Cited by 473Probiotics and Fermented FoodsFood Allergy and Anaphylaxis ResearchAsthma and respiratory diseases

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World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics

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Fiocchi, Alessandro, Pawankar, Ruby, Cuello-Garcia, Carlos, Ahn, Kangmo, Al-Hammadi, Suleiman, Agarwal, Arnav, Beyer, Kirsten, Burks, Wesley, Canonica, Giorgio W, Ebisawa, Motohiro, Gandhi, Shreyas, Kamenwa, Rose, Lee, Bee Wah, Li, Haiqi, Prescott, Susan, Riva, John J, Rosenwasser, Lanny, Sampson, Hugh, Spigler, Michael, Terracciano, Luigi, Vereda-Ortiz, Andrea, Waserman, Susan, Yepes-Nuñez, Juan José, Brożek, Jan L, Schünemann, Holger J·2015·World Allergy Organization Journal

DOI 10.1186/s40413-015-0055-2PMC PMC4307749

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Abstract

BACKGROUND: Prevalence of allergic diseases in infants, whose parents and siblings do not have allergy, is approximately 10% and reaches 20-30% in those with an allergic first-degree relative. Intestinal microbiota may modulate immunologic and inflammatory systemic responses and, thus, influence development of sensitization and allergy. Probiotics have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention. OBJECTIVE: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations about the use of probiotics in the prevention of allergy. METHODS: We identified the most relevant clinical questions and performed a systematic review of randomized controlled trials of probiotics for the prevention of allergy. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. We searched for and reviewed the evidence about health effects, patient values and preferences, and resource use (up to November 2014). We followed the GRADE evidence-to-decision framework to develop recommendations. RESULTS: Currently available evidence does not indicate that probiotic supplementation reduces the risk of developing allergy in children. However, considering all critical outcomes in this context, the WAO guideline panel determined that there is a likely net benefit from using probiotics resulting primarily from prevention of eczema. The WAO guideline panel suggests: a) using probiotics in pregnant women at high risk for having an allergic child; b) using probiotics in women who breastfeed infants at high risk of developing allergy; and c) using probiotics in infants at high risk of developing allergy. All recommendations are conditional and supported by very low quality evidence. CONCLUSIONS: WAO recommendations about probiotic supplementation for prevention of allergy are intended to support parents, clinicians and other health care professionals in their decisions whether to use probiotics in pregnancy and during breastfeeding, and whether to give them to infants.

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GRADEpro Guideline Development Tool (G2DT): Brożek J, Nowak A, Kunstman P, Schünemann HJ. (Computer Program) Version 2.xx. (Available from: www.guidelinedevelopment.org). In Book GRADEpro Guideline Development Tool (G2DT): Brożek J, Nowak A, Kunstman P, Schünemann HJ. (Computer Program) Version 2.xx. (Available from: www.guidelinedevelopment.org). (Editor ed.^eds.). City; 2014.

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“Evidence from a meta-analysis supports the use of probiotics for the treatment of AD in infants; however, the benefit likely results from primary prevention of atopic dermatitis, as also concluded by the World Allergy Organization [114,196,197].”
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Authors: Fiocchi, A., Pawankar, R., Cuello-Garcia, C., Ahn, K., Al-Hammadi, S., Agarwal, A., Beyer, K., Burks, W., Canonica, G. W., Ebisawa, M., Gandhi, S., Kamenwa, R., Lee, B. W., Li, H., Prescott, S., Riva, J. J., Rosenwasser, L., Sampson, H., Spigler, M., Terracciano, L., Vereda-Ortiz, A., Waserman, S., Yepes-Nuñez, J. J., Brożek, J. L., & Schünemann, H. J.
Affiliations: Bambino Gesù Children's Hospital (IT)
Nippon Medical School (JP)
Samsung Medical Center (KR)
University of Toronto (CA)
Stiftung Charité (DE)
University of North Carolina at Chapel Hill (US)
Ospedale Policlinico San Martino (IT)
National Sagamihara Hospital (JP)
Aga Khan University Hospital Nairobi (KE)
National University of Singapore (SG)
Children's Hospital of Chongqing Medical University (CN)
The Kids Research Institute Australia (AU)
McMaster University (CA)
Children's Mercy Hospital (US)
Icahn School of Medicine at Mount Sinai (US)
Food Allergy Research and Education (US)
University of Milan (IT)
Hospital Infantil Universitario Niño Jesús (ES)
Corresponding author: Fiocchi, Alessandro
Pawankar, Ruby
Brożek, Jan L
ORCID: Fiocchi, Alessandro
Pawankar, Ruby
Ahn, Kangmo
Agarwal, Arnav
Beyer, Kirsten
Canonica, Giorgio W
Ebisawa, Motohiro
Kamenwa, Rose
Lee, Bee Wah
Prescott, Susan
Riva, John J
Rosenwasser, Lanny
Sampson, Hugh
Terracciano, Luigi
Waserman, Susan
Brożek, Jan L
Schünemann, Holger J
Venue: World Allergy Organization Journal
Publisher: Elsevier BV
Published: 2015
Volume: 8
Issue: 1
Pages: 4
ISSN: 1939-4551 (ISSN-L)
DOI: 10.1186/s40413-015-0055-2
PMC: PMC4307749
OpenAlex: W2141887889
Cited by: 473
References: 119
Citations by year: 2026: 6 · 2025: 23 · 2024: 40 · 2023: 43 · 2022: 36 · 2021: 45 · 2020: 54 · 2019: 48 · 2018: 47 · 2017: 45 · 2016: 56 · 2015: 29
FWCI: 78.90
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor, 1583 d)
www.springer.com/tdm (unspecified)
Locations: World Allergy Organization Journal (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Institutional Repository University of Antioquia (University of Antioquia) (publishedVersion, cc-by-nc-nd)
Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
TSpace (University of Toronto) (submittedVersion)
eCommons - AKU (Aga Khan University) (submittedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
UNC Libraries
Topics: Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Keywords: probiotics, allergy prevention, infants, eczema prevention, gut microbiota, probiotic supplementation, pregnancy, breastfeeding, high-risk infants, immunomodulation

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World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics

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