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REVIEW ARTICLE
Korean J Pediatr 2013 September;56(9) :369-376.
Published online 2013 June 13.       
Clinical efficacy and mechanism of probiotics in allergic diseases
Ha-Jung Kim2, Hyung Young Kim3, So-Yeon Lee4, Ju-Hee Seo5, Eun Lee6, Soo-Jong Hong1
1Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Seoul, Korea
2Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
3Department of Pediatrics, Kosin University College of Medicine, Busan, Korea
4Department of Pediatrics, Hallym University Scared Heart Hospital, University of Hallym College of Medicine, Anyang, Korea
5Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
6Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Soo-Jong Hong ,Tel: 02-3010-3379, Fax: 02-473-3725, Email: sjhong@amc.seoul.kr
Copyright © 2013 by The Korean Pediatric Society
ABSTRACT
A complex interplay between genetic and environmental factors partially contributes to the development of allergic diseases through immune development during prenatal and early life. To explain the dramatic increase in the prevalence of allergic diseases, hygiene hypothesis was proposed that allergic diseases were prevented by early exposure to infection. This hygiene hypothesis has been changed to microbial hypothesis, which is closely linked to the development of early immune system and allergic diseases. The intestinal flora may be a contributor to allergic disease due to its substantial effect on mucosal immunity. On the basis of the findings that exposure to microbial flora early in life allows for a change in the Th1/Th2 balance, favoring a Th1 cell response, probiotics may be beneficial in preventing allergic diseases. However, evidence to prove its efficacy is lacking from both clinical and basic researches. To date, studies have yielded inconsistent findings on the usefulness of probiotics in allergic diseases. Due to limitations such as different first supplementation period, duration, different strains, short follow-up period, and host factors, it is difficult to demonstrate an exact effect of probiotics in asthma, allergic rhinitis, and food allergy. However, there are many literatures that demonstrate a significant clinical improvement in atopic dermatitis with the use of probiotics. An accurate understanding of the development of human immunity, intestinal barrier function, intestinal microbiota, and systemic immunity is required to comprehend the effects of probiotics on allergic diseases.
Keywords: Allergic disease | Hygiene hypothesis | Immunity | Microbiota | Probiotics
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