Prevention of food allergies with probiotics, prebiotics, and synbiotics

Environmental changes are considered to be a major cause of the recent rapid increase in allergic diseases including food allergy (FA). The disturbance of gut microbiota (dysbiosis) is considered to be pivotal in the causation of FA, among several environmental factors. The formation of normal intestinal microbiota and improvement of dysbiosis with probiotics and/or prebiotics may prevent FA. Hitherto, there is no strong evidence that probiotics or prebiotics prevent FA. Currently, the administration of probiotics and prebiotics only during pregnancy and after birth is considered to prevent FA. However, the WAO guideline does not recommend probiotic and/or prebiotic supplementation during pregnancy or breastfeeding for the prevention of FA because of the low certainty of the evidence. There are many unresolved concerns, like the selection of target subjects, the selection and combination of bacterial species to be used, etc. Nevertheless, probiotics and prebiotics could be promising therapeutic interventions for the prevention of FA. However, further research needs to be conducted in the future to explore the role of prebiotics and probiotics in preventing FA. A collaborative effort between researchers and clinicians to explore this topic should be encouraged.