Department of Pulmonology, Academic Medical Center (University of Amsterdam), Amsterdam, the Netherlands.
Allergy. 2011 Jan;66(1):39-47. doi: 10.1111/j.1398-9995.2010.02454.x. Epub 2010 Aug 17.
Previous studies suggest that pre/probiotics can be used in the prevention and treatment of early allergic disease in newborns and young children.
To determine the effect of treatment with synbiotics (90% short-chain galacto-oligosaccharides, 10% long-chain fructo-oligosaccharides: Immunofortis(®) and Bifidobacterium breve M-16V) on allergic responses in adults with established allergic asthma. Primary outcome was allergen-induced bronchial inflammation as represented by eosinophil counts.
Twenty-nine patients with asthma and house dust mite (HDM) allergy were randomized in a double-blind, parallel design to receive placebo or synbiotics for 4 weeks. At study entry and after treatment, a bronchial allergen challenge with HDM was performed, followed by lung function tests, collection of blood (in/ex vivo IL-5) and induced sputum (inflammatory parameters). During treatment, a diary was kept with peak expiratory flow (PEF) and asthma scores.
Treatment did not affect the allergen-induced increase in sputum eosinophils at 6 and 24 h after challenge. Likewise, other parameters for bronchial inflammation and early and late changes in lung function did not differ upon treatment. Both the morning and evening PEF, however, significantly increased during synbiotics treatment (morning P = 0.003, evening P = 0.011). Also, the increase in serum IL-5 after allergen challenge was significantly inhibited by synbiotics (P = 0.034), as was ex vivo allergen-induced Th2-cytokine (IL-5 and IL-4+ IL-13) production by PBMCs (P = 0.046). In vivo (24 h) and ex vivo IL-5 production were associated.
Four-week treatment with synbiotics had no effect on bronchial inflammation and LAR, but did significantly reduce systemic production of Th2-cytokines after allergen challenge and improved PEF.
先前的研究表明，益生菌和益生元可用于预防和治疗新生儿及幼儿的早期过敏性疾病。
确定合生制剂（90%短链半乳糖寡糖，10%长链果糖寡糖：Immunofortis®和短双歧杆菌 M-16V）治疗对已确诊过敏性哮喘的成年人过敏反应的影响。主要结局是过敏原诱导的支气管炎症，表现为嗜酸性粒细胞计数。
29 名患有哮喘和屋尘螨（HDM）过敏的患者被随机分为双盲、平行设计，接受安慰剂或合生制剂治疗 4 周。在研究开始和治疗后，进行 HDM 支气管变应原挑战，随后进行肺功能测试、血液（体内/体外 IL-5）和诱导痰（炎症参数）采集。在治疗期间，使用日记记录呼气峰流速（PEF）和哮喘评分。
治疗并未影响变应原诱导后 6 小时和 24 小时痰液中嗜酸性粒细胞的增加。同样，支气管炎症的其他参数以及早期和晚期肺功能变化在治疗后也没有差异。然而，合生制剂治疗期间，清晨和傍晚的 PEF 均显著增加（清晨 P=0.003，傍晚 P=0.011）。此外，合生制剂还显著抑制了过敏原挑战后血清中 IL-5 的增加（P=0.034），并抑制了 PBMC 中过敏原诱导的 Th2 细胞因子（IL-5 和 IL-4+IL-13）产生（P=0.046）。体内（24 小时）和体外 IL-5 产生呈正相关。
合生制剂治疗 4 周对支气管炎症和晚期气道反应没有影响，但显著减少了过敏原挑战后的全身 Th2 细胞因子产生，并改善了 PEF。
