Inventing probiotic functional foods for patients with allergic disease.

OBJECTIVE: The primary objective of this review is to discuss the rationale for and applicability of probiotics as part of the nutritional approach to the prevention and management of allergic disease. DATA SOURCES: This review represents a synthesis of recent literature published in the fields of probiotics, nutrition, and allergic disease. STUDY SELECTION: The expert opinions of the authors were used to select the relevant data for the review.
RESULTS: The hygiene hypothesis suggests that allergic disease may arise from a lack of counterbalancing microbial exposure at an early age. Thus, the initial compositional development of gut microbiota is considered a key determinant in the development of both the immune responder phenotype and the normal gut barrier functions. A wide range of data documents the specific actions of selected probiotics. The regulatory role of probiotics in allergic disease has been demonstrated as improving the clinical course or preventing the development of atopic eczema in infants given a probiotic-supplemented diet. In addition, certain types of fatty acids and antioxidants have been proposed for protective effects against the development of allergy and to diminish the inflammatory response in allergic disease.
CONCLUSIONS: The increase in the prevalence of allergic disease during the past decades is likely to be explained by changes in the environment, including reduced microbial exposure and altered food consumption. Scientifically composed functional foods containing probiotics and other functional components offer a nutritional strategy for both the prevention and the management of allergic disease. Further research is needed to characterize the gut microbiota and to clarify the mechanisms of action that control specific physiologic processes not only in the evolution of allergic disease in at-risk populations but also in the management of allergic diseases.