Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
Department of Otorhinolarygology Head and Neck Surgery, Fifth Hospital, Guangzhou Medical University, Guangzhou, China.
Rhinology. 2019 Dec 1;57(6):451-459. doi: 10.4193/Rhin19.161.
Probiotics are mainly distributed in the mucosal system and have the ability to enhance mucosal barrier function and regulate immune responses. Broncho-Vaxom (BV), as a probiotic, has been applied to patients suffering from respiratory tract infections, but its potential effectiveness in allergic rhinitis (AR) has not been evaluated in human. This study aimed to investigate the clinical efficacy of BV in patients with persistent AR and to elucidate the underlying cellular mechanisms.
Sixty patients with AR were enrolled to this study and were randomly assigned to the BV group (n=30) and the placebo group (n=30). Changes of clinical symptoms and laboratory parameters of allergic inflammation were measured at baseline visit, immediately after BV treatment, four weeks, and eight weeks after the BV treatment.
After BV treatment, medication score in the BV group was significantly decreased compared with placebo group, along with a significant drop of the total nasal symptom score and the individual nasal symptom scores (itching score: 23.72±5.32%; nasal rhinorrhea score: 18.59±4.83%; sneezing score: 23.08±4.98%). The levels of IL-4 and IL-13 in nasal lavage were diminished remarkably while the level of INF-γ was markedly increased in the BV group. This rendered a significant reduction of the ratio of IL-4/INF-γ. Moreover, a decrease of eosinophils in nasal smear was observed after BV treatment. The BV-induced favorable changes sustained for at least four to eight weeks post BV treatment.
Oral administration of BV offers remarkable and sustained efficacy in alleviating AR symptoms and may be considered as an alternative therapeutic strategy for patients with persistent AR. BV acts by improving the overall mucosal immunity via restoring and maintaining the normal Th1/Th2 cytokine balance as an underlying cellular/signaling mechanism.
益生菌主要分布在黏膜系统，具有增强黏膜屏障功能和调节免疫反应的能力。Broncho-Vaxom（BV）作为一种益生菌，已应用于呼吸道感染患者，但尚未在人类过敏性鼻炎（AR）中评估其潜在疗效。本研究旨在探讨 BV 对持续性 AR 患者的临床疗效，并阐明其潜在的细胞机制。
本研究纳入 60 例 AR 患者，随机分为 BV 组（n=30）和安慰剂组（n=30）。在基线访视、BV 治疗后即刻、4 周和 8 周后，测量过敏炎症的临床症状和实验室参数的变化。
BV 治疗后，BV 组的用药评分明显低于安慰剂组，总鼻症状评分和各鼻症状评分（瘙痒评分：23.72±5.32%；鼻流涕评分：18.59±4.83%；打喷嚏评分：23.08±4.98%）均显著下降。BV 组鼻灌洗液中 IL-4 和 IL-13 水平明显降低，IFN-γ水平明显升高，IL-4/IFN-γ比值显著降低。此外，BV 治疗后鼻拭子中嗜酸性粒细胞减少。BV 诱导的有利变化至少在 BV 治疗后 4 至 8 周内持续存在。
口服 BV 对缓解 AR 症状具有显著而持久的疗效，可作为持续性 AR 患者的一种替代治疗策略。BV 通过恢复和维持正常 Th1/Th2 细胞因子平衡来改善整体黏膜免疫，作为一种潜在的细胞/信号机制发挥作用。
