Current insights into cow's milk allergy in children: Microbiome, metabolome, and immune response—A systematic review

作者：Mariyana V. Savova, Pingping Zhu, Amy C. Harms, Renate G. van der Molen, Clara Belzer, Diana M. Hendrickx · 发表于：Pediatric Allergy and Immunology · 年份：2024 · DOI：10.1111/pai.14084 · 被引用次数：14 · 研究领域：Food Allergy and Anaphylaxis Research、Probiotics and Fermented Foods、Gut microbiota and health

Abstract The increasing prevalence of IgE‐mediated cow's milk allergy (CMA) in childhood is a worldwide health concern. There is a growing awareness that the gut microbiome (GM) might play an important role in CMA development. Therefore, treatment with probiotics and prebiotics has gained popularity. This systematic review provides an overview of the alterations of the GM, metabolome, and immune response in CMA children and animal models, including post‐treatment modifications. MEDLINE, PubMed, Scopus, and Web of Science were searched for studies on GM in CMA‐diagnosed children, published before 1 March 2023. A total of 21 articles (13 on children and 8 on animal models) were included. The studies suggest that the GM, characterized by an enrichment of the Clostridia class and reductions in the Lactobacillales order and Bifidobacterium genus, is associated with CMA in early life. Additionally, reduced levels of short‐chain fatty acids (SCFAs) and altered amino acid metabolism were reported in CMA children. Commonly used probiotic strains belong to the Bifidobacterium and Lactobacillus genera. However, only Bifidobacterium levels were consistently upregulated after the intervention, while alterations of other bacteria taxa remain inconclusive. These interventions appear to contribute to the restoration of SCFAs and amino acid metabolism balance. Mouse models indicate that these interventions tend to restore the T h 2/T h 1 balance, increase the T reg response, and/or silence th...