Abstract
Allergic diseases now affect over 30% of individuals in many communities, particularly young children, underscoring the need for effective prevention strategies in early life. These allergic conditions have been linked to environmental and lifestyle changes driving the dysfunction of three interdependent biological systems: microbiota, epithelial barrier and immune system. While this is multifactorial, dietary changes are of particular interest in the altered establishment and maturation of the microbiome, including the associated profile of metabolites that modulate immune development and barrier function. Prebiotics are non-digestible food ingredients that beneficially influence the health of the host by 1) acting as a fermentable substrate for some specific commensal host bacteria leading to the release of short-chain fatty acids in the gut intestinal tract influencing many molecular and cellular processes; 2) acting directly on several compartments and specifically on different patterns of cells (epithelial and immune cells). Nutrients with prebiotic properties are therefore of central interest in allergy prevention for their potential to promote a more tolerogenic environment through these multiple pathways. Both observational studies and experimental models lend further credence to this hypothesis. In this review, we describe both the mechanisms and the therapeutic evidence from preclinical and clinical studies exploring the role of prebiotics in allergy prevention.
Highlights
Allergic diseases (atopic dermatitis (AD), respiratory allergies and food allergies (FA)) are a mounting public health burden— classified as the 4th most common global disease by the WorldHealth Organization
Prebiotics were first described by Gibson and Roberfroid in 1995 as “non-digestible food ingredients that beneficially influence the health of the host by stimulating the activity of one or more commensal colon bacteria” [17]
GOS was the only prebiotic able to promote functional T regulatory cell (Treg). They conclude that direct modulation of the intestinal epithelial cells (IEC)-dendritic cells (DC) crosstalk can induce a regulatory immune phenotype and selecting dietary fibers could be essential for future clinical trials on efficacy in allergy management
Summary
Allergic diseases (atopic dermatitis (AD), respiratory allergies and food allergies (FA)) are a mounting public health burden— classified as the 4th most common global disease by the World. Pre-symptomatic changes in the immune function have been detected at birth in children who develop a subsequent allergic disease [1,6,12,13], suggesting that the impact of environmental change is occurring very early in development— reflected in the early onset of conditions such as AD and FA, often within the first months of life [14]. This underscores the importance of very early interventions to prevent allergic diseases. The aim of this review is to review these concepts, describe the mechanisms of prebiotic effects on the microbiota, IS and epithelial barrier, and how these may be of value in allergy preventive strategies
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