Lactic acid bacteria as novel adjuvant systems for prevention and treatment of atopic diseases

Allergic diseases have become the new epidemic in westernized countries. Several factors including reduction of microbial contact early in life may have contributed to this dramatic development. As conventional immunotherapy has obvious limitations, there is a need for the development of new prophylactic and therapeutic treatment approaches. In this respect, lactic acid bacteria have received increasing attention as potential treatment tools against allergy. In this review, different treatment strategies with probiotics will be discussed in light of the recent literature.

Supplementation trials with probiotics have shown to reduce allergic manifestations in children. New treatment approaches use selected probiotic strains as mucosal antigen delivery vehicles for recombinant allergens. The most recent studies focus on the optimal intervention time to enhance the treatment efficacy with probiotics for primary disease prevention.

Probiotics may serve as attractive adjuvant systems for improved allergy treatment. Recent work supports the value of well conducted clinical and experimental studies that compare different treatment regimes and identify the best candidate probiotic strains for therapeutic immunomodulation. Such data, as well as understanding the mechanisms of immune modulation in pathogenic and therapeutic settings, are fundamental to be able to recommend probiotic use in allergy treatment.