Huang Xinyu, Zhang Xu, Zhang Zhiqiang, Liu Mengyuan, Bai Daoming, Yang Rui, Yang Chunping
Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
Sci Prog. 2025 Apr-Jun;108(2):368504251355373. doi: 10.1177/00368504251355373. Epub 2025 Jun 30.
Allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are chronic inflammatory disorders of the upper airways with rising global prevalence, contributing significantly to health and socioeconomic burdens. Conventional treatments-including glucocorticoids, antibiotics, antihistamines, and leukotriene inhibitors-remain insufficient in targeting the underlying pathophysiology. Bacterial lysates (BLs), functioning as immunomodulators, activate both innate, and adaptive immune pathways, reestablish Th1/Th2 equilibrium, lower immunoglobulin E concentrations, and attenuate Th2-mediated inflammation. Emerging evidence indicates that BLs (e.g. OM-85, Broncho-Vaxom) markedly improve total nasal symptom scores in AR, suppress Th2 cytokine (IL-4 and IL-13) secretion, and reduce recurrence rates and surgical interventions in CRS. In conjunction with standard therapies, BLs enhance mucosal immune defense and contribute to sustained clinical efficacy. Following the Scale for the Assessment of Narrative Review Articles guidelines, this review critically evaluates the composition, manufacturing processes, immunoregulatory mechanisms, and clinical progress of BLs in AR and CRS, providing a conceptual framework for their clinical application.
变应性鼻炎（AR）和慢性鼻-鼻窦炎（CRS）是上呼吸道的慢性炎症性疾病，在全球范围内患病率不断上升，对健康和社会经济负担造成了重大影响。包括糖皮质激素、抗生素、抗组胺药和白三烯抑制剂在内的传统治疗方法，在针对潜在病理生理学方面仍然不足。细菌溶解产物（BLs）作为免疫调节剂，可激活固有免疫和适应性免疫途径，重建Th1/Th2平衡，降低免疫球蛋白E浓度，并减轻Th2介导的炎症。新出现的证据表明，BLs（如OM-85、泛福舒）可显著改善AR患者的总鼻症状评分，抑制Th2细胞因子（IL-4和IL-13）分泌，并降低CRS的复发率和手术干预率。与标准疗法联合使用时，BLs可增强黏膜免疫防御，并有助于实现持续的临床疗效。遵循叙述性综述文章评估量表指南，本综述对BLs在AR和CRS中的成分、生产工艺、免疫调节机制和临床进展进行了批判性评价，为其临床应用提供了概念框架。
