Probiotics and Prebiotics for the Prevention or Treatment of Allergic Asthma

Gut microflora is essential for oral tolerance and proper immunity. A promising approach to prevent allergic diseases in genetically at-risk infants is to modify gut microbiota by the administration of prebiotics or probiotics early in life when their immune system is still relatively immature. Prebiotics in the form of short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides (lcFOS), when added to infant feeds with probiotics (beneficial microbes), have the potential to prevent sensitization of infants to dietary allergens. In this chapter, our aim is to determine the effect of pre- and/or probiotics for the prevention or treatment of asthma. We performed a systematic updated search in November 2014 of the Cochrane Central Register of Controlled Trials (The Cochrane Library 2012, Issue 8), MEDLINE, EMBASE, Academic Search Complete, and included randomized controlled trials that compared the use of a prebiotic or probiotic for prevention or treatment of asthma. We identified 29 studies (37 papers) as eligible for inclusion. There is no strong evidence to support use of pro- and prebiotics in the prevention of asthma. There is some minute evidence that a prebiotic supplement may display beneficial therapeutic effects in asthma. Further research is needed to elucidate a potential role of pro- and prebiotics as supportive modality in asthma.