The effect of food elimination and probiotic supplementation in asthmatic children with food allergy

INTRODUCTION Both bronchial asthma and food allergy show increase in prevalence worldwide, this makes the management of children with food allergy and asthma a growing concern. Population studies have shown that an early food sensitization or food allergy in the first year of life may precede the development of asthma. When asthma and food allergy coexist, they adversely influence the course of each other. Asthma attack can be elicited by food allergens in sensitized children. The cornerstone of the nutritional management of food allergies is an individualized allergen avoidance management plan. In children, the main goals are to prevent the occurrence of acute and chronic symptoms by avoiding the offending food(s), whilst providing an adequate, healthy and nutritionally balanced diet and maintaining optimal growth. The role of the intestinal microbiota in the development of immune tolerance to food is increasingly appreciated. The commensal gut microbiota targets different cellular components of the innate and adaptive immune compartments to promote oral tolerance. One mechanism by which the commensal microbiota influences the outcome of the allergic response is by modulating the innate lymphoid cells (ILC) to secrete IL-12. The commensal microbiota also targets the adaptive immune response to promote tolerance through promoting the differentiation of induced T regulatory (iTreg) cells from naive CD4+ T cell. Probiotics are living bacteria intended to have health benefits, they are not only a driver of growth but also a modulator of the immune system and prevention of many diseases. The most commonly used probiotics are the strains of lactic acid bacteria such as Lactobacillus, Bifidobacterium and Streptococcus (S.) Original article