Review
Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials

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Objective

To evaluate the clinical evidence for the use of probiotics as a therapeutic modality for allergic rhinitis (AR) and asthma.

Data Sources

PubMed was searched to identify randomized controlled trials (RCTs) that studied the effects of probiotics on AR (n = 12) and asthma (n = 4).

Study Selection

RCTs that studied the effects of probiotics administration on the treatment but not the prevention of AR and asthma were selected for inclusion in this review.

Results

Nine of the 12 RCTs that evaluated clinical outcomes in AR showed an improvement due to the use of probiotics. All the RCTs that studied perennial AR showed lower symptom scoring and medication use with the use of probiotics compared with placebo. Also, 5 of the 8 RCTs that referred to seasonal AR suggested an improvement in clinical outcomes. Nine RCTs that reported various immunologic measurements of allergy found no significant probiotic effects. The RCTs that studied the effect of probiotic administration on the treatment of asthma showed no positive effects.

Conclusions

Probiotics may have a beneficial effect in AR by reducing symptom severity and medication use. Many more good-quality studies are needed to resolve this issue.

Section snippets

INTRODUCTION

Atopy affects more than 30% of the population. Its prevalence and the prevalence of the most common allergic diseases, such as allergic rhinitis (AR) and asthma, have been increasing in the Western world during the past 20 years.1 In 2002, in the United States, almost 31 million adults had been diagnosed as having asthma during their lifetime,2 and approximately 40 million have seasonal AR (SAR) or perennial AR (PAR). Although we have a variety of effective therapeutic options for AR and

DISCUSSION

The main conclusion of this systematic review is that probiotics may be beneficial for the treatment of AR. Treatment with probiotics showed clinical improvement in patients with SAR and PAR in most of the published studies. Most of the RCTs show a reduction in symptom severity and decreased use of relief medications in patients treated with probiotics. Overall quality of life also tended to improve in patients receiving probiotics. Trials of the effects of probiotics on asthma are few and show

CONCLUSIONS

It is clear from the review of the literature that this issue cannot be resolved at this time. The idea is very promising, and there is good experimental evidence from animals to suggest its effectiveness. Basic science studies on each probiotic strain that include genomic, proteomic, and metabolomic data and their effects on the immune system followed by systematic evaluation of the effects of the most promising strains in specific allergic diseases are required before we can draw any definite

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    Disclosures: Authors have nothing to disclose.

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