The effects of maternal probiotic administration on development of eosinophilic esophagitis in newborns

Problem: Eosinophilic esophagitis (EoE) is an allergic disorder in which inflammation from eosinophil infiltration and mucosal fibrosis occurs in the esophagus. EoE has become more prevalent in pediatric populations in recent years and is often associated with other allergic manifestations such as atopic dermatitis, eczema and asthma. The most common differential diagnosis is gastroesophageal reflux disease (GERD), which is more prevalent and must be ruled out before further investigation for EoE. It has been noted that parents with a history of allergic conditions have a higher probability of bearing offspring with EoE. Probiotics have been proven to be safe when taken during pregnancy and research has shown considerable protective effects on allergic conditions such as eczema, but no studies test its effect on EoE. Methods: Peer-reviewed articles from within the past 10 years were collected and reviewed regarding pathogenesis, presentation and diagnosis of EoE as well as effects of maternal use of probiotics on subsequent allergic conditions in offspring. Results: Various studies have shown the benefits of maternal probiotic use on the immune development of the offspring on a physiologic level with reduced expression of certain cytokines associated with allergic conditions. Other research has shown the clinical absence of allergic disorders in offspring of mothers who took probiotics as compared to those who did not. Conclusions: Knowing familial risk factors for EoE and the preventative effects probiotics have on other allergic conditions, more research on the use of probiotics during pregnancy could possibly aid in fetal immunologic development and subsequent prevention of developing EoE.