Abstract
BackgroundThere is promising but conflicting evidence to recommend the addition of probiotics to foods for prevention and treatment of allergy. Based on previous studies with fermented milk containing Lactobacillus paracasei NCC2461, we aimed to compare the effect of a powder form of the latter probiotic with the effect of a blend of Lactobacillus acidophilus ATCC SD5221 and Bifidobacterium lactis ATCC SD5219 in patients with allergic rhinitis.MethodsA double-blind, randomized, cross-over study, involving 31 adults with allergic rhinitis to grass pollen, was performed outside the grass pollen season (registration number: NCT01233154). Subjects received each product for 4-weeks in two phases separated by a wash-out period of 6 to 8 weeks. A nasal provocation test was performed before and after each 4-week product intake period, and outcome parameters (objective and subjective clinical symptoms; immune parameters) were measured during and/or 24 hours after the test.ResultsOut of the 31 subject enrolled, 28 completed the study. While no effect was observed on nasal congestion (primary outcome), treatment with NCC2461 significantly decreased nasal pruritus (determined by VAS), and leukocytes in nasal fluid samples, enhanced IL-5, IL-13 and IL-10 production by peripheral blood mononuclear cells in an allergen specific manner and tended to decrease IL-5 secretion in nasal fluid, in contrast to treatment with the blend of L. acidophilus and B. lactis.ConclusionsDespite short-term consumption, NCC2461 was able to reduce subjective nasal pruritus while not affecting nasal congestion in adults suffering from grass pollen allergic rhinitis. The associated decrease in nasal fluid leukocytes and IL-5 secretion, and the enhanced IL-10 secretion in an allergen specific manner may partly explain the decrease in nasal pruritus. However, somewhat unexpected systemic immune changes were also noted. These data support the study of NCC2461 consumption in a seasonal clinical trial to further demonstrate its potentially beneficial effect.
Highlights
Current available treatments for allergic rhinitis are not devoid of side-effects and primary prevention strategies are non-existent
Population Thirty-one adult volunteers with a history of grass pollen allergic rhinitis were enrolled (Figure 1) in a single center study (CHUV, Lausanne, Switzerland) on the basis of the following inclusion criteria: (1) age between 18 and 35 years; (2) a history of allergic rhinitis during the latest grass pollen season confirmed by positive skin prick test (SPT) to grass pollen; and (3) a positive response to a nasal provocation test (NPT) with grass pollen (combined nasal reaction threshold ≤ 10′000 standardized quality units (SQs)/ml grass pollen or less at the screening/ inclusion phase)
This study aimed at assessing the effect of two probiotic preparations on established allergic rhinitis in the frame of a well-reproducible and well-standardized nasal provocation test (NPT)
Summary
Current available treatments for allergic rhinitis are not devoid of side-effects and primary prevention strategies are non-existent. This has led to the search for new approaches to prevent or reduce allergic symptoms and improve quality of life of patients. In this context, and regarding its safety profile, interest in nutritional intervention for allergy management has been growing. Several studies pointed out differences in the gut microbial composition between infants developing allergy or not, suggesting a crucial role of the intestinal microbiota on the immune system orientation [6,7,8,9]. Based on previous studies with fermented milk containing Lactobacillus paracasei NCC2461, we aimed to compare the effect of a powder form of the latter probiotic with the effect of a blend of Lactobacillus acidophilus ATCC SD5221 and Bifidobacterium lactis ATCC SD5219 in patients with allergic rhinitis
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