Effects of probiotics in uncontrolled asthma

Abstract

<b>Introduction:</b> Refractory asthma still represents a certain percentage of asthmatic patients despite the use of high medication. There is a need for new therapeutics allowing a better asthma control. Probiotics are able to modulate the intestinal microbiota homeostasis as well as the immune system, to moderate inflammation and appeared to be very well tolerated and safe. <b>Goal:</b> The goal of this study was to assess if probiotics have a beneficial impact on refractory asthma. <b>Methods:</b> The randomized double blind placebo control study was performed at the CHU of Liege (Clinicaltrial.org ID: NCT03341403). Fifty-five uncontrolled asthmatics patients were included. Patients received the dietary Supplement Synbiotic “Probiotical®/Bactecal®” 3 pills a day or a placebo during 3 months. Patients were evaluated before and 1-3-6 months for the lung function, the exhaled nitric oxide value, the inflammatory blood and sputum profiles and the quality of life and asthma control assessed by questionnaires: asthma control test (ACT), asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ ). This study was approved by the Ethics committee of CHU Liege (2017/248) and all subjects gave written informed consent for participation. <b>Results:</b> The ACQ and AQLQ scores improved significantly in the probiotic group at 3 months which was not the case in the placebo group. Also, the FEV1/FVC post bronchodilation improved at 3 months compared to baseline in the probiotic group only. Finally, the IgE, fibrinogen and neutrophils blood levels decreased at 1 month after probiotics. <b>Conclusions:</b> Probiotics may have a valuable impact in refractory asthma. These promising results need to be validated in a larger population of asthmatic patients.