Peran Sinbiotik pada Pencegahan Penyakit Alergi
Abstract
Penyakit alergi menjadi masalah kesehatan dunia terutama di negara maju karena angka kejadiannya semakin meningkat, saat ini tercatat sekitar 30% dari populasi. Penyakit alergi berhubungan dengan faktor genetik (keturunan) dan atau faktor lingkungan yang mengakibatkan ketidakseimbangan mikrobiota usus ( dysbiosis)
dan perubahan sistem imun tubuh. Walaupun faktor genetik dapat mendasari perkembangan dari penyakit alergi, namun kecenderungan semakin meningkat kejadiannya pada 2 dekade terakhir. Hal ini bisa disebabkan oleh adanya faktor lingkungan termasuk cara persalinan, penggunaan anti biotika, diet tinggi lemak dan rendah serat, rendahnya kadar asam lemak omega-3 dan defisiensi/ insufisiensi vitamin D. Pada keadaan normal, mikrobiota usus berada dalam keadaan eubiosis, berbeda dengan keadaan disbiosis akibat ketidak seimbangan komposisi dan
atau fungsi mikrobiota usus, yang berhubungan dengan penyakit alergi seperti eksim, asma dan alergi makanan. Pada penyakit alergi terjadi pengurangan variasi mikrobiota termasuk laktobasilus dan bifidobakteri dalam usus bayi sebelum timbulnya gejala klinis penyakit atopia. Upaya untuk memperbaiki keseimbangan mikrobiota dengan pemberian prebiotik, probiotik atau sinbiotik merupakan strategi pencegahan penyakit alergi yang sudah banyak dilaporkan. Pelbagai penelitian intervensi sudah pernah dilakukan pada binatang maupun uji klinis pada manusia
dengan menggunakan pelbagai macam prebiotik, probiotik maupun sinbiotik. Beberapa analisis sistematik sudah dilakukan dengan hasil yang kontroversial.
(Synbiotics : A new Perspective to Overcome Hereditary Basis of Allergic Disease)
Abstract
Allergic diseases are becoming a world health problem, especially in developed countries because the incidence rate is increasing, currently recorded about 30% of the population. Allergic diseases are associated with genetic factors (heredity) and/or environmental factors that result in an imbalance of the gut microbiota (dysbiosis) and
changes in the body's immune system. Although genetic factors can underlie the development of allergic diseases, the trend has increased in the last 2 decades. This can be due to the presence of environmental factors including the mode of delivery, the use of anti-biotics, a high-fat and low-fiber diet, low levels of omega-3 fatty acids and vitamin D deficiency/ insufficiency. Under normal circumstances, the gut microbiota is in a state of eubiosis, in contrast to the state of dysbiosis due to imbalance of the composition and or function of the gut microbiota, which is associated with allergic diseases such as eczema, Asthma and food allergies. In allergic diseases there is a reduction in variations of the microbiota including lactobasilus and bifidobakteri in the baby's intestines before the onset of clinical symptoms of aopia disease. Efforts to improve the balance of the microbiota with the
administration of prebiotics, probiotics or synbiotics are a widely reported allergy disease prevention strategy. Various intervention studies have been conducted in animals and clinical trials in humans using a variety of prebiotics, probiotics and synbiotics. Some systematic analysis has already been done with controversial results.
Key word: prebiotic, probiotic, synbiotic, allergic diseases
Keywords
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Von Mutius E. The rising trends in asthma and allergic diseases. Clin Exp Allergy 1998; 28:45–9. doi: 10.1046/j.1365-2222.1998.028s5045.x
Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018; 141:41–8. doi: 10.1016/j.jaci.2017. 11.003
Simona Sestito, Enza D’Auria, Maria Elisabetta Baldassarre, Silvia Salvatore, Valeria Tallarico1, Ettore Stefanelli, et al. The role of prebiotics and probiotics in prevention of allergic diseases in infants. Frontier in Paed. 2020; 8: 1-28. doi: 10.3389/tped. 2020. 583946.
Prescott SL. Early-life environmental determinants of allergic diseases and the wider pandemic of inflammatory noncommunicable diseases. J Allergy Clin Immunol. 2013;131:23–30. doi: 10.1016/j.jaci.2012.11.019
Ke X. Presence of multiple independent effects in risk loci of common complex human diseases. Am J Hum Genet. 2012; 91:185–92. doi: 10.1016/j.ajhg.2012.05.020
Mitselou N, Hallberg J, Stephansson O, Almqvist C, Melén E, LudvigssonJF. Cesarean delivery, preterm birth, and risk of food allergy: NationwideSwedish cohort study of more than 1 million children. J Allergy ClinImmunol. 2018; 142:1510–14. doi: 10.1016/j.jaci. 2018.06.044
Kummeling I, Stelma FF, Dagnelie PC, Snijders BE, Penders J, HuberM, et al. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: the KOALA Birth Cohort Study. Pediatrics. 2007; 119: e225–31. doi: 10.1542/peds.2006-0896
Wu GD, Chen J, Hoffmann C, Bittinger K, Chen YY, Keilbaugh SA, et al. Linking long–term dietary patterns with gut microbial enterotypes. Science. 2011; 334:105–8. doi: 10.1126/science.1208344
Trompette A, Gollwitzer ES, Yadava K, Sichelstiel AK, Sprenger N, Ngom– Bru C, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med. 2014; 20:159–66. doi: 10.1038/nm.3444
Jones AP, Tulic MK, Rueter K, Prescott SL. Vitamin D and allergic disease: sunlight at the end of the tunnel? Nutrients. 2012; 4:13–2. doi: 10.3390/nu4010013
Bisgaard H, Li N, Bonnelykke K, Chawes BL, Skov T, Paludan-Muller G, et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol. 2011; 128:646–52 doi: 10.1016/j.jaci.2011.04.060
Abrahamsson TR, Jakobsson HE, Andersson Bjorksten B, Engstrand L, Jenmalm MC. Low diversity of the gut microbiota in infants with atopic eczema. J Allergy Clin Immunol. 2012;129:434–40. doi: 10.1016/j.jaci.2011.10.025
Abrahamsson TR, Jakobsson HE, Andersson AF, Bjeorksten B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy. 2014; 44:842–50. doi: 10.1111/cea.12253
Ling Z, Li Z, Liu X, Cheng Y, Luo Y, Tong X, et al. Altered fecal microbiota composition associated with food allergy in infants. Appl Environ Microbiol. 2014; 80:2546–54. doi: 10.1128/AEM.00003-14
Kalliomäki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001;107:129–34. doi: 10.1067/mai.2001.111237
Sjögren YM, Jenmalm MC, Böttcher MF, Björkstén B, SverremarkEkström E. Altered early infant gut microbiota in children developing allergy up to 5 years of age. Clin Exp Allergy. 2009;39:518–26. doi: 10.1111/j.1365-2222.2008.03156.x
Penders J, Thijs C, van den Brandt PA, Kummeling I, Snijders B, Stelma F, et al. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study. Gut. 2007;56:661–7. doi: 10.1136/gut.2006.100164
Cukrowska B. Microbial and nutritional programming—the importance of the microbiome and early exposure to potential food allergens in the development of allergies. Nutrients. 2018;10:1541. doi: 10.3390/nu10101541
Cukrowska B, Bierła JB, Zakrzewska M, Klukowski M, Maciorkowska E. The relationship between the infant gut microbiota and allergy. The role of bifidobacterium breve and prebiotic oligosaccharides in the activation of anti-allergic mechanisms in early life. Nutrients. 2020;12:946. doi: 10.3390/nu12040946
Mackowiak PA. Recycling Metchnikoff: Probiotics, the intestinal microbiome and the quest for long life. Frontier in Pub Health 2013; 1:1-3. doi: 10.3389/fpubh2013.00052
Stambler I. Elie Metchnikoff - The founder of Longevity Science and Founder of Modern Medicine : In Honor of 170th anniversary. Avanced in Gerontology 2015;5:201-15. doi: 10.1134/S2079057015040219
Bawany F, Beck LA, Järvinen KM. Halting the march: primary prevention of atopic dermatitis and food allergies. J Allergy Clin Immunol Pract. 2020; 8:860–75. doi: 10.1016/j.jaip.2019.12.005
Fiocchi A, Pawankar R, Cuello-Garcia C, Ahn K, Al-Hammadi S, Agarwal A, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): probiotics. World Allergy Organ J. 2015; 8:4. doi: 10.1186/s40413-015-0055-2
Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S. Probiotics: effects on immunity. Am J Clin Nutr. 2001;73:444–50. doi: 10.1093/ajcn/73.2.444s
Fiocchi A, Burks W, Bahna SL, Bielory L, Boyle RJ, Cocco R, et al. Clinical use of probiotics in pediatric allergy (CUPPA): a world allergy organization position paper. World Allergy Organ J. 2012;5:148–67. doi: 10.1097/WOX.0b013e3182784ee0
Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, et al. Expert consensus document: the International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14:491–502. doi: 10.1038/nrgastro.2017.75
Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr. 2010; 104:1–63. doi: 10.1017/ S0007114510003363
Björkstén B. Environmental influences on the development of the immune system: consequences for disease outcome. Nestle Nutr Workshop Ser Pediatr Program. (2008) 61:243–54. doi: 10.1159/000113498
Ellwood P, Asher MI, Garcia-Marcos L, Williams H, Keil U, Robertson C, et al. Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC). phase three. Thorax. 2013; 68:351–60. doi: 10.1136/thoraxjnl-2012-202285
Goldsmith JR, Sartor RB. The role of diet on intestinal microbiota metabolism: downstream impacts on host immune function and health, and therapeutic implications. J Gastroenterol. 2014;49:785–98. doi: 10.1007/s00535-014-0953-z
Gibson GR, Probert HM, Loo JV, Rastall RA, Roberfroid MB. Dietary modulation of the human colonic microbiota: updating the concept of prebiotics. Nutr Res Rev. (2004) 17:259–75. doi: 10.1079/NRR200479
Scott KP, Gratz SW, Sheridan PO, Flint HJ, Duncan SH. The influence of diet on the gut microbiota. Pharmacol Res. 2013;69:52–60. doi: 10.1016/j.phrs.2012.10.020
Austin S, De Castro CA, Bénet T, Hou Y, Sun H, Thakkar SK, et al. Temporal change of the content of 10 oligosaccharides in the milk of Chinese urban mothers. Nutrients. 2016; 8:346. doi: 10.3390/nu8060346
Xu G, Davis JC, Goonatilleke E, Smilowitz JT, German JB, Lebrilla CB. Absolute quantitation of human milk oligosaccharides reveals phenotypic variations during lactation. J Nutr. 2017; 147:117–24. doi: 10.3945/jn.116.238279
Moro G, Minoli I, Mosca M, Fanaro S, Jelinek J, Stahl B, et al. Dosage related bifidogenic effects of galacto and fructo oligosaccharides in formula fed term infants. J Pediatr Gastroenterol Nutr. (2002) 34:291–5. doi: 10.1097/00005176-200203000-00014
Knol J, Scholtens B, Kafka C, Steenbakkers J, Gro S, Helm K, et al. Colon microflora in infant fed formula with galacto- and fructooligosaccharides: more like breast fed infants. J Pediatr Gastroenterol Nutr. 2005;40:36–42. doi: 10.1097/00005176-200501000-00007
Tanabe S, Hochi S. Oral administration of a galactooligosaccharide preparation inhibits development of atopic dermatitis-like skin lesions in NC/Nga mice. Int J Mol Med. 2010; 25:331–6. doi: 10.3892/ijmm_00000349
Schouten B, Van Esch BC, Kormelink TG, Moro GE, Arslanoglu S, Boehm G, et al. Nondigestible oligosaccharides reduce immunoglobulin free lightchain concentrations in infants at risk for allergy. Pediatr Allergy Immunol. 2011;22:537–42. doi: 10.1111/j.1399-3038.2010.01132.x
Ozdemir O. Prebiotics and probiotics in allergy: potential mechanisms of prebiotics’ and probiotics’ actions in allergy -(part 1). MOJ Immunol. 2016; 3:00069. doi: 10.15406/moji.2015.02.00069
Wahn U. Strategies for atopy prevention. J Nutr. 2008; 138:1770–2. doi: 10.1093/jn/138.9.1770S
Feleszko W, Jaworska J, Rha RD, Steinhausen S, Avagyan A, Jaudszus A, et al. Probiotic-induced suppression of allergic sensitization and airway inflammation is associated with an increase of T regulatory-dependent mechanisms in a murine model of asthma. Clin Exp Allergy. 2007; 37:498– 505. doi: 10.1111/j.1365-2222.2006.02629.x
Frei R, Akdis M, O’Mahony L. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence. Curr Opin Gastroenterol 2015; 31: 153-158. doi:10.1097/MOG.0000000000000151
Sampson HA, O’Mahoney L, Burks AW, Plaut M, Lack G, Akdis CA. Mechanisms of food allergy. J Allergy Clin Immunol 2018; 141: 11-9. doi: 10.1016/j.jaci.2017.11005
Moro G, Arslanoglu S. A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age. Arch Dis Child. 2006; 91:814–9. doi: 10.1136/adc.2006.098251
Arslanoglu S, Moro GE, Schmitt J, Tandoi L, Rizzardi S, Boehm G. Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life. J Nutr. 2008;138:1091–5. doi: 10.1093/jn/138. 6.1091
Osborn DA, Sinn JK. Prebiotics in infants for prevention of allergy. Cochrane Database Syst Rev. 2013;3:CD006474. doi: 10.1002/14651858.CD006474.pub3
Ranucci G, Buccigrossi V, Borgia E, Piacentini D, Visentin F, Cantarutti L, et al. Galacto-oligosaccharide/polidextrose enriched formula protects against respiratory infections in infants at high risk of atopy: a randomized clinical trial. Nutrients. 2018;10:E286. doi: 10.3390/nu100 30286
Doherty AM, Lodge CJ. Human milk oligosaccharides and associations with immune-mediated disease and infection in childhood: a systematic review. Front Pediatr. 2018; 6:91. doi: 10.3389/fped.2018.00091
Nazir Y, Hussain SA, Abdul Hamid A, Song Y. Probiotics and their potential preventive and therapeutic role for cancer, high serum cholesterol, and allergic and HIV diseases. Biomed Res Int. 2018; 29:3428437. doi: 10.1155/2018/3428437
West CE, Jenmalm MC, Prescott SL. The gut microbiota and its role in the development of allergic disease: a wider perspective. Clin Exp Allergy. 2015; 45:43–53. doi: 10.1111/cea.12332
Marschan E, Kuitunen M, Kukkonen K, Poussa T, Sarnesto A, Haahtela T, et al. Probiotics in infancy induce protective immune profiles that are characteristic for chronic low-grade inflammation. Clin Exp Allergy. 2008; 38:611–8. doi: 10.1111/j.1365-2222.2008.0 2942.x
Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomized placebo-controlled trial. Lancet. 2001; 357:1076–9. doi: 10.1016/S0140-6736(00)04259-8
Marlow G, Han DY, Wickens K, Stanley T, Crane J, Mitchell EA, et al. Differential effects of two probiotics on the risks of eczema and atopy associated with single nucleotide polymorphisms to Toll-like receptors. Pediatr Allergy Immunol. 2015;26:262–71. doi: 10.1111/pai.12371
Fernández L, Langa S, Martín V, Rogriguez JM. The microbiota of human milk in healthy women. Cell Mol. Biol. 2013;59, 31–42.
Martín R, Jiménez E, Heilig H, Fernández L, Marín ML, Zoetendal EG, et al. Isolation of bifidobacteria from breast milk and assessment of the bifidobacterial population by PCR-denaturing gradient gel electrophoresis and quantitative real-time PCR. Appl Environ Microbiol. 2009;75:965–9. doi: 10.1128/AEM.02063-08
Jost T, Lacroix C, Braegger C, Chassard C. Impact of human milk bacteria and oligosaccharides on neonatal gut microbiota establishment and gut health. Nutr Rev. 2015; 73:426–37. doi: 10.1093/nutrit/nuu016
Chang YS, Trivedi MK, Jha A, Lin YF, Dimaano L, Garcia-Romero MT. Synbiotics for prevention and treatment of atopic dermatitis: a meta- analysis of randomized clinical trials. JAMA Pediatr. 2016; 170:236–42. doi: 10.1001/jamapediatrics.2015.3943
Meirlaen L, Levy EI, Vanderplas Y. Prevention and management with pro-, pre- and symbiotic in children with asthma and allergic rhinitis: A narrative review. Nutrients 2021; 13:934-52. doi.org:10.3390/nu13030934.
DOI: http://dx.doi.org/10.24198/obgynia.v4i2s.327
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