Probiotics for allergy prevention

Beneficial Microbes

Volumn 7, Issue 2, 2016, Pages 171-179

  West, C E ^a  

^a UMEÅ UNIVERSITY   (Sweden)

Author keywords

Asthma; Children; Eczema; Microbiota; Probiotic

Indexed keywords

INTERLEUKIN 5; PROBIOTIC AGENT; TRANSFORMING GROWTH FACTOR BETA;

ALLERGIC ASTHMA; ALLERGIC RHINITIS; BIFIDOBACTERIUM; CYTOKINE PRODUCTION; DISEASE SEVERITY; DRUG EFFICACY; ECZEMA; HIGH RISK PATIENT; HUMAN; IMMUNOREGULATION; INTESTINE FLORA; MICROBIAL DIVERSITY; NONHUMAN; PRIMARY PREVENTION; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; TREATMENT DURATION; TREATMENT OUTCOME; FEMALE; HYPERSENSITIVITY; MALE; PREGNANCY;

FEMALE; HUMANS; HYPERSENSITIVITY; MALE; PREGNANCY; PROBIOTICS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 84961827991     PISSN: 18762883     EISSN: 18762891     Source Type: Journal    
DOI: 10.3920/BM2015.0073     Document Type: Review

References (76)

1. Abrahamsson, T.R., Jakobsson, T., Björkstén, B., Oldaeus, G. and Jenmalm, M.C., 2013. No effect of probiotics on respiratory allergies: a seven-year follow-up of a randomized controlled trial in infancy. Pediatric Allergy and Immunology 24: 556-561.
2. Abrahamsson, T.R., Jakobsson, T., Böttcher, M.F., Fredrikson, M., Jenmalm, M.C., Björkstén, B. and Oldaeus, G., 2007. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology 119: 1174-1180.
3. Allen, S.J., Jordan, S., Storey, M., Thornton, C.A., Gravenor, M.B., Garaiova, I., Plummer, S.F., Wang, D. and Morgan, G., 2014. Probiotics in the prevention of eczema: a randomised controlled trial. Archives of Disease in Childhood 99: 1014-1019.
4. Azad, M.B., Coneys, J.G., Kozyrskyj, A.L., Field, C.J., Ramsey, C.D., Becker, A.B., Friesen, C., Abou-Setta, A.M. and Zarychanski, R., 2013. Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and metaanalysis. BMJ 347: f6471.
5. Bertelsen, R.J., Brantsaeter, A.L., Magnus, M.C., Haugen, M., Myhre, R., Jacobsson, B., Longnecker, M.P., Meltzer, H.M. and London, S.J., 2014. Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases. Journal of Allergy and Clinical Immunology 133: 165-171.
6. Björkstén, B., Naaber, P., Sepp, E. and Mikelsaar, M., 1999. The intestinal microflora in allergic Estonian and Swedish 2-year-old children. Clinical and Experimental Allergy 29: 342-346.
7. Björkstén, B., Sepp, E., Julge, K., Voor, T. and Mikelsaar, M., 2001. Allergy development and the intestinal microflora during the first year of life. Journal of Allergy and Clinical Immunology 108: 516-520.
8. Böttcher, M.F., Abrahamsson, T.R., Fredriksson, M., Jakobsson, T. and Björkstén, B., 2008. Low breast milk TGF-beta2 is induced by Lactobacillus reuteri supplementation and associates with reduced risk of sensitization during infancy. Pediatric Allergy and Immunology 19: 497-504.
9. Boyle, R.J., Ismail, I.H., Kivivuori, S., Licciardi, P.V., Robins-Browne, R.M., Mah, L.J., Axelrad, C., Moore, S., Donath, S., Carlin, J.B., Lahtinen, S.J. and Tang, M.L., 2011. Lactobacillus GG treatment during pregnancy for the prevention of eczema: a randomized controlled trial. Allergy 66: 509-516.
10. Cross, M.L. and Gill, H.S., 2001. Can immunoregulatory lactic acid bacteria be used as dietary supplements to limit allergies? International Archives of Allergy and Immunology 125: 112-119.
11. Cuello-Garcia, C.A., Brozek, J.L., Fiocchi, A., Pawankar, R., Yepes-Nunez, J.J., Terracciano, L., Gandhi, S., Agarwal, A., Zhang, Y. and Schunemann, H.J., 2015. Probiotics for the prevention of allergy: a systematic review and meta-analysis of randomized controlled trials. Journal of Allergy and Clinical Immunology 136: 952-961.
12. Dotterud, C.K., Avershina, E., Sekelja, M., Simpson, M.R., Rudi, K., Storro, O., Johnsen, R. and Oien, T., 2015. Does maternal perinatal probiotic supplementation alter the intestinal microbiota of mother and child? A randomized controlled trial. Journal of Pediatric Gastroenterology and Nutrition 61: 200-207.
13. Dotterud, C.K., Storro, O., Johnsen, R. and Oien, T., 2010. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. British Journal of Dermatology 163: 616-623.
14. Draaisma, E., Garcia-Marcos, L., Mallol, J., Sole, D., Perez-Fernandez, V., Brand, P.L. and the EISL Study Group, 2015. A multinational study to compare prevalence of atopic dermatitis in the first year of life. Pediatric Allergy and Immunology 26: 359-366.
15. Enomoto, T., Sowa, M., Nishimori, K., Shimazu, S., Yoshida, A., Yamada, K., Furukawa, F., Nakagawa, T., Yanagisawa, N., Iwabuchi, N., Odamaki, T., Abe, F., Nakayama, J. and Xiao, J.Z., 2014. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Allergology International 63: 575-585.
16. Fiocchi, A., Burks, W., Bahna, S.L., Bielory, L., Boyle, R.J., Cocco, R., Dreborg, S., Goodman, R., Kuitunen, M., Haahtela, T., Heine, R.G., Lack, G., Osborn, D.A., Sampson, H., Tannock, G.W., Lee, B.W. on behalf of the WAO Special Committee on Food Allergy and Nutrition, 2012. Clinical use of probiotics in pediatric allergy (CUPPA): a world allergy organization position paper. World Allergy Organization Journal 5: 148-167.
17. 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-Nunez, J.J., Brozek, J.L. and Schunemann, H.J., 2015. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): probiotics. World Allergy Organization Journal 8: 4.
18. Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO), 2001. Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. Available at: http://tinyurl.com/8bccc3r.
19. Foolad, N., Brezinski, E.A., Chase, E.P. and Armstrong, A.W., 2013. Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formula, and fatty acids. JAMA Dermatology 149: 350-355.
20. Forsberg, A., Abrahamsson, T.R., Björkstén, B. and Jenmalm, M.C., 2013. Pre-and post-natal Lactobacillus reuteri supplementation decreases allergen responsiveness in infancy. Clinical and Experimental Allergy 43: 434-442.
21. Gaboriau-Routhiau, V., Rakotobe, S., Lecuyer, E., Mulder, I., Lan, A., Bridonneau, C., Rochet, V., Pisi, A., De Paepe, M., Brandi, G., Eberl, G., Snel, J., Kelly, D. and Cerf-Bensussan, N., 2009. The key role of segmented filamentous bacteria in the coordinated maturation of gut helper T cell responses. Immunity 31: 677-689.
22. Gorissen, D.M., Rutten, N.B., Oostermeijer, C.M., Niers, L.E., Hoekstra, M.O., Rijkers, G.T. and Van der Ent, C.K., 2014. Preventive effects of selected probiotic strains on the development of asthma and allergic rhinitis in childhood. The Panda study. Clinical and Experimental Allergy 44: 1431-1433.
23. Haahtela, T., Holgate, S., Pawankar, R., Akdis, C.A., Benjaponpitak, S., Caraballo, L., Demain, J., Portnoy, J., Von Hertzen, L., Change, and the WAO Special Committee on Climate Change and Biodiversity, 2013. The biodiversity hypothesis and allergic disease: world allergy organization position statement. World Allergy Organization Journal 6: 3.
24. Hanski, I., Von Hertzen, L., Fyhrquist, N., Koskinen, K., Torppa, K., Laatikainen, T., Karisola, P., Auvinen, P., Paulin, L., Makela, M.J., Vartiainen, E., Kosunen, T.U., Alenius, H. and Haahtela, T., 2012. Environmental biodiversity, human microbiota, and allergy are interrelated. Proceedings of the National Academy of Sciences of the USA 109: 8334-8339.
25. Harb, H. and Renz, H., 2015. Update on epigenetics in allergic disease. Journal of Allergy and Clinical Immunology 135: 15-24.
26. Hoffjan, S. and Stemmler, S., 2015. Unravelling the complex genetic background of atopic dermatitis: from genetic association results towards novel therapeutic strategies. Archives of Dermatological Research 307: 659-670.
27. Huurre, A., Laitinen, K., Rautava, S., Korkeamaki, M. and Isolauri, E., 2008. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebocontrolled study. Clinical and Experimental Allergy 38: 1342-1348.
28. Ismail, I.H., Oppedisano, F., Joseph, S.J., Boyle, R.J., Robins-Browne, R.M. and Tang, M.L., 2012. Prenatal administration of Lactobacillus rhamnosus has no effect on the diversity of the early infant gut microbiota. Pediatric Allergy and Immunology 23: 255-258.
29. Isolauri, E., Arvola, T., Sutas, Y., Moilanen, E. and Salminen, S., 2000. Probiotics in the management of atopic eczema. Clinical and Experimental Allergy 30: 1604-1610.
30. Jackson, P.G., Lessof, M.H., Baker, R.W., Ferrett, J. and MacDonald, D.M., 1981. Intestinal permeability in patients with eczema and food allergy. The Lancet 317: 1285-1286.
31. Jensen, M.P., Meldrum, S., Taylor, A.L., Dunstan, J.A. and Prescott, S.L., 2012. Early probiotic supplementation for allergy prevention: long-term outcomes. Journal of Allergy and Clinical Immunology 130: 1209-1211.
32. Kalliomäki, M., Kirjavainen, P., Eerola, E., Kero, P., Salminen, S. and Isolauri, E., 2001a. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. Journal of Allergy and Clinical Immunology 107: 129-134.
33. Kalliomäki, M., Salminen, S., Arvilommi, H., Kero, P., Koskinen, P. and Isolauri, E., 2001b. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. The Lancet 357: 1076-1079.
34. Kalliomäki, M., Salminen, S., Poussa, T., Arvilommi, H. and Isolauri, E., 2003. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. The Lancet 361: 1869-1871.
35. Kalliomäki, M., Salminen, S., Poussa, T. and Isolauri, E., 2007. Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology 119: 1019-1021.
36. Kim, J.Y., Kwon, J.H., Ahn, S.H., Lee, S.I., Han, Y.S., Choi, Y.O., Lee, S.Y., Ahn, K.M. and Ji, G.E., 2010. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebocontrolled trial. Pediatric Allergy and Immunology 21: e386-393.
37. Kocourkova, I., Ladnikova, R., Zizka, J. and Rosova, V., 2007. Effect of oral application of a probiotic E. coli strain on the intestinal microflora of children of allergic mothers during the first year of life. Folia Microbiologica 52: 189-193.
38. Kopp, M.V., Hennemuth, I., Heinzmann, A. and Urbanek, R., 2008. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of Lactobacillus GG supplementation. Pediatrics 121: e850-856.
39. Kozakova, H., Schwarzer, M., Tuckova, L., Srutkova, D., Czarnowska, E., Rosiak, I., Hudcovic, T., Schabussova, I., Hermanova, P., Zakostelska, Z., Aleksandrzak-Piekarczyk, T., Koryszewska-Baginska, A., Tlaskalova-Hogenova, H. and Cukrowska, B., in press. Colonization of germ-free mice with a mixture of three Lactobacillus strains enhances the integrity of gut mucosa and ameliorates allergic sensitization. Cellular and Molecular Immunology. DOI: http://dx.doi.org/10.1038/cmi.2015.09.
40. Kuitunen, M., Kukkonen, K., Juntunen-Backman, K., Korpela, R., Poussa, T., Tuure, T., Haahtela, T. and Savilahti, E., 2009. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. Journal of Allergy and Clinical Immunology 123: 335-341.
41. Kukkonen, K., Savilahti, E., Haahtela, T., Juntunen-Backman, K., Korpela, R., Poussa, T., Tuure, T. and Kuitunen, M., 2007. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy and Clinical Immunology 119: 192-198.
42. Kumar, H., Lund, R., Laiho, A., Lundelin, K., Ley, R.E., Isolauri, E. and Salminen, S., 2014. Gut microbiota as an epigenetic regulator: pilot study based on whole-genome methylation analysis. MBio Journal 5: e02113-14.
43. Lodinova-Zadnikova, R., Prokesova, L., Kocourkova, I., Hrdy, J. and Zizka, J., 2010. Prevention of allergy in infants of allergic mothers by probiotic Escherichia coli. International Archives of Allergy and Immunology 153: 201-206.
44. Loo, E.X., Llanora, G.V., Lu, Q., Aw, M.M., Lee, B.W. and Shek, L.P., 2014. Supplementation with probiotics in the first 6 months of life did not protect against eczema and allergy in at-risk Asian infants: a 5-year follow-up. International Archives of Allergy and Immunology 163: 25-28.
45. Madhok, V., Futamura, M., Thomas, K.S. and Barbarot, S., 2015. What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 2. Treatment and prevention. Clinical and Experimental Dermatology 40: 349-354.
46. Morgan, A.R., Han, D.Y., Wickens, K., Barthow, C., Mitchell, E.A., Stanley, T.V., Dekker, J., Crane, J. and Ferguson, L.R., 2014. Differential modification of genetic susceptibility to childhood eczema by two probiotics. Clinical and Experimental Allergy 44: 1255-1265.
47. Niers, L.E., Hoekstra, M.O., Timmerman, H.M., Van Uden, N.O., De Graaf, P.M., Smits, H.H., Kimpen, J.L. and Rijkers, G.T., 2007. Selection of probiotic bacteria for prevention of allergic diseases: immunomodulation of neonatal dendritic cells. Clinical and Experimental Immunology 149: 344-352.
48. Niers, L.E., Martin, R., Rijkers, G.T., Sengers, F., Timmerman, H.M., Van Uden, N.O., Smidt, H., Kimpen, J.L. and Hoekstra, M.O., 2009. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy 64: 1349-1358.
49. Niers, L.E., Timmerman, H.M., Rijkers, G.T., Van Bleek, G.M., Van Uden, N.O., Knol, E.F., Kapsenberg, M.L., Kimpen, J.L. and Hoekstra, M.O., 2005. Identification of strong interleukin-10 inducing lactic acid bacteria which down-regulate T helper type 2 cytokines. Clinical and Experimental Allergy 35: 1481-1489.
50. Ou, C.Y., Kuo, H.C., Wang, L., Hsu, T.Y., Chuang, H., Liu, C.A., Chang, J.C., Yu, H.R. and Yang, K.D., 2012. Prenatal and postnatal probiotics reduces maternal but not childhood allergic diseases: a randomized, double-blind, placebo-controlled trial. Clinical and Experimental Allergy 42: 1386-1396.
51. Ouwehand, A.C., Isolauri, E., Kirjavainen, P.V., Tolkko, S. and Salminen, S.J., 2000. The mucus binding of Bifidobacterium lactis Bb12 is enhanced in the presence of Lactobacillus GG and Lact. delbrueckii subsp. bulgaricus. Letters in Applied Microbiology 30: 10-13.
52. Patel, R.M., Myers, L.S., Kurundkar, A.R., Maheshwari, A., Nusrat, A. and Lin, P.W., 2012. Probiotic bacteria induce maturation of intestinal claudin 3 expression and barrier function. American Journal of Pathology 180: 626-635.
53. Pawankar, R., 2014. Allergic diseases and asthma: a global public health concern and a call to action. World Allergy Organizational Journal 7: 12.
54. Pelucchi, C., Chatenoud, L., Turati, F., Galeone, C., Moja, L., Bach, J.F. and La Vecchia, C., 2012. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology 23: 402-414.
55. Prescott, S.L., Wickens, K., Westcott, L., Jung, W., Currie, H., Black, P.N., Stanley, T.V., Mitchell, E.A., Fitzharris, P., Siebers, R., Wu, L. and Crane, J., 2008a. Supplementation with Lactobacillus rhamnosus or Bifidobacterium lactis probiotics in pregnancy increases cord blood interferon-gamma and breast milk transforming growth factor-beta and immunoglobin A detection. Clinical and Experimental Allergy 38: 1606-1614.
56. Prescott, S.L., Wiltschut, J., Taylor, A., Westcott, L., Jung, W., Currie, H. and Dunstan, J.A., 2008b. Early markers of allergic disease in a primary prevention study using probiotics: 2.5-year follow-up phase. Allergy 63: 1481-1490.
57. Rautava, S., Kainonen, E., Salminen, S. and Isolauri, E., 2012. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. Journal of Allergy and Clinical Immunology 130: 1355-1360.
58. Renz, H., Brandtzaeg, P. and Hornef, M., 2012. The impact of perinatal immune development on mucosal homeostasis and chronic inflammation. Nature Reviews Immunology 12: 9-23.
59. Rijkers, G.T., Bengmark, S., Enck, P., Haller, D., Herz, U., Kalliomäki, M., Kudo, S., Lenoir-Wijnkoop, I., Mercenier, A., Myllyluoma, E., Rabot, S., Rafter, J., Szajewska, H., Watzl, B., Wells, J., Wolvers, D. and Antoine, J.M., 2010. Guidance for substantiating the evidence for beneficial effects of probiotics: current status and recommendations for future research. Journal of Nutrition 140: 671S-676S.
60. Rosenfeldt, V., Benfeldt, E., Valerius, N.H., Paerregaard, A. and Michaelsen, K.F., 2004. Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis. Journal of Pediatrics 145: 612-616.
61. Simpson, M.R., Dotterud, C.K., Storro, O., Johnsen, R. and Oien, T., 2015. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial. BMC Dermatology 15: 13.
62. Soh, S.E., Aw, M., Gerez, I., Chong, Y.S., Rauff, M., Ng, Y.P., Wong, H.B., Pai, N., Lee, B.W. and Shek, L.P., 2009. Probiotic supplementation in the first 6 months of life in at risk Asian infants-effects on eczema and atopic sensitization at the age of 1 year. Clinical and Experimental Allergy 39: 571-578.
63. Sudo, N., Sawamura, S., Tanaka, K., Aiba, Y., Kubo, C. and Koga, Y., 1997. The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. Journal of Immunology 159: 1739-1745.
64. Szajewska, H., Shamir, R., Turck, D., van Goudoever, J.B., Mihatsch, W.A. and Fewtrell, M., in press. Recommendations on probiotics in allergy prevention should not be based on pooling data from different strains. Journal of Allergy and Clinical Immunology.
65. Taylor, A.L., Dunstan, J.A. and Prescott, S.L., 2007. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. Journal of Allergy and Clinical Immunology 119: 184-191.
66. Walker, J., Dieleman, L., Mah, D., Park, K., Meddings, J. and Vethanayagam, D., 2014. High prevalence of abnormal gastrointestinal permeability in moderate-severe asthma. Clinical and Investigative Medicine 37: E53-E57.
67. West, C.E. and Prescott, S.L., 2015c. Prebiotics and probiotics for prevention of allergic disease. UptoDate 20 October 2015. Available at: http://tinyurl.com/grmwzb7.
68. West, C.E., Hammarström, M.L. and Hernell, O., 2009. Probiotics during weaning reduce the incidence of eczema. Pediatric Allergy and Immunology 20: 430-437.
69. West, C.E., Hammarström, M.L. and Hernell, O., 2013. Probiotics in primary prevention of allergic disease-follow-up at 8-9 years of age. Allergy 68: 1015-1020.
70. West, C.E., Hernell, O., Andersson, Y., Sjöstedt, M. and Hammarström, M.L., 2012. Probiotic effects on T-cell maturation in infants during weaning. Clinical and Experimental Allergy 42: 540-549.
71. West, C.E., Jenmalm, M.C. and Prescott, S.L., 2015a. The gut microbiota and its role in the development of allergic disease: a wider perspective. Clinical and Experimental Allergy 45: 43-53.
72. West, C.E., Renz, H., Jenmalm, M.C., Kozyrskyj, A.L., Allen, K.J., Vuillermin, P., Prescott, S.L., in, F.M.I.G. and in, F.M.I.G., 2015b. The gut microbiota and inflammatory noncommunicable diseases: associations and potentials for gut microbiota therapies. Journal of Allergy and Clinical Immunology 135: 3-13.
73. Wickens, K., Black, P.N., Stanley, T.V., Mitchell, E., Fitzharris, P., Tannock, G.W., Purdie, G. and Crane, J., 2008. A differential effect of 2 probiotics in the prevention of eczema and atopy: a doubleblind, randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology 122: 788-794.
74. Wickens, K., Black, P.N., Stanley, T.V., Mitchell, E., Barthow, C., Fitzharris, P., Purdie, G. and Crane, J., 2012. A protective effect of Lactobacillus rhamnosus HN001 against eczema in the first 2 years of life persists to age 4 years. Clinical and Experimental Allergy 42: 1071-1079.
75. Wickens, K., Stanley, T.V., Mitchell, E.A., Barthow, C., Fitzharris, P., Purdie, G., Siebers, R., Black, P.N. and Crane, J., 2013. Early supplementation with Lactobacillus rhamnosus HN001 reduces eczema prevalence to 6 years: does it also reduce atopic sensitization? Clinical and Experimental Allergy 43: 1048-1057.
76. Zuccotti, G., Meneghin, F., Aceti, A., Barone, G., Callegari, M.L., Di Mauro, A., Fantini, M.P., Gori, D., Indrio, F., Maggio, L., Morelli, L., Corvaglia, L. and the Italian Society of Neonatology, 2015. Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis. Allergy 70: 1356-1371.