Probiotics and prebiotics: clinical effects in allergic disease.

PURPOSE OF REVIEW: This paper summarizes recent publications on probiotics and prebiotics in allergic disease. It focuses on clinical studies of prevention or treatment of allergic disease.

RECENT FINDINGS: Studies suggest a role for certain probiotics (alone or with prebiotics) in the prevention of atopic eczema. Treatment during the prenatal period appears to be important for beneficial effects. The use of probiotics for the treatment of established allergic disease is less promising, despite some positive results. A Cochrane systematic review concluded that, when the results for the different probiotic strains used in clinical trials are pooled, probiotics are not effective for the treatment of eczema. There are fewer studies of prebiotics for the treatment or prevention of allergic disease, but data suggest that prebiotic-supplemented formulas may be effective for preventing eczema in infants at high risk of developing allergic disease when breast-feeding is not possible.

SUMMARY: Allergic diseases continue to increase in prevalence worldwide, and primary prevention of allergic disease has proved an elusive goal. Probiotic bacteria represent the most promising intervention for primary prevention that has been studied to date, and definitive intervention studies should now be a research priority.