Exploring the Connection Between the Microbiome and Allergy Development

Jenifer R. Lightdale, MD, MPH, introduces the role of the gut microbiome in immune system development and allergen sensitization. She briefly reviews the epidemiology, diagnosis, and management of cow’s milk protein allergy (CMPA), with a focus on the latest guidelines and recommendations for reintroduction. Dr. Lightdale builds upon these topics by discussing the evidence supporting probiotics for the treatment of CMPA, summarizing the clinical data supporting the use of extensively hydrolyzed formula supplemented with Lactobacillus rhamnosus GG (LGG®) for the induction of oral tolerance. She concludes with the clinical implications of the current evidence for LGG in CMPA resolution and recommendations for milk reintroduction through a ladder approach.