Probiotic therapy on children with allergic rhinitis
Abstract
phils in nasal secretions of patients with allergic rhinitis may cause persistent nasal blockage. A common therapy for allergic rhinitis is oral or intranasal corticosteroids. However, corticosteroids carry the risk of disrupting growth and development in children. Probiotic treatment in allergic rhinitis patients works by manipulating the bacterial ecosystem of the digestive tract, stimulating the balance of Th1 and Th2 immune responses.Objective To assess the effects of probiotic supplementation on eosinophil levels in nasal secretions, duration of allergic episodes, and total nasal symptom scores in children aged 2-18 years with allergic rhinitis.
Methods A randomized, double-blind, controlled trial was performed on children aged 2 to 18 years who visited Sanglah Hospital, Denpasar, between March to July 2012 due to allergic rhinitis. Fifty-five eligible subjects were involved in the study. Subjects were randomly allocated to receive either standard therapy (antihistamines) and probiotics or standard therapy and placebo for 30 days. Mann-Whitney test was used for statistical non-parametric unpaired samples analysis. P values of <0.05 were considered to be statistically significant.
Results Fifty-five subjects with allergic rhinitis were randomized into either the probiotic group (27 subjects) or the placebo group (28 subjects). We found that the median (range) nasal eosinophil percentage reduction before the study compared to after 30 days of treatment was higher in the probiotic group than in the placebo group (34 (15-65) vs 6 (0-24) %, respectively, P<0.0001). Median (range) duration of allergic rhinitis episode in the probiotic group was shorter compared to the placebo group (48 (0-96) hours vs 72 (6-168) hours, respectively; P<0.0001). The median (range) total nasal symptom score was also lower in the probiotic group compared to the placebo group (2 (0-3) vs 5 (1-6), respectively; P<0.0001).
Conclusion Probiotic supplementation reduces the percentage of nasal eosinophils, duration of allergic rhinitis episode, and total nasal symptoms.
References
2. Rahmawati AQP, Eka S. Relationship between rhinitis severity, skin prick test reactivity and mite-specific immunoglobulin E in allergic rhinitis patients in Makassar. Indonesian J Med Sci. 2008;1:1-9.
3. M Munazir Z, Martani WR. Rinitis Alergi. In: Arwin APA, Munazir Z, Nia K, editor. Buku ajar alergi-imunologi anak. 2nd ed. Jakarta: IDAI; 2007. p. 245-52.
4. Fuller R. Probiotics in human medicine. Gut. 1991;32:439-42.
5. E Endaryanto A, Harsono A. Prospek probiotik dalam pencegahan alergi melalui induksi aktif toleransi imunologis. Surabaya: FK-Unair; 2006. p. 1-13.
6. Ciprandi G, Vizzaccaro A, Cirillo I, Tosca MA. Bacillus clausii effects in children with allergic rhinitis. Allergy. 2005;60:702-3.
7. Wang MF, Lin HC, Wang YY, Hsu CH. Treatment of perennial allergic rhinitis with lactic acid bacteria. Pediatr Allergy Immunol. 2004;15:152-8.
8. Morita H, He F, Kawase M, Kubota A, Hiramatsu N, Kunsaki J, et al. Preliminary human study for possible alteration of serum immunologlobulin E production in perennial allergic rhinitis with fermented milk prepared with Lactobacillus gasseri TM0356. Microbiol Immunol. 2006;50:701-6.
9. Inggrid S. Efek probiotik, prebiotik dan sinbiotik. In: Inggrid S, editor. Probiotik susu fermentasi dan kesehatan. Jakarta: PT. Tri Cipta Karya (TRICK); 2004. p. 197-229.
10. Vliagoftis H, Kouranos VD, Betsi GI, Falagas ME. Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials. Ann Allergy Asthma Immunol. 2008;101:570–9.
11. Nogueira JC, Gonçalves Mda C. Probiotics in allergic rhinitis. Braz J Otorhinolaryngol. 2011;77:129-34.
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Accepted 2016-08-21
Published 2013-10-30