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Allergic asthma

Imbalances in intestinal flora in infants favors the development of allergic asthma. Studies have been carried out on the prevention of allergic asthma with probiotics or prebiotics. 

Allergic origin

The prevalence of asthma is estimated at 14% in children and around 6% in adults1. This inflammatory disease of the bronchi has an allergic origin in most cases. The allergen can be of various origins: pollen, tobacco, food, pollution; a personal history of atopy or allergic rhinitis in childhood also increases the risk of asthma2. Furthermore, the occurrence of certain events can modify intestinal flora in very early life (cesarean birth, use of antibiotics), and are likely to increase the risk of allergies and asthma as a result3

Intestinal microbiota dysbiosis

Several studies have established a connection with an intestinal microbiota dysbiosis4-6, but also with a pulmonary microbiota dysbiosis7,8, which suggests that these bacterial ecosystems play a role in allergic asthma, though without establishing a clear effect on the microbiota of these patients. An increase in the level of colonization by Bacteroidaceae and/or colonization by the species Bacteroides fragilis at the age of 3 weeks have been associated with an increased risk of developing asthma later in life9. Generally speaking, low diversity in the intestinal microbiota in the first weeks of life is associated with a higher risk of sensitivity and respiratory allergies10,11

Prebiotics and probiotics as prevention

Currently, treatment relies on the removal of the allergen associated to long-term control medication and fast-acting medication for excerbations.
The relationship between intestinal microbiota and allergy suggests that changes to the microbiota could prevent or reduce allergies. According to the literature, GOS and FOS prebiotics have an effect in some allergic asthma models12. Furthermore, several studies have shown positive effects of probiotics on asthma in animal models13-15

1. Global burden of disease due to asthma. The global Asthma Report 2014. 
2. Rhinitis and onset of asthma: a longitudinal population-based study. Shaaban R, Zureik M, Soussan D et al. Lancet. 2008 Sep 20;372(9643):1049-57.
3. Pearl D. Houghteling et al. From Birth to “Immunohealth,” Allergies and Enterocolitis. J Clin Gastroenterol 2015;49:S7–S12 
4. Vael C, Nelen V, Verhulst S, Goossens H, Desager K. Early intestinal Bacteroides fragilis colonisation and development of asthma. BMC Pulm Med 2008: 8: 19
5. Songjinda P, Nakayama J, Tateyama A, et al. Differences in developing intestinal microbiota between allergic and nonallergic infants: a pilot study in Japan. Biosci Biotechnol Biochem 2007 ; 71 : 2338-42
6. Vael C, Vanheirstraeten L, Desager KN, Goossens H. Denaturing gradient gel electrophoresis of neonatal intestinal microbiota in relation to the development of asthma. BMC Microbiol 2011 ; 11 : 68
7. Hilty M, Conor Burke et al. Disordered Microbial Communities in Asthmatic Airways. PLOS One. 2010
8. Millares L, Bermudo G, Pérez-Brocal V, et al. The respiratory microbiome in bronchial mucosa and secretions from severe IgE-mediated asthma patients. BMC Microbiology. 2017;17:20.doi:10.1186/s12866-017-0933-6.
9. Vael C et al. Early intestinal Bacteroides fragilis colonisation and development of asthma. BMC Pulm Med. 2008 Sep 26;8:19
10. Bisgaard H, Li N, Bonnelykke K, et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol 2011 ; 128 : 646-52. 
11. Abrahamsson TR, Jakobsson HE, Andersson AF, Björkstén B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy 2014 ; 44 : 842-50. 
12. Vos AP, van Esch BC, Stahl B, et al. Dietary supplemen- tation with specific oligosaccharide mixtures decreases para- meters of allergic asthma in mice. Int Immunopharmacol 2007 ; 7 : 1582-7. 
13. de Azevedo MS, Innocentin S, Dorella FA, et al. Immuno- therapy of allergic diseases using probiotics or recombinant probiotics. J Appl Microbiol 2013 ; 115 : 319-33.
14. Fonseca VM, Milani TM, Prado R, Bonato VL, Ramos SG, Martins FS, Vianna EO, Borges MC . Oral administration of Saccharomyces cerevisiae UFMG A-905 prevents allergic asthma in mice. Respirology. 2017 Feb 6. doi: 10.1111/resp.12990 . [Epub ahead of print] PMID: 28166610 
15. Juan Z, Zhao-Ling S, Ming-Hua Z, Chun W, Hai-Xia W, Meng-Yun L, Jian-Qiong H, Yue-Jie Z, Xin S. Oral administration of Clostridium butyricum CGMCC0313-1 reduces ovalbumin-induced allergic airway inflammation in mice. Respirology. 2017 Jan 25. doi: 10.1111/resp.12985 . [Epub ahead of print] PMID: 28122397


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