY, Chang GZ, Zhang LT. The prevention effect of probiotics against eczema in children: an update systematic review and meta-analysis[J]. J Dermatolog Treat, 2021, 18: 1-11.
[26]	Jiang W, Ni B, Liu Z, et al. The role of probiotics in the prevention and treatment of atopic dermatitis in children: an updated systematic review and meta-analysis of randomized controlled trials[J]. Paediatr Drugs, 2020, 22(5): 535-549. doi: 10.1007/s40272-020-00410-6 pmid: 32748341
[27]	Azad MB, Coneys JG, Kozyrskyj AL, et al. Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis[J]. BMJ, 2013, 347: f6471. doi: 10.1136/bmj.f6471
[28]	Peldan P, Kukkonen AK, Savilahti E, et al. Perinatal probiotics decreased eczema up to 10 years of age, but at 5-10 years, allergic rhino-conjunctivitis was increased[J]. Clin Exp Allergy, 2017, 47(7): 975-979. doi: 10.1111/cea.12924 pmid: 28316095
[29]	Wei XC, Jiang P, Liu JB, et al. Association between probiotic supplementation and asthma incidence in infants: a meta-analysis of randomized controlled trials[J]. J Asthma, 2020, 57(2): 167-178. doi: 10.1080/02770903.2018.1561893
[30]	Du X, Wang L, Wu S, et al. Efficacy of probiotic supplementary therapy for asthma, allergic rhinitis, and wheeze: a meta-analysis of randomized controlled trials[J]. Allergy Asthma Proc, 2019, 40(4): 250-260. doi: 10.2500/aap.2019.40.4227
[31]	Huang CF, Chie WC, Wang IJ. Efficacy of Lactobacillus administration in school-age children with asthma: a randomized, placebo-controlled trial[J]. Nutrients, 2018, 10(11): 1678. doi: 10.3390/nu10111678
[32]	Drago L, Cioffi L, Giuliano M, et al. The probiotics in pediatric asthma management (PROPAM) study in the primary care setting: a randomized, controlled, double-blind trial with Ligilactobacillus salivarius LS01 (DSM22775) and Bifidobacterium breve B632 (DSM 24706)[J]. J Immunol Res, 2022, 2022: 3837418.
[33]	Bertelsen RJ, Brantsaeter AL, Magnus MC, et al. Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases[J]. J Allergy Clin Immunol, 2014, 133(1): 165-171. doi: 10.1016/j.jaci.2013.07.032 pmid: 24034345
[34]	Meirlaen L, Levy EI, Vandenplas Y. Prevention and management with pro-, pre and synbiotics in children with asthma and allergic rhinitis: a narrative review[J]. Nutrients, 2021, 13(3): 934. doi: 10.3390/nu13030934
[35]	Anania C, Di Marino VP, Olivero F, et al. Treatment with a probiotic mixture containing Bifidobacterium animalis Subsp. Lactis BB12 and Enterococcus faecium L3 for the prevention of allergic rhinitis symptoms in children: a randomized controlled trial[J]. Nutrients, 2021, 13(4): 1315. doi: 10.3390/nu13041315
[36]	Chen N, Liu F, Gao Q, et al. A meta-analysis of probiotics for the treatment of allergic airway diseases in children and adolescents[J]. Am J Rhinol Allergy, 2022: 19458924221080159.
[37]	Nabil F, Elbehedy EM, Sedeek R, et al. Clinical efficacy of combined probiotics and immunotherapy in childhood allergic rhinitis[J]. Egypt J Immunol, 2020, 27(2): 73-79.
[38]	吴炜倩, 陆合, 郭亚楠, 等. 益生菌防治过敏性疾病的进展和展望[J]. 中国微生态学杂志, 2020, 32(7): 862-865.
[39]	McFarland LV. Efficacy of singlestrain probiotics versus multistrain mixtures: systematic review of strain and disease specificity[J]. Dig Dis Sci, 2021, 66(3): 694-704. doi: 10.1007/s10620-020-06244-z
[40]	Spacova I, Ceuppens JL, Seys SF, et al. Probiotics against airway allergy: host factors to consider[J]. Dis Model Mech, 2018, 11(7): dmm034314.
[41]	Kallio S, Kukkonen AK, Savilahti E, et al. Perinatal probiotic intervention prevented allergic disease in a Caesarean-delivered subgroup at 13-year follow-up[J]. Clin Exp Allergy, 2019, 49(4): 506-515. doi: 10.1111/cea.13321 pmid: 30472801
[42]	Jamalkandi SA, Ahmadi A, Ahrari I, et al. Oral and nasal probiotic administration for the prevention and alleviation of allergic diseases, asthma and chronic obstructive pulmonary disease[J]. Nutr Res Rev, 2021, 34(1): 1-16. doi: 10.1017/S0954422420000116
[43]	van Reenen CA, Dicks LM. Horizontal gene transfer amongst probiotic lactic acid bacteria and other intestinal microbiota: what are the possibilities? A review[J]. Arch Microbiol, 2011, 193(3): 157-168. doi: 10.1007/s00203-010-0668-3 pmid: 21193902
[44]	Doron S, Snydman DR. Risk and safety of probiotics[J]. Clin Infect Dis, 2015, 60(Suppl 2): S129-S134.
[45]	Fiocchi A, Pawankar R, Cuello-Garcia C, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): probiotics[J]. World Allergy Organ J, 2015, 8(1): 4. doi: 10.1186/s40413-015-0055-2