Effects of Probiotics on Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Background The prevalence of allergic rhinitis has been estimated to range from 10 to 30% in adults and up to 40% in children. Probiotics have been tested as for this condition, but no census on which probiotic types are most effective. Objective Our aim of this study was to provide probiotic strain-specific evaluation for the treatment of allergic rhinitis. Methods Databases (PubMed, Google Scholar, and ScienceDirect) were searched (from inception to October 2020) to identify randomized controlled trials (RCTs) of probiotic treatments in allergic rhinitis patients. A systematic review was done comparing types of reported outcomes, clinical and immunological parameters and safety data. A meta-analysis was done for probiotics with at least two RCTs per probiotic strain(s) and sharing a common outcome. Results A total of 13 randomized, double-blind, placebo-controlled trials (N = 1591 participants) were included in the systematic review. Overall, 8 of 9 probiotic types alleviated at least one clinical symptom of allergic rhinitis. The meta-analysis results showed that, neither L. paracasei Lp33 (SMD = −1.61, 95% CI −4.67, 1.45) nor L. rhamnosus GG (SMD = −1.00, 95% CI −3.01, 1.00) had significant efficacy for reducing nasal symptom scores. Conclusions Our analysis showed probiotics produced a slight improvement in some clinical and immunological measurements on allergic rhinitis. Due to the diversity of outcome measurements and lack of sufficient trials for each probiotic strain, future trials are needed with similar study design and uniform outcomes to better compare the effect of probiotics on allergic rhinitis.

Research Advances in the Treatment of Allergic Rhinitis by Probiotics

“… 35 However, the research and application of probiotics as an alternative treatment method in the world is increasing, and most of the studies suggest that probiotics can significantly improve the symptoms of AR patients. 36 , 37 Probiotics can activate Th1 or inhibit Th2, causing anti-inflammatory effects, and can also stimulate the production of immune factors such as interleukin 10 (IL-10), whose main role is to suppress inflammatory responses. 38 , 39 Probiotics have the advantages of safety and high cost performance, therefore, the basic research and clinical application of probiotics for AR treatment are increasing.…”

(R)Evolution in Allergic Rhinitis Add-On Therapy: From Probiotics to Postbiotics and Parabiotics

“…Some recent systematic reviews and meta-analyses [ 79 , 80 , 81 , 82 ] have evaluated the efficacy and safety of probiotics in managing AR. Probiotics can play an important role in the prevention and treatment of allergic rhinitis.…”

“…The clinical benefit of probiotic therapy depends on numerous factors, including the type of bacterium, route of administration, dosage, regimen, and other underlying host factors. Concerning the treatment of AR with probiotics, these studies showed a clinical improvement in the quality of life (QoL) and rhinitis symptoms, sometimes associated with immunological improvement [ 79 , 80 ].…”

Oral administration of Lactiplantibacillus plantarum NR16 isolated from Kimchi ameliorates murine allergic rhinitis

“…Currently, immunomodulatory effects of different Lactobacillus strains on innate or adoptive immunity have been studied to prevent or treat various health conditions, including inflammation, infection, hypersensitivity and cancer (George Kerry et al 2018). Indeed, certain strains are now considered potential therapeutic regimens to treat type I hypersensitivity, such as AR, atopic dermatitis and food allergy, since consumption of these strains could restore immune homeostasis by inducing immune tolerance to allergen, leading to reduced allergen-specific antibody production (Sharma and Im 2018;Pratap et al 2020;Sun et al 2021;Farahmandi et al 2022).…”