Peran probiotik terhadap pembentukan toleransi imun pada bayi dengan alergi susu sapi: A literature review
DOI:
https://doi.org/10.33024/hjk.v18i7.451Keywords:
Alergi Susu Sapi, Bayi, Probiotik, Toleransi ImunAbstract
Background: One of the types of food allergy that often occurs in infants even those given exclusive breast milk is cow's milk allergy. In recent years, treatments for cow’s milk protein allergy have shifted from a cow’s milk protein-free diet to a more active intervention in regulating the immune system. At the infancy stage, the growth of immune response and food allergies is affected by probiotic modulated intestinal microbiota, through the potential of modulating immune tolerance in infants with cow’s milk protein allergy.
Purpose: To provide an overview of recent research results on the role of probiotics in the formation of immune tolerance in infants with cow's milk allergy.
Method: Descriptive research with Systematic Literature Review method conducted in June 2024 with PRISMA guidelines for RCT. Literature search is obtained through: PubMed, Scopus, ScienceDirect, Google Scholar, Cochrane Library, ProQuest, Wiley Online Library, MDPI, and Taylor & Francis Online with the range of 2019-2024. Of the 620 search results, 6 articles met the criteria and then analyzed.
Results: This systematic review shows that probiotics significantly have a role in developing immune tolerance including decreased symptoms, risk of infection, and sensitization in infants with cow’s milk protein allergy.
Conclusion: Probiotics provided in Extensively Hydrolyzed Casein-based Formula (EHCF) or Amino Acid-based Formula (AAF) have a role in developing immune tolerance in infants with cow’s milk protein allergy through modulation in the gut microbiota by affecting epigenetic mechanisms related to immune tolerance.
Suggestion: There is a need for synthesis of stronger current RCT results with more inclusion studies to evaluate the most effective dosage and duration of probiotic administration in the treatment of infants with cow’s milk allergy, especially its effect on developing immune tolerance.
Keywords: Cow’s Milk Allergy; Immune Tolerance; Infants; Probiotics.
Pendahuluan: Alergi susu sapi termasuk alergi makanan yang sering ditemui pada bayi, bahkan yang diberikan ASI eksklusif. Dalam beberapa tahun terakhir, tatalaksana alergi susu sapi beralih dari diet bebas protein susu sapi menjadi intervensi yang lebih aktif dalam memodulasi sistem imun. Pada masa bayi, perkembangan respon imun dan alergi makanan dipengaruhi oleh mikrobiota usus yang dimodulasi probiotik, dengan potensi modulasi toleransi imun pada bayi dengan alergi susu sapi.
Tujuan: Untuk memberikan gambaran dari hasil penelitian terkini tentang peran probiotik dalam pembentukan toleransi imun pada bayi dengan alergi susu sapi.
Metode: Penelitian deskriptif dengan metode Systematic Literature Review yang dilakukan pada bulan Juni 2024 dengan pedoman PRISMA untuk RCT. Pencarian literatur didapatkan melalui: PubMed, Scopus, ScienceDirect, Google Scholar, Cochrane Library, ProQuest, Wiley Online Library, MDPI, dan Taylor & Francis Online dengan rentang tahun 2019-2024. Dari 620 hasil pencarian, 6 artikel memenuhi kriteria dan dianalisis.
Hasil: Tinjauan sistematis ini menunjukkan bahwa probiotik secara signifikan berperan dalam meningkatkan toleransi imun termasuk penurunan gejala, risiko infeksi, dan sensitisasi pada bayi yang menderita alergi susu sapi.
Simpulan: Probiotik yang disediakan pada formula Extensively Hydrolyzed Casein Formula (EHCF) ataupun Amino Acid-based Formula (AAF) berperan dalam meningkatkan toleransi imun pada bayi dengan alergi susu sapi melalui modulasi mikrobiota usus dengan memengaruhi mekanisme epigenetik terkait toleransi imun.
Saran: Diperlukan adanya sintesis terhadap hasil RCT terkini yang lebih kuat dengan jumlah studi inklusi yang lebih banyak untuk mengevaluasi dosis dan durasi pemberian probiotik yang paling efektif dalam tatalaksana pada bayi dengan alergi susu sapi, terutama efeknya dalam peningkatan toleransi imun.
Kata Kunci: Alergi Susu Sapi; Bayi; Probiotik; Toleransi Imun.
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