Probiotics, prebiotics and food allergy

Background:The prevalence of food allergy (FA) has increased, a possible consequence of intestinal dysbiosis, environmental or genetic factors.Currently, no formal indications exist for probiotic or prebiotic supplementation in FA.This review aims to analyse the role of probiotics and prebiotics in the prevention and treatment of FA.Methods: A Pubmed/ Medline search was carried out on articles published between 2011 and 2021 with the following query: ("Food Hypersensitivity"[Mesh]) AND (("Probiotics"[Mesh]) OR ("Prebiotics"[Mesh])).Subsequently, the titles and abstracts were analysed and selected according to established criteria.After full reading of these articles, 54 were included and a narrative review was performed. Results:The review was structured in the following sections: i) Cow's Milk Proteins Allergy (CMA), ii) Food Allergy to Peanuts and iii) Prevention of Food Allergy.In CMA, several studies have supported the benefits of extensively hydrolysed casein formula supplemented with Lactobacillus Rhamnosus GG in the earlier acquisition of tolerance to cow's milk proteins, resolution of gastrointestinal symptoms and prevention of other allergic manifestations.In peanut oral immunotherapy (OI), supplementation with Lactobacillus Rhamnosus CGMCC 1.3724 seems to have a favourable impact in inducing a sustained desensitization response.Regarding the use of probiotics in the prevention of FA, this assumption lacks robust scientific evidence in order to confirm the effectiveness.Current evidence supports the use of oligosaccharides from breast milk in the first months of life for preventing atopic dermatitis, FA and asthma. Conclusions:The potential of probiotics to be used as therapeutic adjuvants in CMA and peanut OI is promising.However, there is inconsistency regarding the type of probiotic, the dose and duration of supplementation.Further studies are needed to clarify the role of probiotics and prebiotics in FA.