Abstract：
The increasing prevalence of IgE-mediated cow\'s milk allergy (CMA) in childhood is a worldwide health concern. There is a growing awareness that the gut microbiome (GM) might play an important role in CMA development. Therefore, treatment with probiotics and prebiotics has gained popularity. This systematic review provides an overview of the alterations of the GM, metabolome, and immune response in CMA children and animal models, including post-treatment modifications. MEDLINE, PubMed, Scopus, and Web of Science were searched for studies on GM in CMA-diagnosed children, published before 1 March 2023. A total of 21 articles (13 on children and 8 on animal models) were included. The studies suggest that the GM, characterized by an enrichment of the Clostridia class and reductions in the Lactobacillales order and Bifidobacterium genus, is associated with CMA in early life. Additionally, reduced levels of short-chain fatty acids (SCFAs) and altered amino acid metabolism were reported in CMA children. Commonly used probiotic strains belong to the Bifidobacterium and Lactobacillus genera. However, only Bifidobacterium levels were consistently upregulated after the intervention, while alterations of other bacteria taxa remain inconclusive. These interventions appear to contribute to the restoration of SCFAs and amino acid metabolism balance. Mouse models indicate that these interventions tend to restore the Th 2/Th 1 balance, increase the Treg response, and/or silence the overall pro- and anti-inflammatory cytokine response. Overall, this systematic review highlights the need for multi-omics-related research in CMA children to gain a mechanistic understanding of this disease and to develop effective treatments and preventive strategies.
摘要：
儿童期IgE介导的牛奶过敏(CMA)患病率日益增加,是全球关注的健康问题。越来越多的人意识到肠道微生物组（GM）可能在CMA发育中发挥重要作用。因此,益生菌和益生元的治疗已经普及。本系统综述概述了GM的变更，代谢组，和CMA儿童和动物模型的免疫反应，包括治疗后的修改。MEDLINE,PubMed,Scopus,在CMA诊断的儿童中搜索了关于转基因的研究，2023年3月1日前出版。共纳入21篇文章(13篇关于儿童的文章和8篇关于动物模型的文章)。研究表明，转基因，其特征在于梭菌属的富集和乳杆菌属和双歧杆菌属的减少，与早期生活中的CMA有关。此外,据报道,CMA儿童短链脂肪酸(SCFA)水平降低,氨基酸代谢改变.常用的益生菌菌株属于双歧杆菌属和乳杆菌属。然而,干预后，只有双歧杆菌水平持续上调，而其他细菌类群的改变仍不确定。这些干预似乎有助于恢复SCFA和氨基酸代谢平衡。小鼠模型表明，这些干预措施往往会恢复Th2/Th1平衡，增加Treg反应，和/或沉默总体促炎和抗炎细胞因子应答。总的来说,本系统综述强调,需要在CMA儿童中开展多组学相关研究,以获得对该疾病的机制性认识,并制定有效的治疗和预防策略.
