A Comprehensive Review on Natural Bioactive Compounds and Probiotics as Potential Therapeutics in Food Allergy Treatment

Front Immunol. 2020 May 22;11:996. doi: 10.3389/fimmu.2020.00996. eCollection 2020.


Food allergy is rising at an alarming rate and is a major public health concern. Globally, food allergy affects over 500 million people, often starting in early childhood and increasingly reported in adults. Commercially, only one approved oral immunotherapy-based treatment is currently available and other allergen-based immunotherapeutic are being investigated in clinical studies. As an alternative approach, a substantial amount of research has been conducted on natural compounds and probiotics, focusing on the immune modes of action, and therapeutic uses of such sources to tackle various immune-related diseases. Food allergy is primarily mediated by IgE antibodies and the suppression of allergic symptoms seems to be mostly modulated through a reduction of allergen-specific IgE antibodies, upregulation of blocking IgG, and downregulation of effector cell activation (e.g., mast cells) or expression of T-helper 2 (Th-2) cytokines. A wide variety of investigations conducted in small animal models or cell-based systems have reported on the efficacy of natural bioactive compounds and probiotics as potential anti-allergic therapeutics. However, very few lead compounds, unlike anti-cancer and anti-microbial applications, have been selected for clinical trials in the treatment of food allergies. Natural products or probiotic-based approaches appear to reduce the symptoms and/or target specific pathways independent of the implicated food allergen. This broad range therapeutic approach essentially provides a major advantage as several different types of food allergens can be targeted with one approach and potentially associated with a lower cost of development. This review provides a brief overview of the immune mechanisms underlying food allergy and allergen-specific immunotherapy, followed by a comprehensive collection of current studies conducted to investigate the therapeutic applications of natural compounds and probiotics, including discussions of their mode of action and immunological aspects of their disease-modifying capabilities.

Keywords: allergen; food allergy; gut microbiome; immunotherapy; medicinal plants; natural compounds; polysaccharides; probiotics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Allergic Agents / adverse effects
  • Anti-Allergic Agents / therapeutic use*
  • Bacteria / drug effects*
  • Bacteria / immunology
  • Bacteria / metabolism
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Dysbiosis
  • Food Hypersensitivity / blood
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / microbiology
  • Food Hypersensitivity / therapy*
  • Gastrointestinal Microbiome / drug effects*
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology*
  • Intestines / drug effects*
  • Intestines / immunology
  • Intestines / microbiology
  • Plant Preparations / adverse effects
  • Plant Preparations / therapeutic use*
  • Probiotics / adverse effects
  • Probiotics / therapeutic use*
  • Treatment Outcome


  • Anti-Allergic Agents
  • Biological Products
  • Plant Preparations
  • Immunoglobulin E