Diary allergy can be overcome by gut bacteria

At the RIKEN Centre for Integrative Medical Sciences in Japan, researchers under the direction of Hiroshi Ohno have found a connection between gut microbiota and the effectiveness of oral immunotherapy for milk allergies. The study, which was published in the scholarly journal Allergology International, discovered a link between a higher likelihood of effective therapy and the species Bifidobacterium, which is a good bacterium present in the gut. The discovery might potentially aid in the creation of more potent oral immunotherapies, possibly in conjunction with probiotic supplements.

A lot of kids react allergic to cow’s milk, especially to particular proteins in the milk. While the majority recover, some people find it extremely difficult to avoid any meals containing milk for the rest of their lives, particularly if their allergic responses are severe and cause anaphylactic shock. Researchers have discovered that oral immunotherapy, a procedure in which patients consciously consume tiny quantities of milk, improves milk allergy. Regretfully, tolerance typically vanishes shortly after therapy finishes, even while allergic responses are managed throughout treatment.

Although the relationship between gut bacteria and oral immunotherapy for milk allergy is poorly understood, it is assumed that these bacteria may help lessen allergic reactivity to certain meals. Consequently, the RIKEN IMS team evaluated 32 kids who were allergic to cow’s milk and were receiving oral immunotherapy; the initial month of the study was spent in a hospital.

Oral immunotherapy is not without risk.

We closely monitored the children in the hospital, and in fact 4 children had such severe reactions to the milk that we could not allow them to continue the treatment.

Hiroshi Ohno

After that, the remaining 28 kids finished a further 12 months of at-home therapy. They were then tested on a double-blind, placebo-controlled food challenge to check if they could still handle milk without experiencing any allergic responses after going without it for two weeks. Children were originally given a very small amount of milk or placebo during the food challenge just 0.01 ml which was progressively increased every 20 minutes until they experienced an allergic response or were able to consume the remaining 30 ml without experiencing one.

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The association between gut flora and effective therapy defined as demonstrating milk tolerance that persisted beyond the treatment time by passing the food challenge was the main focus of the researchers’ findings, along with immunological and bacterial alterations that occurred throughout the treatment. They discovered that throughout therapy, gut flora altered and immunological markers for cow’s milk allergy improved. Even though the 28 kids had been allowed to safely consume milk after the therapy, only 7 of them succeeded in passing the food challenge following the two weeks of milk restriction.

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The researchers searched for the clinical characteristics and gut bacterial species associated with effective therapy to comprehend why the medication was effective for these seven kids but not for the rest. Among the clinical variables, children receiving therapy for eczema or asthma as well as those with initial higher levels of milk-protein antibodies were more likely to have unsatisfactory treatment. A higher likelihood of a favourable outcome from therapy was associated with the presence of Bifidobacterium, a species of beneficial bacteria in the Bifidobacteriaceae family, among the gut bacteria. During therapy, these bacteria only exhibited a rising trend in the children who passed the final meal test. This is fantastic news when thinking about how to enhance oral immunotherapy since, unlike the previous two parameters, which are hard to modify, the kinds of bacteria in a person’s stomach are not fixed.

Source: Riken News

Journal Reference: Shibata, Ryohei, et al. “Gut Microbiota and Fecal Metabolites in Sustained Unresponsiveness by Oral Immunotherapy in School-age Children with Cow’s Milk Allergy.” Allergology International, vol. 73, no. 1, 2023, pp. 126-136, https://doi.org/10.1016/j.alit.2023.10.001.

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