| 1. |
- Fleming, Stephen A., et al.
(författare)
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An expert panel on the adequacy of safety data and physiological roles of dietary bovine osteopontin in infancy
- 2024
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Ingår i: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 11
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Forskningsöversikt (refereegranskat)abstract
- Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of bovine milk osteopontin (bmOPN) to formula may replicate OPN’s concentration and function in human milk. To address safety concerns, we convened an expert panel to assess the adequacy of safety data and physiological roles of dietary bmOPN in infancy. The exposure of breastfed infants to human milk OPN (hmOPN) has been well-characterized and decreases markedly over the first 6 months of lactation. Dietary bmOPN is resistant to gastric and intestinal digestion, absorbed and cleared from circulation within 8–24 h, and represents a small portion (<5%) of total plasma OPN. Label studies on hmOPN suggest that after 3 h, intact or digested OPN is absorbed into carcass (62%), small intestine (23%), stomach (5%), and small intestinal perfusate (4%), with <2% each found in the cecum, liver, brain, heart, and spleen. Although the results are heterogenous with respect to bmOPN’s physiologic impact, no adverse impacts have been reported across growth, gastrointestinal, immune, or brain-related outcomes. Recombinant bovine and human forms demonstrate similar absorption in plasma as bmOPN, as well as effects on cognition and immunity. The panel recommended prioritization of trials measuring a comprehensive set of clinically relevant outcomes on immunity and cognition to confirm the safety of bmOPN over that of further research on its absorption, distribution, metabolism, and excretion. This review offers expert consensus on the adequacy of data available to assess the safety of bmOPN for use in infant formula, aiding evidence-based decisions on the formulation of infant formula.
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| 2. |
- Forsberg, Anna, et al.
(författare)
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Pre- and probiotics for allergy prevention: time to revisit recommendations?
- 2016
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Ingår i: Clinical and Experimental Allergy. - : WILEY-BLACKWELL. - 0954-7894 .- 1365-2222. ; 46:12, s. 1506-1521
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Forskningsöversikt (refereegranskat)abstract
- Reduced intensity and diversity of microbial exposure is considered a major factor driving abnormal postnatal immune maturation and increasing allergy prevalence, particularly in more affluent regions. Quantitatively, the largest important source of early immunemicrobial interaction, the gut microbiota, is of particular interest in this context, with variations in composition and diversity in the first months of life associated with subsequent allergy development. Attempting to restore the health consequences of the ` dysbiotic drift in modern society, interventions modulating gut microbiota for allergy prevention have been evaluated in several randomized placebo-controlled trials. In this review, we provide an overview of these trials and discuss recommendations from international expert bodies regarding prebiotic, probiotic and synbiotic interventions. Recent guidelines from the World Allergy Organization recommend the use of probiotics for the primary prevention of eczema in pregnant and breastfeeding mothers of infants at high risk for developing allergy and in high-risk infants. It is however stressed that these recommendations are conditional, based on very low-quality evidence and great heterogeneity between studies, which also impedes specific and practical advice to consumers on the most effective regimens. We discuss how the choice of probiotic strains, timing and duration of administration can critically influence the outcome due to different effects on immune modulation and gut microbiota composition. Furthermore, we propose strategies to potentially improve allergy-preventive effects and enable future evidence-based implementation.
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| 3. |
- Karlsson Videhult, Frida, et al.
(författare)
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Nutrition, gut microbiota and child health outcomes
- 2016
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Ingår i: Current opinion in clinical nutrition and metabolic care. - 1363-1950 .- 1473-6519. ; 19:3, s. 208-213
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review Diet is one of the main drivers of the composition and function of the gut microbiota. The scope of this review is to summarize recent studies assessing the role of gut microbiota in clinical pediatric conditions and to review studies using nutritional approaches to favorably modify the gut microbiota to improve health outcomes in children. Recent findings New studies underscore that breastfeeding and infant diet impact the gut microbiome and metagenome. A comprehensive study using metagenomic shotgun sequencing, suggests that the cessation of breastfeeding rather than the introduction of solid foods, drives the functional maturation of the infant gut microbiome toward an adult-like state. There is further support for the view that a disturbed early gut microbiota is implicated in allergic and autoimmune diseases. New studies using prebiotics, probiotics, and synbiotics in various pediatric disorders have yielded promising results, yet the evidence for specific guidelines on their use is still low. Summary Intestinal dysbiosis is associated with several pediatric disorders but a cause-effect relationship remains to be clearly demonstrated in most conditions. Future studies using new systems biology approaches are anticipated to provide further insight into the functional capacities of the gut microbiome and its establishment in childhood. This may then lay the ground for improved treatment and prevention strategies targeting the gut microbiota.
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| 4. |
- Prescott, Susan L., et al.
(författare)
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The skin microbiome : impact of modern environments on skin ecology, barrier integrity, and systemic immune programming
- 2017
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Ingår i: World Allergy Organization Journal. - : BIOMED CENTRAL LTD. - 1939-4551. ; 10
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Forskningsöversikt (refereegranskat)abstract
- Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.
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| 5. |
- Sjödin, Kotryna Simonyte, et al.
(författare)
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Emerging evidence of the role of gut microbiota in the development of allergic diseases
- 2016
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Ingår i: Current Opinion in Allergy and Clinical Immunology. - 1528-4050 .- 1473-6322. ; 16:4, s. 390-395
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review The purpose is to review recent studies examining the role of gut microbiota in allergic diseases and asthma.Recent findings Work in experimental models gives further evidence that a disturbed gut microbiota influences the propensity to develop allergic manifestations, and that changing the gut microbiota by dietary means (high fiber/acetate or prebiotics) in pregnancy may reduce the risk of allergic airways disease and food allergy in the offspring, respectively. The gut microbiome in established allergic disease and prior to disease onset has also been assessed in clinical trials. One study demonstrated a strong association between high abundance of Faecalibacterium prausnitzii and decreased levels of butyrate and propionate, and established eczema. Lower relative abundance of Ruminococcaceae appears to be implicated in food sensitization and to precede the development of atopic eczema. Decreased relative abundance of Lachnospira, Veillonella, Faecalibacterium, and Rothia in early infancy was reported to be associated with increased asthma risk. Inoculation of germ-free mice with these genera decreased airway inflammation in their offspring thereby proposing a causal role of bacteria in preventing allergic airways disease.Summary Gut microbiome research is an actively developing field. Although candidate bacterial taxa have been reported it still remains unclear which bacteria (or other microbes), in which numbers and combinations, and when during the gut colonization process may prevent allergic diseases and asthma. There is still a call for standardized approaches that will enable direct comparison of different studies.
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| 6. |
- West, Christina E., et al.
(författare)
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Bugging allergy; role of pre-, pro- and synbiotics in allergy prevention
- 2017
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Ingår i: Allergology International. - : JAPANESE SOCIETY ALLERGOLOGY. - 1323-8930 .- 1440-1592. ; 66:4, s. 529-538
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Forskningsöversikt (refereegranskat)abstract
- Large-scale biodiversity loss and complex changes in social behaviors are altering human microbial ecology. This is increasingly implicated in the global rise in inflammatory diseases, most notably the "allergy epidemic" in very early life. Colonization of human ecological niches, particularly the gastrointestinal tract, is critical for normal local and systemic immune development and regulation. Disturbances in composition, diversity and timing of microbial colonization have been associated with increased allergy risk, indicating the importance of strategies to restore a dysbiotic gut microbiota in the primary prevention of allergic diseases, including the administration of probiotics, prebiotics and synbiotics. Here, we summarize and discuss findings of randomized clinical trials that have examined the effects of these microbiome-related strategies on short and long-term allergy preventative effects - including new guidelines from the World Allergy Organization which now recommend probiotics and prebiotics for allergy prevention under certain conditions. The relatively low quality evidence, limited comparative studies and large heterogeneity between studies, have collectively hampered recommendations on specific probiotic strains, specific timing and specific conditions for the most effective preventive management. At the same time the risk of using available products is low. While further research is needed before specific practice guidelines on supplement probiotics and prebiotics, it is equally important that the underlying dietary and lifestyle factors of dysbiosis are addressed at both the individual and societal levels.
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| 7. |
- West, Christina E.
(författare)
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Gut microbiota and allergic disease : new findings
- 2014
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Ingår i: Current opinion in clinical nutrition and metabolic care. - 1363-1950 .- 1473-6519. ; 17:3, s. 261-266
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Forskningsöversikt (refereegranskat)abstract
- Purpose of reviewDisturbed gut colonization patterns are proposed to be associated with the development of allergic disease.Recent findingsStudies using new systems biology methods confirm previous findings that early environmental exposures, for example cesarean delivery, are associated with disturbed gut colonization patterns and reduced microbial diversity. Low microbial diversity in infancy is also observed to precede onset of allergic disease. In a large population-based cohort study, probiotic consumption in pregnancy was associated with reduced risk of eczema and rhinoconjunctivitis in the child, but not asthma. The association between probiotics and rhinoconjunctivitis appeared stronger if both mother and child (from 6 months) consumed probiotics. Follow-up data from primary prevention studies with probiotics do not support a role for probiotics in asthma prevention. In meta-analyses, both prebiotics (high-risk infants only) and probiotics modestly reduce the eczema risk, but no other allergic manifestations. Their use is not generally recommended for prevention, or treatment, of allergic disease.SummaryGut microbial patterns are associated with susceptibility to allergic disease, but the incomplete understanding of what constitutes a healthy gut microbiota that promotes tolerance, remains a challenge. Further understanding of gut microbial functions may pave the way for more effective allergy prevention and treatment strategies.
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| 8. |
- West, Christina E.
(författare)
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Impact of the environment on gut microbiome and allergy
- 2023
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Ingår i: BMJ Nutrition, Prevention & Health. - : BMJ Publishing Group Ltd. - 2516-5542. ; 6:Suppl 3, s. S30-S37
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Forskningsöversikt (refereegranskat)abstract
- Rapid urbanisation and global biodiversity loss are changing human microbial ecology, which is accelerated by the progressive loss of protective factors for example, contact with natural environments and animals, and less consumption of traditional foods. Early life represents a critical window both for optimal colonisation and immune system development. The frequency of caesarean section (CS) delivery is high and increasing in many parts of the world, and there is strong evidence that CS delivery has a marked influence on early colonisation, with depletion of strains of commensal bacteria. Colonisation of human ecological niches, particularly the gastrointestinal tract, parallels normal local and systemic immune development. CS delivery has been associated with increased risk of allergic diseases and there is emerging evidence that this is mediated by alterations of the microbiome. Small proof-of-concept studies have demonstrated that transfer of maternal vaginal microbes directly after elective CS delivery partially restores the offspring microbiome but transfer of maternal faecal microbes is needed for restoration of the offspring gut microbiome. Randomised clinical trials (RCTs) using microbiome seeding after CS delivery are underway and are anticipated to unravel if this procedure will impact microbial, immunological and metabolic programming, and decrease allergy risk. RCTs using prebiotics and probiotics for primary prevention of allergic diseases (primarily eczema) have been conducted, but large heterogeneity between studies have hampered meta-analysis and the development of specific practice guidelines. In the first RCT to test the biodiversity hypothesis, exposure to playground sand with added microbially diverse soil, led to shifts in the skin and gut bacterial communities and increases in immunoregulatory biomarkers compared with exposure to microbially poor sand (placebo). Collectively, appropriate health-supporting microbial exposures by optimised nutrition and a microbially diverse environment in early life may curb the epidemic rise in allergic diseases, however, considerably more research is needed before this can be translated into specific practice guidelines.
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| 9. |
- West, Christina E.
(författare)
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Probiotics for allergy prevention
- 2016
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Ingår i: Beneficial Microbes. - 1876-2883 .- 1876-2891. ; 7:2, s. 171-179
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Forskningsöversikt (refereegranskat)abstract
- Probiotics, given either as a supplement or in infant foods, have been evaluated in randomised controlled trials for allergy prevention. Here, the aim is to give an overview of the results from these primary prevention studies and to discuss current strategies. In most studies, single strains or a mixture of strains of lactic acid bacteria and bifidobacteria have been used - prenatally, postnatally or perinatally. Several meta-analyses have reported a moderate benefit of probiotics for eczema prevention, and the most consistent effect has been observed with a combined perinatal intervention in infants at high risk of allergic disease due to familial predisposition. In a recent meta-analysis, the use of multi-strain probiotics appeared to be most effective for eczema prevention. No preventive effect has been shown for other allergic manifestations. As long-term follow-up data on later onset allergic conditions (asthma and allergic rhinitis) are available only from a few of the initiated studies, reports from ongoing follow-up studies that are adequately powered to examine long-term outcomes are anticipated to provide more insight. Arguably, the differences in many aspects of study design and the use of different probiotic strains and combinations have made direct comparison difficult. To date, expert bodies do not generally recommend probiotics for allergy prevention, although the World Allergy Organization (WAO) in their recently developed guidelines suggests considering using probiotics in pregnant women, during breastfeeding and/or to the infant if at high risk of developing allergic disease (based on heredity). However, in concordance with other expert bodies, the WAO guideline panel stressed the low level of evidence and the need for adequately powered randomised controlled trials and a more standardised approach before clinical recommendations on specific strains, dosages and timing can be given.
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| 10. |
- West, Christina E., et al.
(författare)
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Probiotics for treatment and primary prevention of allergic diseases and asthma : looking back and moving forward
- 2016
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Ingår i: Expert Review of Clinical Immunology. - : Taylor & Francis. - 1744-666X .- 1744-8409. ; 12:6, s. 625-639
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Forskningsöversikt (refereegranskat)abstract
- Microbial ecosystems cover the surface of the human body and it is becoming increasingly clear that our modern environment has profound effects on microbial composition and diversity. A dysbiotic gut microbiota has been associated with allergic diseases and asthma in cross-sectional and observational studies. In an attempt to restore this dysbiosis, probiotics have been evaluated in randomized controlled trials. Here, we review treatment and primary prevention studies, recent meta-analyses, and discuss the current understanding of the role of probiotics in this context. Many meta-analyses have shown a moderate benefit of probiotics for eczema prevention, whereas there is less evidence of a benefit for other allergic manifestations. Because of very low quality evidence and heterogeneity between studies, specific advice on the most effective regimens cannot yet be given -not even for eczema prevention. To be able to adopt results into specific recommendations, international expert organizations stress the need for well-designed studies.
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