TY - JOUR
T1 - World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P)
T2 - Probiotics
AU - Fiocchi, Alessandro
AU - Pawankar, Ruby
AU - Cuello-Garcia, Carlos
AU - Ahn, Kangmo
AU - Al-Hammadi, Suleiman
AU - Agarwal, Arnav
AU - Beyer, Kirsten
AU - Burks, Wesley
AU - Canonica, Giorgio W.
AU - Ebisawa, Motohiro
AU - Gandhi, Shreyas
AU - Kamenwa, Rose
AU - Lee, Bee Wah
AU - Li, Haiqi
AU - Prescott, Susan
AU - Riva, John J.
AU - Rosenwasser, Lanny
AU - Sampson, Hugh
AU - Spigler, Michael
AU - Terracciano, Luigi
AU - Vereda-Ortiz, Andrea
AU - Waserman, Susan
AU - Yepes-Nuñez, Juan José
AU - Brozek, Jan L.
AU - Schünemann, Holger J.
N1 - Publisher Copyright:
© 2015 Fiocchi et al.; licensee BioMed Central.
PY - 2015/1/27
Y1 - 2015/1/27
N2 - 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.
AB - 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.
KW - Allergy
KW - GRADE
KW - Practice guidelines
KW - Prevention
KW - Probiotics
UR - http://www.scopus.com/inward/record.url?scp=84938593795&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938593795&partnerID=8YFLogxK
U2 - 10.1186/s40413-015-0055-2
DO - 10.1186/s40413-015-0055-2
M3 - Article
AN - SCOPUS:84938593795
SN - 1939-4551
VL - 8
JO - World Allergy Organization Journal
JF - World Allergy Organization Journal
IS - 1
M1 - 55
ER -