Table 2.
Use of probiotics to treat or prevent allergic diseases in adults and mother–infant pairs.
| Type of Study | Probiotic | Dosage and Time of Exposure | Allergic Disease | Main Findings | Reference |
|---|---|---|---|---|---|
| Double-blind, randomized, placebo-controlled study with 159 mothers with allergic diseases and their infants | Lactobacillus rhamnosus GG (LGG) | 1 × 1010 CFU daily for 2–4 weeks | Atopic eczema, asthma, and allergic rhinitis | The incidence of eczema in the probiotic group was halved. The concentrations of total immunoglobulin (Ig) E and positive reactions in skin-pick tests were similar in both groups | [55] |
| Randomized, double-blind, placebo-controlled trial with 44 adults | Bifidobacterium longum BB536 | 5 × 1010 CFU twice daily for 13 weeks | Japanese cedar pollinosis (JCPsis) | B. longum reduced severe symptoms and medication and decreased nasal blockage in rhinorrhea, and composite scores. Improvements in all symptoms | [58] |
| Randomized trial with newborns of 231 women with allergy | Lactobacillus acidophilus LAVRI-A1 | 3 × 109 CFU/day for the first 6 months of life | Atopic dermatitis | Atopic dermatitis rates were similar in the probiotic and placebo groups. At 12 months, the rate of sensitization was significantly higher in the probiotic group | [85] |
| Double-blind, randomized, placebo-controlled study with 232 mothers | L. reuteri ATCC 55730 | 1 × 108 CFU/day from gestational week 36 until delivery. Their babies then continued with the same product from birth until 12 months | Eczema | The cumulative incidence of eczema was similar in the two groups. The probiotic group had less IgE-associated, and skin prick test reactivity was also less common | [56] |
| Randomized, double-blind, placebo-controlled study with 2 parallel groups of 1223 pregnant women | LGG, L. rhamnosus LC705, Bifidobacterium breve Bb99, and P. freudenreichii spp. shermanii JS | Oral administration of LGG (5 × 109 CFU), L. rhamnosus LC705 (5 × 109), B. breve Bb99 (2 × 108), and Propionibacterium freudenreichii spp. shermanii JS (2 × 108) twice daily for 2 to 4 weeks before delivery. Their infants received the same probiotics (+ prebiotics) once daily for the first 6 months | Food allergy, eczema, asthma, and allergic rhinitis | Administration of these probiotics significantly prevented eczema and atopic eczema | [94] |
| Placebo-controlled, double-blind study with 171 mother–infant pairs | LGG and B. lactis Bb12 | 1010 CFU/day of each probiotic from the first trimester of pregnancy to the end of exclusive breastfeeding | Atopy (eczema) | The concentration of TGF-b2 was higher in colostrum from dams supplemented with probiotics. This supplementation produced a protective effect against sensitization in infants at a high hereditary risk | [95] |
| Two-center, double-blind, randomized, placebo-controlled trial with 512 pregnant women and 474 infants | L. rhamnosus HN001 and Bifidobacterium animalis spp. lactis HN019 | Two treatment groups: 6 × 109 CFU/d of L. rhamnosus or 9 × 109 CFU/d of B. animalis from 35 weeks of gestation until 6 months in pregnant women and from birth to 2 years in infants | Eczema and atopy | Supplementation with only L. rhamnosus reduced the cumulative prevalence of eczema, but not atopy, by 2 years | [96] |
| Double-blind, placebo-controlled, prospective study with 105 pregnant women | LGG | 5 × 109 CFU twice daily. Started 4–6 weeks before expected delivery until a postnatal period of 6 months | Atopic dermatitis | There was no significant difference between the probiotic group and placebo groups | [97] |
| Randomized, double-blind, placebo-controlled trial with 112 pregnant women | Bifidobacterium bifidum BGN4, B. lactis AD011, and L. acidophilus AD031 | Mixture of probiotics (1.6 × 109 CFU/day of each probiotic) for 4–8 weeks before delivery until 6 months after delivery | Eczema | The prevalence of eczema in the probiotic-added group was lower. The cumulative incidence of eczema during the first 12 months was reduced in the probiotic group. No difference in the serum total IgE level or sensitization to food allergens | [7] |
| Double-blind, randomized, placebo-controlled study with 156 pregnant women | B. bifidum W23 and B. lactis W52 | 1 × 109 CFU/day of each strain during the last 6 weeks of pregnancy and postnatally for 12 months to their offspring | Eczema | The prevalence of eczema during the first 3 months of life was significantly lower in the probiotic group. The cumulative incidence was also lower in the probiotic group | [98] |
| Randomized, double-blind trial of children from 415 mothers | LGG, B. animalis ssp. lactis Bb-12, and L. acidophilus La-5 |
Milk contained 5 × 1010 CFU/day of L. rhamnosus and Bb-12. 5 × 109 CFU of L. acidophilus for 4 months, from 36 weeks of gestation to 3 months postnatally | Atopic dermatitis and asthma | In the probiotic group, the cumulative incidence of atopic dermatitis was reduced, but there was no effect on sensitization | [89] |
| Double-blind, placebo-controlled study with 36 subjects with allergic rhinitis | L. rhamnosus GR-1 and Bifidobacterium adolescentis 7007-05 | Added L. rhamnosus at 4% and B. adolescentis at 10% of final milk volume | Rhinitis | Serum IL-10 and IL-12 levels were increased in the probiotic group at the end of the grass pollen season. Additionally, the serum TFG-β levels were higher during the ragweed season | [99] |
| Randomized controlled trial with 250 pregnant women | LGG | 1.8 × 1010 CFU/day from 36 weeks of gestation until delivery | Eczema | Prenatal probiotic treatment was only associated with decreased breast milk soluble CD14 and IgA levels | [100] |
| Randomized, double-blind, placebo-controlled study | Lactobacillus plantarum CJLP133 | 0.5 × 1010 CFU twice a day for 12 weeks | Atopic dermatitis | SCORAD scores were lower with probiotic administration. Additionally, the total eosinophil counts were significantly lower, and the logarithmic IFN-c and IL-4 concentrations were decreased | [101] |
| Parallel, double-blind, placebo-controlled study of 241 mother–infant pairs | L. rhamnosus LPR, B. longum BL999, and Lactobacillus paracasei ST11 | Combination of L. rhamnosus and B. longum or L. paracasei and B. longum. Daily dose for each probiotic (1 × 109 CFU) for 2 months before delivery and during the first 2 months of breastfeeding. The infants were followed for 24 months | Eczema | The risk of eczema was reduced in infants of mothers receiving combinations of probiotics during the first 24 months | [102] |
| Prospective, double-blind, placebo-controlled study with 191 pregnant women | LGG | 1 × 1010 CFU/day from the second trimester of pregnancy | Atopic diseases | No significant effects of prenatal and postnatal probiotic supplementation on sensitization, development of allergic diseases, and maternal IgE levels. The allergic symptoms improved in the probiotic group | [103] |
| Double-blind, parallel-group, placebo-controlled comparison with 49 AD patients | L. acidophilus L-92 | 20.7 mg/day for 8 weeks | Atopic dermatitis | This probiotic contributes to the suppression of Th-2-dominant inflammation and reduces atopic dermatitis symptoms in adults | [104] |
| Randomized controlled study with 415 pregnant women | LGG, B. animalis spp. Lactis Bb-12, and L. acidophilus La-5 | Daily dose of LGG (5 × 1010 CFU), B. animalis spp. Lactis Bb-12 (5 × 1010 CFU), and L. acidophilus La-5 (5 × 109 CFU) from 36 weeks of gestation to 3 months postnatal | Atopic dermatitis | Supplementation with a combination of these probiotics reduced the proportion of Th22 cells. However, the proportion of Tregs, Th1, Th2, and Th17 cells and the Th1/Th2 ratio in the offspring were not affected | [105] |
| Double-blind, placebo-controlled, parallel, randomized clinical study with 173 participants | Lactobacillus gasseri KS-13, B. bifidum G9-1, and B. longum MM-2 | Each capsule (350 mg) contained L. gasseri KS-13 (1.2 billion CFU), B. bifidum G9-1 (0.15 billion), and B. longum MM-2 (0.15 billion) | Rhinoconjunctivitis-specific | An improvement in the rhinoconjunctivitis-specific quality of life during allergy season was seen in the probiotic group | [106] |
| Randomized, double-blind, placebo-controlled study with 22 AD subjects | L. plantarum IS-10506 | 1010 CFU/day for 12 weeks | Atopic dermatitis | Reduction in clinical symptoms in AD children and decreased SCORAD and levels of serum IgE, IL-4, and IL-17. The probiotic acted through the downregulation of the Th2-adaptive immune response | [107] |