Abstract
Aims: This study aimed to determine the effect of probiotic combination on ratio of IFN-γ: IL-4 levels in patients with allergic rhinitis.
 Materials and methods: Single blind, randomized controlled trial.This study included 40 patients with severe allergic rhinitis according to WHO criteria. This study used 2 treatment groups with probiotics and placebo control group. IFN γ and IL-4 levels were evaluated using ELISA method. Data were analyzed using paired T test with 95% confidence intervals
 Results and Discussion: In the treatment group, the levels of IFN-γ increased significantly (p<0.05).In contrast, IL-4 levels decreased significantly(p<0.05). There was a significant difference between the IFN-γ ratio: IL-4 treatment and control group (p <0.05).
 Conclusion: The administration of combination of probiotics can improve the levels of IFN-γ/ IL-4 in patients with moderate to severe allergic rhinitis.
 Bangladesh Journal of Medical Science Vol.18(1) 2019 p.42-45
Highlights
Allergic rhinitis is a global health problem that can affect the quality of life and is often associated with multiple co-morbidity.The characteristic of patients with allergic rhinitis include changes in the body normal immune response such as increased serum levels of immunoglobulin E (IgE), local eosinophil infiltration and Th2 cells and various other response caused by Th1 and Th2 imbalance toward Th2 polarization.[1]
Increased IFN-γ/IL-4 ratio in the probiotic group might have been due to increased IFN-γ and decreased levels of IL-4
This finding supports a study by Mohamadzadeh in 2005 showing that results that probiotics can activate human dendritic cells tend to Th1 polarization indicated by increased IFN γ
Summary
Allergic rhinitis is a global health problem that can affect the quality of life and is often associated with multiple co-morbidity.The characteristic of patients with allergic rhinitis include changes in the body normal immune response such as increased serum levels of immunoglobulin E (IgE), local eosinophil infiltration and Th2 cells and various other response caused by Th1 and Th2 imbalance toward Th2 polarization.[1]. Lactobacillus casei and Lactobacillus acidophilus are potential probiotics to be developed as a new alternative immunomodulatory-based therapy of allergic rhinitis.4The administration of L. asidophilus has been shown to activate Th1 and increase levels of IFN-γ but did not affect the production of IL-4. Induction of immune responses mediated by Th1has been observed after administration of L. casei of which include increased production of IFN-γ, IL-12 and IL-4 and decreased the levels of IgE.[5] The previous study has shown that the administration of fermented milk containing L. casei Shirota strain can reduce levels of IgE in allergic rhinitis patients.[6] As an immunomodulatory probiotics containing L. casei and L. acidophilus are more specific so that it has the potential to be developed as a new alternative method of treatment of allergic rhinitis. This study aimed to determine the effect of probiotic containing L.casei and L.acidophilus on levels of IFN γ/IL-4 in patients with allergic rhinitis
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