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Do we understand the role of microbiota and probiotics in allergic diseases?

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By Mariya Petrova, – PhD, Senior Scientific Educator and Senior Scientists, Winclove Probiotics

As the season of allergies slowly starts with the first spring blooms, one can wonder if we understand these events better. Only a handful of people will associate sneezing and red itchy eyes with the microbiome and will look for probiotic alternatives. However, the last decade has shown us that our microbiota and the potential of probiotic intake should not be ignored. Let’s dive deep and try to provide some lights on the topic.

The last couple of decades have been marked with an enormous increase of allergies especially in the industrialized world. Now up to 40 – 50% of the children in Western countries are sensitized to one or more common allergens and have some form of allergy, with up to 30% of the population experiencing hay fever. Allergies represent a social burden due to a high incidence and substantial impact on Quality of Life (QoL)1. Often, allergies find roots in early infancy expressed in the form of atopic eczema. Eczema remits spontaneously with age, but due to an alert immune system the child is often primed to develop other forms of allergies one after the other such as food allergies, respiratory allergies, and hay fever later in life, a progression of allergic manifestation known as ‘allergic march’2,3. For example, infants with eczema within the first year of life are 11 times more likely to develop peanut allergies at one year of age4. Furthermore, 50% of children that had food allergies during the first 4 years of life were more likely to develop respiratory allergies5.

The increased incidence of allergies is not only linked to genetic predisposition, but researchers have now shown that our microbiota plays a crucial role in this field. Infants are exposed to microbial colonization early in life, and several factors, such as mode of delivery, type of feeding, environment, antibiotics if used, can shape the gut microbiota and thus the development of the immune system. Scientists have found that imbalances in the gut microbiome, low gut microbiota maturity and richness often precede eczema development, as the first allergic event of the allergic march6–8. Depletion of gut microbiota species regulating the immune development early in life has also been linked to the development of allergies. For example, depletion of Bifidobacteria species, Faecalibacterium, lactobacilli, and Ruminococcaceae has been observed in infants who developed eczema within the first 6 months of life and asthma later in life 9–15. Therefore, it appears that allergies are a consequence of reduced exposure to microbial antigens and especially towards beneficial microbes.

When it comes to allergic reactions, most interventions focus on the control of symptoms and their severity. The use of corticosteroid creams, antihistamines or other medications often only reduce part of the symptoms, can have unwanted side effects and some of them are rather expensive. Knowing that clear links exists between the gut microbiota and the development of allergic reactions, increasing attention has been given to probiotics. Probiotic beneficial effects are most likely linked to regulating the immune system via improving the balance between Th1 and Th2 cells, which delays the onset of an inflammatory reaction to an allergen. Indeed, some studies have shown that probiotics may have a beneficial effect on severity of allergy symptoms during hay fever, help reduce the need for medication and improving QoL of patients16. Exact mechanisms are not yet fully understood but proof of concept studies are trying to provide more information on underlying working mechanisms by which probiotics can help 17. Evidence for the beneficial role of probiotic for managing allergic disorders, such as allergic rhinitis come also from a recent systematic review and meta-analyses focusing on RCTs 18. Despite the heterogeneity of the probiotics used, there was sufficient evidence to support the view that probiotics could help reduce the severity of complaints and symptoms in people with allergic rhinitis and could improve their QoL. Additionally, probiotics have also been shown to significantly reduce the risk of eczema development, especially in young children based on systematic review with meta-analyses19.

The research has significantly progressed during the last couple of years. The link between microbiota and allergies is relatively clear. Still, more research is required to understand the underlining mechanisms by which beneficial microbes can help in the field of allergies and consequently improve the quality of life of those experiencing them. 

About the author: Mariya Petrova

Mariya is an internationally recognized expert in the field of human microbiota and probiotics. Mariya holds a PhD degree in Bioscience Engineering from KU Leuven, Belgium. She has worked closely with probiotic and microbiome organizations. In 2020, Mariya started working as Senior Scientific Educator and Senior Scientist at Winclove Probiotics. She is responsible for sharing her knowledge with health professionals, scientists, and business partners and bridging the gap between science and commerce.

References:

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