Severity Of Upper Respiratory Tract Infections Research Articles

Individualized Supplementation of Immunoactive Micronutrients and Severity of Upper Respiratory Infection Symptoms-A Randomized Intervention Study.

Certain micronutrients exhibit immunomodulatory effects. However, no intervention has yet investigated the effect of individualized supplementation on the severity of upper respiratory tract infections (URIs). Therefore, we investigated whether a personalized supplementation moderates the incidence and severity of URI. Selenium, zinc, and vitamin D were measured in dried blood spots from 59 healthy participants. Accordingly, a personalized supplement was provided with or without the respective micronutrients. We used WURSS-21 questionnaires to assess the disease status. The blood values converged during the intervention and micronutrients no longer differed between treated and untreated volunteers at the end of the intervention period. The incidence and severity of the illness did not significantly differ between the groups. However, when analyzing the WURSS-21 scores by the intention to treat, the initially randomized treatment arm revealed a significantly higher score than the placebo arm. Upon acute administration, individualized combinations of selenium, zinc and vitamin D do not reduce the number, or contribute to a milder course of URIs. Therefore, supplementation in acute infectious situations seems questionable. Further studies must address the habitual diet in more detail, to better understand the impact of individual micronutrient status on the prevention of URI.

The Multi-Strain Probiotic OMNi-BiOTiC® Active Reduces the Duration of Acute Upper Respiratory Disease in Older People: A Double-Blind, Randomised, Controlled Clinical Trial.

Immunosenescence is the adverse change in the human immune function during aging, leaving older people more prone to an increased risk of infections and morbidity. Acute upper respiratory tract infections (URTIs) are very common among older people, often resulting in continued morbidity and mortality. Therefore, approaches, such as consuming probiotics, that shorten the duration or even reduce the incidence of URTIs in older people are being studied. The aim of this study was to determine the effects of a multi-strain probiotic OMNi-BiOTiC® Active, which contains 11 live probiotic strains, on the incidence, duration, and severity of URTIs in older people. In this randomized double-blinded placebo-controlled study, 95 participants, with an average age of 70.9 years in the probiotic group and 69.6 years in the placebo group, were randomly allocated to two groups: 1010 cfu per day of the multi-strain probiotic intervention OMNi-BiOTiC® Active (49) or placebo (46). The incidence of URTIs in older people after 12 weeks supplementation with OMNi-BiOTiC® showed no statistically significant difference between the two groups (p = 0.5244). However, the duration of the URTI infections was statistically significantly different between the groups (p = 0.011). The participants that consumed the probiotic had an average duration of illness of 3.1 ± 1.6 days, whilst participants that received the placebo had symptoms for an average of 6.0 ± 3.8 days (p = 0.011). Statistically significant differences in lymphocyte counts in both groups after supplementation (p = 0.035 for the probiotic group and p = 0.029 for the placebo group) and between both groups were found (p = 0.009). Statistically significant differences in eosinophil (p = 0.002) and basophil counts (p = 0.001) in the probiotic groups before and after supplementation with probiotics were also found. Supplementation with the multi-strain probiotic OMNi-BiOTiC® Active may benefit older people with URTIs. Larger randomised controlled clinical trials are warranted. Clinical Trial Registration; identifier NCT05879393.

Upper Respiratory Infections among Under-Five Age Group Children at Urban Slum, Islamabad

Objective: The objective of this study was to identify the prevalence of Upper respiratory infection (URIs) in children less than five years of age. Methodology: This cross-sectional study was carried, in 360 children living in 115 houses of urban community of several socio -economic settings at, Burma Town, Tarlai Kalan, an Urban slum, in Islamabad. 110 children under 5 years were found with URIs out of a total of 360 children. A Questionnaire about Socio-demographic distribution of the sample population having, information of their parents, housing conditions, type of using cooking fuel, and general clinical examination was done. Results: 41.9% of the 110 children were 0 to 1 years old, 45.36% were 1 to 4 years old, and 12.96% were 4 to 5 years old. The gender distribution was 48 % girls and 62 % boys. About 40% children looked malnourished. According to symptoms, about 82% of children were having cough, 75% nasal discharge, 32% fever, 3% with fast breathing. Conclusion: In this study, it was observed that all children were having cough, nasal discharge, fever, sour throat, muscle aches, causing in severity of URI. Keywords: Children, Upper respiratory infections, Socioeconomic & Environmental risk factors, Burden of disease, Incidence, Awareness.

Bacillus clausii UBBC-07 in the symptom management of upper respiratory tract infections in children: a double blind, placebo-controlled randomised study.

In children, upper respiratory tract infections (URTIs) are one of the most common causes of infections which often require outpatient consultations with the doctor. The purpose of this study was to evaluate the effect of probiotic Bacillus clausii UBBC-07 on symptom management of URTIs in children. In this double blind, randomised, placebo-controlled study, 90 children (age 4-7 years) with URTIs were equally divided into two groups, the probiotic and placebo. The children were instructed to take B. clausii UBBC-07 spores (2×109 per 5 ml vial) or placebo suspension daily twice for three months. The total duration of the study was 6 months, 3 months treatment and 3 months follow-up period. The parameters assessed were the mean number of URTIs, duration and severity of URTIs, absenteeism from school/childcare and immunity parameters, such as immunoglobulin (Ig)M, IgG, IgE and salivary IgA levels. At the end of treatment, there was a significant decrease in the number, duration and severity of URTIs in the probiotic treated group as compared to the baseline and placebo. IgE levels were significantly decreased and salivary IgA levels were significantly increased in the probiotic treated group suggesting probiotic mediated Th1/Th2 immune homeostasis to alleviate URTIs in children. In conclusion, B. clausii UBBC-07 may help in the reduction of symptoms of URTIs. The trial was registered prospectively with the Clinical Trial Registry of India (CTRI Reg. No: CTRI/2018/08/015282).

Effect of Catechins on Upper Respiratory Tract Infections in Winter: A Randomized, Placebo-Controlled, Double-Blinded Trial.

Tea catechins are plant-derived compounds that improve immune functions. Previous randomized control trials have demonstrated the efficacy of primarily epi-type catechins against upper respiratory tract infections (URTIs). Green tea can be consumed in several ways, including popular bottled beverages. These beverages, however, require sterilization during manufacturing, which results in catechin isomerization. We conducted a randomized, double-blinded, placebo-controlled trial involving healthy Japanese participants to evaluate whether catechin consumption via bottled beverages has an alleviating effect on the duration and severity of URTIs in winter. The catechin group (490 mg catechin, 0.14%, containing 59% epi-type catechin, n = 55) showed reduced durations of running nose, nasal congestion, and headache, compared with the placebo group (0 mg catechin, n = 54; p = 0.013, 0.018, and <0.001, respectively). Furthermore, when considering physical symptoms, the duration of nasopharyngeal symptoms improved significantly in the catechin group (p < 0.001) compared with that in the control group. The daily consumption of catechin thus reduced the duration and severity of URTIs in healthy men and women. Humans are regularly exposed to several potential infectious threats, and the oral administration of heat-epimerized tea catechins might help prevent and reduce the severity of URTIs.

Effects of yeast β-glucans for the prevention and treatment of upper respiratory tract infection in healthy subjects: a systematic review and meta-analysis.

Yeast β-glucans are known for their immune-modulating effects; however, their effects on human upper respiratory tract infections (URTIs) remain unclear. The aim of the present study was to use a systematic review and meta-analysis approach to investigate the effects of yeast β-glucans for the prevention and treatment of URTIs in healthy subjects. Databases including Pubmed, Web of Science, EMBASE and the Cochrane Library were searched and 13 RCTs investigating the effects of yeast β-glucans on the incidence, duration, and severity of URTIs in healthy subjects were included. The results showed that compared to the placebo group, yeast β-glucan could significantly reduce the incidence of URTIs (OR = 0.345, 95% CI = 0.192 to 0.620, p < 0.001), decrease the average number of URTI episodes (SMD = - 0.315, 95% CI = - 0.500 to - 0.130, p < 0.05), and decrease the duration of URTIs (SMD = - 0.312, 95% CI = - 0.561 to - 0.064, p < 0.001). Improved severity of symptoms was found in yeast β-glucan group compared to the placebo group in the majority of included studies. In addition, yeast β-glucan was well tolerated and safe in general. These findings suggest a positive effect of yeast β-glucans on human URTIs. However, due to the high heterogeneity and small number of included studies, more high-quality research and clinical trials are warranted.

Effect of upper respiratory infection on anaesthesia induced atelectasis in paediatric patients

Upper respiratory tract infection (URI) symptoms are known to increase perioperative respiratory adverse events (PRAEs) in children undergoing general anaesthesia. General anaesthesia per se also induces atelectasis, which may worsen with URIs and yield detrimental outcomes. However, the influence of URI symptoms on anaesthesia-induced atelectasis in children has not been investigated. This study aimed to demonstrate whether current URI symptoms induce aggravation of perioperative atelectasis in children. Overall, 270 children aged 6 months to 6 years undergoing surgery were prospectively recruited. URI severity was scored using a questionnaire and the degree of atelectasis was defined by sonographic findings showing juxtapleural consolidation and B-lines. The correlation between severity of URI and degree of atelectasis was analysed by multiple linear regression. Overall, 256 children were finally analysed. Most children had only one or two mild symptoms of URI, which were not associated with the atelectasis score across the entire cohort. However, PRAE occurrences showed significant correspondence with the URI severity (odds ratio 1.36, 95% confidence interval 1.10–1.67, p = 0.004). In conclusion, mild URI symptoms did not exacerbate anaesthesia-induced atelectasis, though the presence and severity of URI were correlated with PRAEs in children.Trial registration: Clinicaltrials.gov (NCT03355547).

Antioxidant vitamins and their effect on immune system

Antioxidant vitamins are organic molecules that have vital roles in the human body. They are essential nutrients and mainly found in the food and are required in small quantities for the maintenance of the human body. Antioxidant vitamins play a major role in reducing and controlling oxidative stress and infectious diseases. This review aims to broaden the knowledge of the antioxidant vitamins (C, E, and A) and their effect on the immune system. These vitamins protect the immune system and enhance resistance against infectious microbes such as bacteria, viruses, and parasites. It is highly recommended to include antioxidants in the daily diet, as their lack can weaken the immune system and ultimately its ability in defending the body against diseases. Although vitamins are required in specific doses to maintain functional immune system, they mostly used as supplements. Vitamin C supplementation, for example, has been shown to reduce the duration and severity of upper respiratory infections, including colds. Moreover, it has been suggested that there is a close relationship between the deficiency of vitamins and infectious diseases such as tuberculosis, AIDS and CoV-2 SARS, as well as infectious diseases spread through the respiratory and digestive systems.

Effect of fermented milk on upper respiratory tract infection in adults who lived in the haze area of Northern China: a randomized clinical trial

Context Upper respiratory tract infection (URTI) is the most common illness in humans. Fermented milk containing probiotics can mitigate URTI symptoms. Objective This study tests the effect of fermented milk (Qingrun), a yogurt supplemented with Bifidobacterium animalis subsp. lactis Bl-04, on adults with URTIs who live in a haze-covered area in a randomized clinical trial. Materials and methods A total of 136 subjects were enrolled in the study at the baseline and randomized to consume either control yogurt or Qingrun yogurt (250 g) once daily for 12 weeks. The duration and severity of URTI were evaluated by the Wisconsin Upper Respiratory Symptom Survey–24. Blood and faecal samples were collected at the baseline and post-intervention, to determine the changes of immune biomarkers. Results Qingrun yogurt significantly reduced the incidence of the common cold (OR, 0.38; 95% CI, 0.17–0.81; p = 0.013) and influenza-like illness (OR, 0.32; 95% CI, 0.11–0.97; p = 0.045). Compared to the control yogurt, Qingrun yogurt significantly reduced the duration (1.23 ± 2.73 vs. 4.78 ± 5.09 d) and severity score (3.58 ± 7.12 vs. 11.37 ± 11.73) of URTI. In addition, the post-intervention levels of interferon-γ (139.49 ± 59.49 vs. 113.45 ± 65.12 pg/mL) and secretory immunoglobulin A (529.19 ± 91.70 vs. 388.88 ± 53.83 mg/dL) significantly increased in the Qingrun group, compared with those in the control group. Conclusions Qingrun yogurt showed a protective effect against URTI in adults, suggesting that the use of yogurt with probiotics could be a promising dietary supplement for mitigating URTI.

Investigation of the natural supplement IQP-AS-119 for the prevention of upper respiratory tract infections in marathon race participants: A randomized, double-blind, placebo-controlled pilot study.

Intense and prolonged exercise leads to immune suppression, causing upper respiratory tract infections (URTI). A proprietary standardized dietary supplement, IQP-AS-119 has been previously developed to aid immune responses under such conditions. The current randomized, double-blind, placebo-controlled pilot study aimed to investigate the effects of IQP-AS-119 on marathon runners. A total of 80 participants were randomized equally into groups receiving either placebo (P group) or IQP-AS-119 (V group) treatment, starting 3 weeks before and for 14 days after the marathon. Benefit assessment was performed using different questionnaires. Post-marathon, the V and P groups reported 1±2.38 and 2.11±3.25 days with upper respiratory tract symptoms (URTS), respectively (P=0.038). During the 14 days post-marathon, 20.0% of the participants in the V group compared with 44.4% in the P group reported URTS (P=0.042). The V group reported significantly milder URTS compared with the P group on Days 9, 12, 13 and 14 post-marathon (P<0.05). The total Perceived Stress Questionnaire-20 score on days 2-14 were significantly lower for the V group compared with the P group (P=0.035). In the Short Form 12 Health Survey, the V group exhibited significant improvement in mental composite score on days -5 to 14 compared with the P group (P=0.038). In the overall treatment effect assessment, there were no statistically significant differences between the groups. The IQP-AS-119 was rated ‘very good’ or ‘good’ by investigators and participants, respectively, for 71 and 65% of the participants. The tolerability of IQP-AS-119 was rated as ‘very good’ or ‘good’ by both investigators and 95% of participants. No clinically relevant differences were observed between groups regarding adverse events or other safety parameters. Therefore, IQP-AS-119 was demonstrated to reduce the incidence and severity of URTI in marathon runners. Given its good tolerability profile, IQP-AS-119 may be a good nutritional supplement for the reduction of URTS in susceptible individuals.

Homoeopathy for Upper Respiratory Tract Infection in Children: A Narrative Review of Research Evidence

Abstract Background Upper respiratory tract infection (URTI) is one of the leading causes of morbidity worldwide, especially in the paediatric age group. Conventional medications have a minimal role in treating and preventing those diseases and an alternative for this is warranted. In this regard, homoeopathy can be a proper consideration, but the comparative effect and safety need critical evaluation. Methods To evaluate the role of homoeopathic treatment in URTI, particularly in children, we conducted a comprehensive search in PubMed, Core-Hom, Cochrane library and Cam-quest database. All the relevant studies were included for a critical review. Results One-hundred forty articles were found in a preliminary search, and for review, we included 17 studies related to URTI in paediatric age group. All the studies were very diverse in the methodology, type of homoeopathy used and outcome measurement. Different types of homoeopathy in terms of individualised, complex syrup and home-medication were used in studies. Fourteen studies reported the role of homoeopathy in reducing the severity of symptoms, efficacy beyond placebo, superiority or non-inferiority over conventional medications, in lowering the consumption of antibiotics and as prophylaxis. On the other hand, three studies found little or no effect in reducing symptoms or number of visits. Conclusions Homoeopathic treatment improves the symptoms and reduces the severity of URTI in the paediatric age group. It can be an effective and safe way of treatment for reducing the burden of the disease, thus improving the quality of life. Owing to the diversity among the studies, more high-quality trials with focused questions are needed for further conclusion.

Effects of Seasonal Training Load on Performance and Illness Symptoms in Water Polo.

Brisola, GMP, Claus, GM, Dutra, YM, Malta, ES, de Poli, RAB, Esco, MR, and Zagatto, AM. Effects of seasonal training load on performance and illness symptoms in water polo. J Strength Cond Res 34(2): 406-413, 2020-The purpose of the study was to describe the training load distribution of a young female water polo team in different cycles of the season and verify its subsequent effects on specific fitness measured by the repeated sprints ability (RSA) test, aerobic endurance measured by the lactate minimum test, incidence and severity of upper respiratory tract infection (URTI) symptoms, and muscle damage markers. The training load (i.e., rating of perceived exertion × session duration) of 20 young female water polo players (mean ± SD: age = 15.65 ± 1.3 years; body mass = 60.93 ± 11.0 kg; height = 1.62 ± 0.1 m) was monitored, and the incidence and severity of URTI was assessed during part of the season. In addition, we assessed the lactate minimum speed (LMS), RSA, creatine kinase (CK), and lactate dehydrogenase (LDH) blood concentration during the season. The level of significance set was p < 0.05. The training loads were higher in the specific period (p < 0.01), whereas a high incidence of URTI was observed in the general cycle. The LMS was greater in the general cycle (p < 0.05), whereas total time and best time in the RSA test were greater in the competitive cycle (p < 0.05). The CK and LDH concentrations were significantly lower during the competitive cycle (p < 0.01). The general cycle of a female water polo team is critical regarding URTI and muscle damage, even with smaller training loads than the specific period.

Incidence and clinical picture of upper respiratory infection in children receiving zinc supplement

The National Household Health Survey (1995) reported that the prevalence of upper respiratory infection (URI) in Indonesia was found 25.3% for all ages and 47.1% for the under five children. Reports of studies on the effect of zinc in the reduction of respiratory infection stated inconsistentresults. The objective of this community base study is to evaluate the effect of zinc as the attempt to reduce the incidence of URI. We have studied the effect of daily supplementation of 10 mg elemental zinc in a double blind, randomized, controlled trial consisting of 37 children (zinc group) and 36 children (control group) of 6 months - 5 years old. The distribution of preparation and monitoring of morbidity were performed regularly once a week along 2-month study period. During the 2-month study (February-April 2001) we found 24 URI cases in the zinc group and 24 cases in the control group. Time series analysis concerning the incidence and severity of the zinc group showed a negative slope (Yt: a – bx), while the placebo group showed a positive slope (Yt: a + bx). The evidence and severity of URI in zinc groups within the 1st and 2nd months showedsignificant different, while it was not in the control group. The study obviously showed the benefit of zinc supplementation in the reduction of URI as showed by negative slope in the time series analysis, and significant decreased of the incidence and the severity of URI in zinc group. There was no side effect of zinc supplemented noted. We suggest, therefore regular zinc supplementation to the diet of the children in the low economic level community are needed.

Soluble and Insoluble Yeast β-Glucan Differentially Affect Upper Respiratory Tract Infection in Marathon Runners: A Double-Blind, Randomized Placebo-Controlled Trial.

In a previous study, consumption of a dairy beverage incorporating insoluble β-glucan decreased upper respiratory tract infection (URTI) symptomatic days and severity in marathon runners. In this report, we extended our previous findings by presenting data on a dairy beverage containing soluble β-glucan and URTI in marathon runners. Healthy adults running in the 2017 Austin Marathon consumed dairy beverages (250 mL/day) containing 250 mg of insoluble (n = 69) or soluble (n = 76) baker's yeast β-glucan (Wellmune®) or placebo (n = 133) for the 45 days before, day of, and 45 days after the marathon (91 days total). Participants completed a daily online survey assessing compliance and URTI symptoms, which were evaluated using the Jackson Index and confirmed by the study physician. Total severity of URTI was significantly lower in the insoluble yeast β-glucan group compared to the placebo group, but was not different between the soluble yeast β-glucan group and placebo group. Severity ratings for nasal discharge were significantly lower in both the insoluble and soluble yeast β-glucan groups compared to the placebo group. Additionally, severity rating for sore throat was lower in the insoluble, but not the soluble yeast β-glucan group compared to the placebo group. The insoluble yeast β-glucan group, but not the soluble yeast β-glucan group also reported fewer URTI symptomatic days compared to the placebo group. The results suggest that soluble and insoluble yeast β-glucan, incorporated into a food matrix, differentially affected exercise-induced URTI in marathon runners.

SIgA response and incidence of upper respiratory tract infections during intensified training in youth basketball players.

The aim of the present study was to examine the effect of an intensified training phase followed by a tapering phase on the salivary immunoglobulin A concentration and on the upper respiratory tract infection (URTI) symptoms in young male basketball players. The session rating of perceived exertion method was used to quantify the internal training load, and the Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. The Yo-Yo IR1 test and saliva collection were carried out at the beginning of the study (T1), after the intensified phase (T2), and after tapering (T3). A higher internal training load was observed for the intensified phase compared with the tapering phase (t=19.10; p<0.001), and a significant decrease in salivary immunoglobulin A concentration was detected (F=7.48; p=0.004) at T3 compared to T1 (p=0.02) and T2 (p=0.05). However, there was no significant difference between phases for severity of URTI (χ2= 2.83; p=0.242). The Yo-Yo IR1 test performance increased from T2 and T3 compared to T1 (F=58.24; p<0.001). There was no significant effect of aerobic fitness level on salivary immunoglobulin A response (F=1.095; p=0.344). In summary, the present findings suggest that an intensified training load followed by a tapering period negatively affects the mucosal immune function with no significant change in severity of URTI in young basketball players.

Consumption of Bifidobacterium animalis subsp. lactis BB-12 impacts upper respiratory tract infection and the function of NK and Tcells in healthy adults.

Probiotics can modulate immunity and reduce upper respiratory tract infections (URTI) in humans; however few studies have examined both outcomes in the same trial. The goal of the current study was to investigate the effect of Bifidobacterium animalis subsp. lactis BB-12, on natural killer (NK) and T-cell function in conjunction with self-reported cold/flu outcomes in healthy adults. In a randomized, partially blinded, four-period crossover study, healthy adults (n = 30) were recruited, and received four treatments for 4 weeks in a random order: (i) yogurt smoothies alone (YS); smoothies with BB-12 added (ii) before (PRE) or (iii) after (POST) yogurt fermentation, or (iv) BB-12 capsule (CAP). NK- and T-cell function was assessed at baseline and after each treatment. Incidence and severity of cold/flu infection was quantified using self-reported URTI questionnaires. Participants on YS, PRE, or CAP treatments had elevated IL-2 secretion and NK-cell cytotoxicity, concurrently with fewer days with URTI. However, the POST treatment did not change immune outcomes or the severity of URTI. The timing of BB-12 addition to yogurt smoothies in relation to the fermentation process influenced the impact of BB-12 on immune function and cold/flu severity in young healthy adults.

Vitamin D supplementation and upper respiratory tract infections in adolescent swimmers: a randomized controlled trial.

Observational studies identified associations between vitamin D insufficiency (serum 25(OH)D < 30ng·ml-1) and risk of upper respiratory infection (URI). Swimmers are highly prone to URIs, which might hinder their performance. The aim of this study was to examine if vitamin D3 supplementation reduces URI burden in vitamin D-insufficient swimmers. Fifty-five competitive adolescent swimmers with vitamin D insufficiency were randomized to receive vitamin D3 (2,000IU·d-1) or placebo for 12 winter weeks. A URI symptom questionnaire was completed weekly. Serum 25(OH)D concentrations were measured by radio-immunoassay before and after supplementation. We used linear regression to examine the relation between the change in 25(OH)D concentrations during the trial, and the duration and severity of URIs. There were no between-group differences in the frequency, severity, or duration of URIs. Exploratory analyses revealed that in the placebo group only, the change in 25(OH)D concentrations during the trial was highly associated with the duration of URIs (r = -0.90,p < .001), and moderately associated with the severity of URIs (r = -0.65,p = .043). The between-group differences for duration were highly significant. Vitamin D3 supplementation in adolescent swimmers with vitamin D insufficiency did not reduce URI burden. However, larger decreases in serum 25(OH)D concentrations were associated with significantly longer and more severe URI episodes.

Effect of Vitamin D3Supplementation on Upper Respiratory Tract Infections in Healthy Adults

Observational studies have reported an inverse association between serum 25-hydroxyvitamin D (25-OHD) levels and incidence of upper respiratory tract infections (URTIs). However, results of clinical trials of vitamin D supplementation have been inconclusive. To determine the effect of vitamin D supplementation on incidence and severity of URTIs in healthy adults. Randomized, double-blind, placebo-controlled trial conducted among 322 healthy adults between February 2010 and November 2011 in Christchurch, New Zealand. Participants were randomly assigned to receive an initial dose of 200,000 IU oral vitamin D3, then 200,000 IU 1 month later, then 100,000 IU monthly (n = 161), or placebo administered in an identical dosing regimen (n = 161), for a total of 18 months. The primary end point was number of URTI episodes. Secondary end points were duration of URTI episodes, severity of URTI episodes, and number of days of missed work due to URTI episodes. The mean baseline 25-OHD level of participants was 29 (SD, 9) ng/mL. Vitamin D supplementation resulted in an increase in serum 25-OHD levels that was maintained at greater than 48 ng/mL throughout the study. There were 593 URTI episodes in the vitamin D group and 611 in the placebo group, with no statistically significant differences in the number of URTIs per participant (mean, 3.7 per person in the vitamin D group and 3.8 per person in the placebo group; risk ratio, 0.97; 95% CI, 0.85-1.11), number of days of missed work as a result of URTIs (mean, 0.76 days in each group; risk ratio, 1.03; 95% CI, 0.81-1.30), duration of symptoms per episode (mean, 12 days in each group; risk ratio, 0.96; 95% CI, 0.73-1.25), or severity of URTI episodes. These findings remained unchanged when the analysis was repeated by season and by baseline 25-OHD levels. In this trial, monthly administration of 100,000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults. anzctr.org.au Identifier: ACTRN12609000486224.

Influence of yeast-derived 1,3/1,6 glucopolysaccharide on circulating cytokines and chemokines with respect to upper respiratory tract infections

ObjectiveWellmune WGP is a food supplement containing a refined 1,3/1,6 glucopolysaccharide that improves the antimicrobial activity of the innate immune cells by the priming of lectin sites. This study aimed to investigate whether Wellmune decreases the frequency and severity of upper respiratory tract infection (URTI) symptoms over 90 d during the peak URTI season in healthy university students. The secondary aims included an assessment of plasma cytokine and chemokine levels. MethodsThis was a randomized, double-blinded, placebo-controlled trial lasting 90 d. One hundred healthy individuals (18–65 y old, mean age ∼21 y) were randomized to 250 mg of Wellmune once daily or to an identical rice flour-based placebo. Health was recorded daily and two or more reported URTI symptoms for 2 consecutive days triggered a medical assessment and blood collection within 24 h. The URTI symptom severity was monitored. Plasma cytokines and chemokines were measured at day 0, day 90, and during the confirmed URTI. ResultsNinety-seven participants completed the trial (Wellmune, n = 48; placebo, n = 49). The Wellmune tended to decrease the total number of days with URTI symptoms (198 d, 4.6%, versus 241 d, 5.5% in the control group, P = 0.06). The ability to “breathe easily” was significantly improved in the Wellmune group; the other severity scores showed no significant difference. Cytokines and chemokines were not different between the groups at study entry or day 90, but monocyte chemotactic protein-1 was lower in the Wellmune group during the URTI. ConclusionWellmune may decrease the duration and severity of URTI. Larger studies are needed to demonstrate this.

RCT of Montelukast as Prophylaxis for Upper Respiratory Tract Infections in Children

Infections with viruses causing upper respiratory tract infection (URI) are associated with increased leukotriene levels in the upper airways. Montelukast, a selective leukotriene-receptor antagonist, is an effective treatment of asthma and allergic rhinitis. To determine whether prophylactic treatment with montelukast reduces the incidence and severity of URI in children. A randomized, double-blind, placebo-controlled study was performed in 3 primary care pediatric ambulatory clinics in Israel. Healthy children aged 1 to 5 years were randomly assigned in a 1:1 ratio to receive 12-week treatment with 4 mg oral montelukast or look-alike placebo. Patients were excluded if they had a previous history of reactive airway disease. A study coordinator contacted the parents by phone once a week to obtain information regarding the occurrence of acute respiratory episodes. The parents received a diary card to record any acute symptoms of URI. The primary outcome measure was the number of URI episodes. Three hundred children were recruited and randomly assigned into montelukast (n = 153) or placebo (n = 147) groups. One hundred thirty-one (85.6%) of the children treated with montelukast and 129 (87.7%) of the children treated with placebo completed 12 weeks of treatment. The number of weeks in which URI was reported was 30.4% in children treated with montelukast and 30.7% in children treated with placebo. There was no significant difference in any of the secondary variables between the groups. In preschool-aged children, 12-week treatment with montelukast, compared with placebo, did not reduce the incidence of URI.