eosinophilic esophagitis: allergy

Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.
...our results indicate that gut microbiota are involved in regulating the inflammatory processes also in airway allergies.
The fecal levels of bifidobacteria, clostridia and Bacteroides were reduced at the peak of the birch pollen season.
In conclusion, our study showed that consumption of a combination of L. acidophilus NCFM^TM and B. lactis Bl-04 could positively influence markers of respiratory allergy, especially in the mucosae, and also resulted in a tendency for a reduction in reported nasal symptoms.
Probiotics may provide an alternative or complementary treatment for pollen allergies. A future study could investigate whether this would lead to a reduced use of antihistamines.

Various effects of different probiotic strains in allergic disorders

Various effects of different probiotic strains in allergic disorders: an update from laboratory and clinical data
-Ozdemir O., Department of Pediatics, Division of Allergy/Immunology, SEMA Research and Training Hospital, Istanbul, Turkey
2010 Jun;160(3):295-304. doi: 10.1111/j.1365-2249.2010.04109.x. Epub 2010 Mar 16.

Excerpts:

Enhanced presence of probiotic bacteria in the intestinal microbiota is found to correlate with protection against atopy.
There is also very promising evidence to recommend the addition of probiotics to foods for the prevention and treatment of allergic diseases.
Clinical improvement, especially in allergic rhinitis and immunoglobulin (Ig)E-sensitized (atopic) eczema, has been reported in most of the published studies.
After weaning, the microflora of children begins to resemble that of adults, with
increased Bacteroides, Veillonella and Fusobacterium.
In another study, Lctbs acidophilus and Bfdbm lactis treatments prevented OVA-induced allergic symptoms on the skin and gastrointestinal tract, e.g. eosinophilic infiltration.

Editor's notes:

The 'hygiene hypothesis' and its possible connection to increased levels of allergic disease in industrialized countries.
Development of infant immune system, its relation to environmental and dietary bacteria, and its maturation into the adult immune system.
Probiotics: definition and modes of operation.

Probiotics: use in allergic disorders

Probiotics: use in allergic disorders: a Nutrition, Allergy, Mucosal Immunology, and Intestinal Microbiota (NAMI) Research Group Report

-Isolauri E, Salminen S, Department of Paediatrics, University of Turku, Finland.
2008 Jul;42 Suppl 2:S91-6. doi: 10.1097/MCG.0b013e3181639a98.

Excerpts:

The underlying denominators and treatment targets in allergic disorders may be outlined as aberrant barrier functions of the skin epithelium and gut mucosa and dysregulation of the immune response to ubiquitous environmental antigens. Dietary methods to control symptoms and reduce the risk of allergic disease have hitherto focused on elimination diets, alone or in combination with other environmental measures. The results have not been satisfactory regarding long-term prevention, and new approaches are urgently needed.
demonstration that the immunophysiologic regulation in the gut depends on the establishment of the healthy gut microbiota, has led to the introduction of novel modes of therapeutic intervention on the basis of the consumption of monocultures and mixed cultures of beneficial live probiotic microorganisms. The current aims of intervention are to avert deviant microbiota development, strengthen the gut barrier function, and alleviate abnormal immune responsiveness.
Specific probiotics, selected from members of the healthy intestinal microbiota most of them belonging to Lactobacillus or Bifidobacterium, aid in degradation/structural modification of enteral antigens, regulation of the secretion of inflammatory mediators, and direction of the development of the immune system during the critical period of life when these functions are immature and inexperienced and the risk of allergic disease is heightened. In humans, documented effects have been reported for alleviation of intestinal inflammation, normalization of gut mucosal dysfunction, and down-regulation of hypersensitivity reactions, thereby preferentially targeting allergic conditions with intestinal involvement.

Food allergy and eosinophilic esophagitis: Learning what to avoid

Food allergy and eosinophilic esophagitis: Learning what to avoid
-Sandra Hong, MD, Nicola Vogel, MD
doi: 10.3949/ccjm.77a.09018 Cleveland Clinic Journal of Medicine January 2010 vol. 77 1 51-59. (c)2010 The Cleveland Clinic Foundation.

Excerpts:

The gut flora. When mice are raised in a germ-free environment, they fail to develop normal tolerance.They are also more likely to become sensitized if they are treated with antibiotics or if they lack toll-like receptors that recognize bacterial lipopolysaccharides. Furthermore, human studies suggest that probiotics promote tolerance, especially in preventing atopic dermatitis, although the studies have had conflicting results.
The gastric pH. Murine and human studies reveal that antacid medications increase the risk of food allergy.
Three types of immune responses to food. About 20% of all people alter their diet because of concerns about adverse reactions to foods. These adverse reactions include metabolic disorders (eg, lactose intolerance), a reaction to a pharmacologic component such as caffeine or a toxic contaminant of a food (eg, bacterial food poisoning), psychological reactions (eg, food aversion), and documented immunologic responses to a food (eg, food allergy)
Immunologic reactions to foods can be divided into three categories: mediated by immunoglobulin E (IgE), non-IgE-mediated, and mixed. Therefore, these disorders can present as an acute, potentially life-threatening reaction or as a chronic disease such as eosinophilic gastoenteropathy.

20 September 2013

Idiopathic eosinophilic esophagitis is associated with a TH2-type allergic inflammatory response

Idiopathic eosinophilic esophagitis is associated with a TH2-type allergic inflammatory response
-Alex Straumann, MDa, et al.

Journal of Allergy and Clinical Immunology

Volume 108, Issue 6, December 2001, Pages 954–961

"IEE is a selective inflammatory response of the esophagus. T cells, IL-5, eosinophils, and IgE-mediated mechanisms appear to be involved, giving rise to the possibility that allergic reactions might play a role in the pathogenesis of the disease."

Atopic syndrome

"Atopic syndrome is a predisposition toward developing certain allergic hypersensitivity reactions. Atopy may have a hereditary component, although contact with the allergen must occur before the hypersensitivity reaction can develop."
Many EE patients suffer from concurrent autoimmune and allergic disease.
Patients with atopy usually develop what is referred to as the “allergic triad” of symptoms, i.e., eczema (atopic dermatitis), hay fever (allergic rhinitis), and allergy-induced asthma (allergic asthma).
They also have a tendency to have food allergies, and other symptoms characterized by their hyperallergic state. For example, eosinophilic esophagitis is found associated with atopic allergies.
Although atopy has various definitions, in general, it is defined by the presence of elevated levels of total and allergen-specific IgE in the serum, leading to positive skin-prick tests to common allergens.
There is a strong genetic predisposition toward atopic allergies, especially on the maternal side.

-Atopy - Wikipedia, the free encyclopedia

Eosinophilic esophagitis

Eosinophilic esophagitis is an allergic inflammatory condition of the esophagus, and also called allergic oesophagitis.
Symptoms are swallowing difficulty, food impaction, and heartburn.
Eosinophilic oesophagitis (EE) was first described in children but occurs in adults as well.
Food allergy may play a significant role.

-Eosinophilic esophagitis - Wikipedia, the free encyclopedia