Probiotics and Allergy

1. Probiotics and Allergy Shalini Jain , Hariom Yadav and PR Sinha Animal Biochemistry Division National Dairy Research Institute Karnal,Haryana

2. Definition Allergy is an adverse immune reaction to a molecule called allergen (protein) in our environment, which is normally harmless to the non-allergic person.

3. Types of Allergy Classified according to symptoms they produce i.e. skin, nose and lungs etc and causes: • Skin allergy • Food allergy • Allergen inhalation (Allergic rhinitis, Allergic asthma ) • Allergy to medicine

4. Risk factors of Allergy • Family history of allergy - Allergies are hereditary which means there is a genetic component to most allergies and passed from parents to children. • Exposure to allergens at certain times when the body's defenses are lowered or weakened, such as after a viral infection or during pregnancy, seems to contribute to the development of allergies.

5. Allergen An allergen - a substance causing allergic disease in sensitized host. These allergens enter into body by various means: • Through the skin – cosmetics, stinging insects and oak • Injections – drugs • Oral ingestion – Eggs, prawns, peanuts, fish, cow’s milk • Nose and lungs – airborne pollen of weeds, grasses, dust mite droppings

6. Symptoms of Allergy • Skin allergy symptoms include itching, reddening, and flaking or peeling of the skin. • Allergic rhinitis is characterized by congestion, itching and discharge from the nose and itchy, watery eyes. • Asthma include coughing, chest tightness, shortness of breath and wheezing. • Food allergy include, dizziness, lightheadedness or fainting abdominal pain, diarrhea, nausea or vomiting , anaphylaxis and hives. • A severe allergic reaction to food - called anaphylaxis.Anaphylaxis include a feeling of warmth, flushing, tingling in the mouth or a red, itchy rash. Other symptoms may include feelings of light-headedness, shortness of breath, severe sneezing, anexiety, stomach or uterine cramps, and/or vomiting and diarrhea. In severe cases, patients may experience a drop in blood pressure. Anaphylaxis can be fatal.

7. Treatment • Avoidance or Environmental control - Avoiding foods that have caused allergic reactions, removing the pet from the home, dust should be removed from the surface of pillow covers and the bed frame by vacuuming them weekly. Smoking indoors should never be permitted. • Pharmacologic management/Allergy medication - In food allergy injection of adrenaline, antihistamines reduce the effects of an allergic reaction by blocking histamine, Decongestants reduce the nasal congestion, bronchodilators open the airways. • Allergen immunotherapy - Allergen immunotherapy is the process of administering gradually increasing doses of allergens to the patient. • Functional foods - Currently, there is huge interest in the use of foods which may exert a positive functional effect on our health. Two of these ‘functional foods’ are known as probiotics and prebiotics, both of which have a positive effect on the ‘good’ bacteria that reside in our digestive systems, also known as our gut microflora. • Yoga – Yoga is an alternative therapy for allergy.

8. Probiotics Probiotics are friendly bacteria which have been demonstrated to have beneficial effects on human health and available in different forms like dairy products- dahi, yogurt, capsules etc. A probiotic may be defined as: ‘A preparation or product containing viable, defined micro-organisms in sufficient numbers, which alter the microflora of the host intestine and, consuming by that, exert beneficial health effects on the host’ (Schrezenmeier & De Vrese 2001). For example: bifidus, lactobacillus.

9. Probiotics in Treatment of disease • Probiotics have been found to act as alternative medicine for a number of diseases: • Lactose intolerance • Diarrhea • Constipation • Inflammatory bowel disease • Respiratory disease • Atherosclerosis • Osteoporosis • Allergy

10. Probiotics Role in Allergy • Lactobacillus GG have been reported to treat allergy (Majamaa et al 1997) when administered to breast feeding mothers of infants with atopic eczema/dermatitis due to allergy to milk. • Lactobacillus GG may be effective in treating allergic diseases if administered at birth and to pregnant mothers (Kalliomaki et al 2001). • Consumption of yogurt for a year reduced the symptoms of nasal allergies among volunteers who consumed yogurt than in control group (Trapp et al 1993).

11. How probiotics work to prevent allergy To treat allergy, probiotic acts in different ways: • Degradation/structural modification of enteral antigens. • Normalization of the properties of aberrant indigenous microbiota and of gut barrier functions. • Regulation of the secretion of inflammatory mediators, and promoting development of the immune system. • Prevents food allergy by promoting endogenous barrier mechanisms and alleviating intestinal inflammation. • Stimulating immune response and reduction of serum IgE levels. • Reduction of Th2 cytokine response.

12. Intestinal microflora Probiotics Epithelium AP-Cell Th0 IL-2 IL-12 TNF-α IFN- γ IL-4 IL-10 Il-6 Th2 Th1 IL-2 IFN-α IFN-β TNF-β Allergy B B IgE IgA Virus Tumors

13. Future directions/ perspectives • Future probiotics will have more thoroughly clarified mechanisms to either control specific physiological processes in the evolution of allergic disease or in their dietary management. The modern view on probiotic therapy is based on specific effects of clearly defined strains.

14. Conclusion The term allergy encompasses a wide range of symptoms and conditions. Although allergies cannot be prevented, they can be treated and controlled. By making changes in the environment and to their diets patients can greatly limit exposure to certain allergens and reduce and control their symptoms. If environmental control does not work, medication, immunotherapy and alternative therapy can help control the disease. Probiotics will offer consumers an alternative to more invasive, medical means of treating allergy, and provide a dietary means of optimizing health and well-being.