CURRENT USE OF “HEALTHY” BACTERIA (PROBIOTICS) IN ALLERGY (A NARRATIVE REVIEW)
DOI:
https://doi.org/10.52340/jecm.2025.04.20Keywords:
Probiotics, Allergies, Microbiome, Hygiene hypothesis, ImmunomodulationAbstract
The human microbiome plays a crucial role in immune regulation, and its imbalance is associated with allergic diseases such as atopic dermatitis, allergic rhinitis, and asthma. Probiotics have emerged as a potential strategy for restoring microbial balance and modulating immune responses. This review evaluated 34 studies published between 2010 and 2025, including randomized controlled trials, clinical trials, and systematic reviews, focusing on pediatric populations. The findings indicate that specific probiotic strains can reduce allergic symptoms, decrease Th2 cytokines (IL-4, IL-5, IL-13), increase IFN-γ, improve clinical scores (SCORAD, TNSS, C-ACT), and modulate inflammatory miRNAs. Children showed higher responsiveness, likely due to greater immune plasticity and microbiome development. No serious adverse effects were reported. Although probiotics are not a replacement for conventional therapies, they represent a promising, safe adjunct in the prevention and management of allergic diseases, particularly in children. Further research is needed to define optimal strains, dosages, and treatment protocols.
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Hajjo, R., Sabbah, D. A., & Bawab, A. Q. A. (2022). Unlocking the potential of the human microbiome for identifying disease diagnostic biomarkers. Diagnostics, 12(7), 1742. https://doi.org/10.3390/diagnostics12071742
Zhang, Y., Li, S., Gan, R., Zhou, T., Xu, D., & Li, H. (2015). Impacts of gut bacteria on human health and diseases. International Journal of Molecular Sciences, 16(4), 7493–7519. https://doi.org/10.3390/ijms16047493
Bokulich, N. A., Amiranashvili, L., Chitchyan, K., Ghazanchyan, N., Darbinyan, K., Gagelidze, N., Sadunishvili, T., Goginyan, V., Kvesitadze, G., Torok, T., & Mills, D. A. (2015). Microbial biogeography of the transnational fermented milk matsoni. Food Microbiology, 50, 12–19. https://doi.org/10.1016/j.fm.2015.03.008
Petschow, B. W., Dore, J., Hibberd, P., Dinan, T., Reid, G., Blaser, M. J., & Cani, P. D. (2013). Probiotics, prebiotics, and the host microbiome: The science of translation. Annals of the New York Academy of Sciences, 1306(1), 1–17. https://doi.org/10.1111/nyas.12303
Zmora, N., Zilberman-Schapira, G., Mor, U., Suez, J., Regev-Lehavi, D., Bashiardes, S., Kotler, E., Zur, M., Regev, A., Dori-Bachash, M., Federici, S., Cohen, Y., Linevsky, R., Rothschild, D., Moor, A. E., Ben-Moshe, S., Harmelin, A., Itzkovitz, S., Maharshak, N., ... Elinav, E. (2018). Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell, 174(6), 1388–1405.e21. https://doi.org/10.1016/j.cell.2018.08.041
Dong, J., Ping, L., Cao, T., Sun, L., Liu, D., Wang, S., Huo, G., & Li, B. (2022). Immunomodulatory effects of the Bifidobacterium longum BL-10 on lipopolysaccharide-induced intestinal mucosal immune injury. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.947755
Eslami, M., Bahar, A., Keikha, M., Karbalaei, M., Kobyliak, N. M., & Yousefi, B. (2020). Probiotics function and modulation of the immune system in allergic diseases. Allergologia et Immunopathologia, 48(6), 771–788. https://doi.org/10.1016/j.aller.2020.04.005
Pellegrini, S., Vivarelli, S., De Vittori, L., Baldassarre, A., De Marco, G., Carbone, F., Capristo, C., Amato, A., Capasso, M., Del Chierico, F., Indrio, F., & Stronati, L. (2020). Probiotics as a possible strategy for the prevention and treatment of allergic diseases. Foods, 10(4), 701. https://doi.org/10.3390/foods10040701
Anania, C., Brindisi, G., Martinelli, I., Bonucci, E., D’Orsi, M., Ialongo, S., Nyffenegger, A., Raso, T., Spatuzzo, M., De Castro, G., Zicari, A. M., Carraro, C., Piccioni, M. G., & Olivero, F. (2022). Probiotics function in preventing atopic dermatitis in children. International Journal of Molecular Sciences, 23(10), 5409. https://doi.org/10.3390/ijms23105409
Cukrowska, B., Ceregra, A., Maciorkowska, E., Surowska, B., Zegadło-Mylik, M. A., Konopka, E., Trojanowska, I., Zakrzewska, M., Bierła, J. B., Zakrzewski, M., Kanarek, E., & Motyl, I. (2021). The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study. Nutrients, 13(4), 1169. https://doi.org/10.3390/nu13041169
Navarro-López, V., Ramírez-Boscá, A., Ramón-Vidal, D., Ruzafa-Costas, B., Genovés-Martínez, S., Chenoll-Cuadros, E., Carrión-Gutiérrez, M., De La Parte, J. H., Prieto-Merino, D., & Codoñer-Cortés, F. M. (2017). Effect of oral administration of a mixture of probiotic strains on SCORAD index and use of topical steroids in young patients with moderate atopic dermatitis. JAMA Dermatology, 154(1), 37. https://doi.org/10.1001/jamadermatol.2017.3647
Wang, I., & Wang, J. (2015). Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. Clinical & Experimental Allergy, 45(4), 779–787. https://doi.org/10.1111/cea.12489
Umborowati, M. A., Damayanti, D., Anggraeni, S., Endaryanto, A., Surono, I. S., Effendy, I., & Prakoeswa, C. R. S. (2022b). The role of probiotics in the treatment of adult atopic dermatitis: a meta-analysis of randomized controlled trials. J of Health Population and Nutrition,41(1). https://doi.org/10.1186/s41043-022-00318-6
Jeong, K., Jang, S. W., Jeon, S., Seo, H. J., Kang, S., Han, S., Suh, D. I., & Lee, S. (2024b). Efficacy of Bifidobacterium longum and Lactobacillus plantarum (NVP-1703) in Children With Allergic Rhinitis: A Randomized Controlled Trial. Journal of Korean Medical Science, 39(40). https://doi.org/10.3346/jkms.2024.39.e266
Ahmed, M., Billoo, A. G., & Iqbal, K. (2019). Efficacy of probiotic in perennial allergic rhinitis under five year children: A randomized controlled trial. Pakistan Journal of Medical Sciences, 35(6). https://doi.org/10.12669/pjms.35.6.744
Giovannini, M., Agostoni, C., Riva, E., Salvini, F., Ruscitto, A., Zuccotti, G. V., & Radaelli, G. (2007). A Randomized Prospective Double Blind Controlled Trial on Effects of Long-Term Consumption of Fermented Milk Containing Lactobacillus casei in Pre-School Children With Allergic Asthma and/or Rhinitis. Pediatric Research, 62(2), 215–220. https://doi.org/10.1203/pdr.0b013e3180a76d94
Costa, D. J., Marteau, P., Amouyal, M., Poulsen, L. K., Hamelmann, E., Cazaubiel, M., Housez, B., Leuillet, S., Stavnsbjerg, M., Molimard, P., Courau, S., & Bousquet, J. (2014). Efficacy and safety of the probiotic Lactobacillus paracasei LP-33 in allergic rhinitis: a double-blind, randomized, placebo-controlled trial (GA2LEN Study). European Journal of Clinical Nutrition, 68(5), 602–607. https://doi.org/10.1038/ejcn.2014.13
Sadrifar, S., Gholami, M., Gharibi, T., Kazemi Arababadi, M., Khosravi, A., & Hashemzadeh, M. (2023). Effects of probiotics on clinical and immunological parameters in mild to moderate asthma patients: A randomized controlled trial. Microbial Pathogenesis, 174, 105924. https://doi.org/10.1016/j.micpath.2023.105924
Chen, Y., Li, X., Zhou, X., Wang, C., Zhang, X., & Zhang, Y. (2010). Lactobacillus gasseri A5 in school-aged children with asthma: A randomized controlled trial. J of Microbiology and Biotechnology,20(8),1233–39
Farid, R., Ahanchian, H., Jabbari, F., Moghiman, T., & Kianifar, H. R. (2020). Effect of probiotics on asthma control in children: A double-blind randomized trial. Electronic Physician, 12(3), 8120–8125. https://doi.org/10.19082/8120
Calvo‑Henríquez, C., Rodríguez‑Rivas, P., Mayo‑Yáñez, M., González‑Barcala, F. J., Boronat‑Catalá, B., Martins‑Neves, S., Martínez‑Capoccioni, G., & Martín‑Martín, C. (2023). Allergic rhinitis and dental caries: A systematic review. Allergología e Inmunopatología, 51(2), 168–176. https://doi.org/10.15586/aei.v51i2.752
Lai, W.-Y., Wei, C.-C., Wan, L., Mai, C.-H., Lin, C.-L., & Tsai, J.-D. (2021). Allergic rhinitis and dental-supporting tissue diseases in children: A population-based cohort study. Medicine (Baltimore), 100(7), e24780. https://doi.org/10.1097/MD.0000000000024780
Kim, D., et al. (2022). Unique inverse association between allergic rhinitis and periodontitis: A nationwide population-based study. Scientific Reports, 13(1), Article 15693. https://doi.org/10.1038/s41598-022-23543-9
Farronato, M., Lanteri, V., Fama, A., & Maspero, C. (2020). Correlation between malocclusion and allergic rhinitis in pediatric patients: A systematic review. Children, 7(12), 260. https://doi.org/10.3390/children7120260
Yousefi, B., Eslami, M., Ghasemian, A., Kokhaei, P., Salek Farrokhi, A., Darabi, N., & et al. (2019). Probiotics importance and their immunomodulatory properties. Journal of Cellular Physiology, 234(6), 8008–8018. https://doi.org/10.1002/jcp.27559
Eslami, M., Bahar, A., Keikha, M., Karbalaei, M., Kobyliak, N. M., & Yousefi, B. (2020). Probiotics function and modulation of the immune system in allergic diseases. Allergologia et Immunopathologia, 48(6), 771–788. https://doi.org/10.1016/j.aller.2020.04.005
Ring, J. (2012). Davos declaration: Allergy as a global problem. Allergy, 67(2), 141–143. https://doi.org/10.1111/j.1398-9995.2011.02770.x
Gupta, R., Sheikh, A., Strachan, D. P., & Anderson, H. R. (2007). Time trends in allergic disorders in the UK. Thorax, 62(1), 91–96. https://doi.org/10.1136/thx.2004.038844
Ring, J., Krämer, U., Schäfer, T., & Behrendt, H. (2001). Why are allergies increasing? Current Opinion in Immunology, 13(6), 701–708. https://doi.org/10.1016/S0952-7915(01)00282-5
Yates, A., Callard, R., & Stark, J. (2004). Combining cytokine signalling with T-bet and GATA-3 regulation in Th1 and Th2 differentiation: A model for cellular decision-making. Journal of Theoretical Biology, 231(2), 181–196. https://doi.org/10.1016/j.jtbi.2004.06.005
Romagnani, S. (2006). Regulation of the T cell response. Clinical & Experimental Allergy, 36(11), 1357–1366. https://doi.org/10.1111/j.1365-2222.2006.02606
Dietert, R. R., & Zelikoff, J. T. (2008). Early-life environment, developmental immunotoxicology, and the risk of pediatric allergic disease including asthma. Birth Defects Research Part B: Developmental and Reproductive Toxicology, 83(6), 547–560. https://doi.org/10.1002/bdrb.20172
Mikocka-Walus, A., Pittet, V., Rossel, J. B., von Känel, R., Anderegg, C., & Bauerfeind, P. (2016). Symptoms of depression and anxiety are independently associated with clinical recurrence of inflammatory bowel disease. Clinical Gastroenterology and Hepatology, 14(6), 829–835.e1. https://doi.org/10.1016/j.cgh.2015.12.040
Jakubczyk, D., & Górska, S. (2021). Impact of probiotic bacteria on respiratory allergy disorders. Frontiers in Microbiology, 12, Article 688137. https://doi.org/10.3389/fmicb.2021.688137
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