Abstract
Probiotic supplementation for eight weeks with a multi-strain probiotic by individuals with allergic rhinitis (AR) reduced overall symptom severity, the frequency of medication use and improved quality of life. The purported mechanism of action is modulation of the immune system. This analysis examined changes in systemic and mucosal immune gene expression in a subgroup of individuals, classified as either responders or non-responders based on improvement of AR symptoms in response to the probiotic supplement. Based on established criteria of a beneficial change in the mini-rhinoconjunctivitis quality of life questionnaire (mRQLQ), individuals with AR were classified as either responders or non-responders. Systemic and mucosal immune gene expression was assessed using nCounter PanCancer Immune Profiling (Nanostring Technologies, Seattle, WA, USA) kit on blood samples and a nasal lysate. There were 414 immune genes in the blood and 312 immune genes in the mucosal samples expressed above the limit of detection. Unsupervised hierarchical clustering of immune genes separated responders from non-responders in blood and mucosal samples at baseline and after supplementation, with key T-cell immune genes differentially expressed between the groups. Striking differences in biological processes and pathways were evident in nasal mucosa but not blood in responders compared to non-responders. These findings support the use of network approaches to understand probiotic-induced changes to the immune system.
Highlights
Probiotic supplements continue to receive attention as a strategy which may promote positive health outcomes in a range of disease states
Using a two-stage adaptive trial design [3] we have shown that daily probiotic supplementation improved mini-rhinoconjunctivitis quality of life questionnaire scores and reduced the overall severity of symptoms and the frequency of medication use in seasonal allergic rhinitis (AR) [4]
Immune cell scoring based on immune-cell-specific gene expression revealed a significantly higher abundance of T-cells and a trend for a lower abundance of mast cells in blood at baseline in responders (Figure 1b)
Summary
Probiotic supplements continue to receive attention as a strategy which may promote positive health outcomes in a range of disease states. For allergic rhinitis (AR), evidence that probiotics can produce clinically meaningful improvements in rhinitis symptoms is mixed [1,2] and may be confounded by issues related to study design. Using a two-stage adaptive trial design [3] we have shown that daily probiotic supplementation improved mini-rhinoconjunctivitis quality of life questionnaire (mRQLQ) scores and reduced the overall severity of symptoms and the frequency of medication use in seasonal AR [4]. The assessment of immune differences between trial participants classified as “responders” and “non-responders” to probiotics may reveal key mucosal immune mechanisms underpinning the clinical effects of these supplements. To examine the effect of probiotics on systemic and mucosal immunity, we utilized NanoString digital immune gene expression profiling in blood and nasal lavage/ nasal brushing samples in a subset of responders and non-responders from an eight-week supplementation study [4]
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