Efficacy of probiotic supplementary therapy for asthma, allergic rhinitis, and wheeze: a meta-analysis of randomized controlled trials

Du, Xiao; Wang, Leyuan; Wu, Shuangyan; Lin, Yuan; Tang, Sha; Xiang, Yang; Qu, Xiangping; Liu, Huijun; Qin, Xiaoqun; Liu, Chi

doi:10.2500/aap.2019.40.4227

Cited by 66 publications

(44 citation statements)

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“…According to the World Health Organization (WHO), 2001, probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit to the host [137]. Their efficacy in asthma prevention and treatment is not absolutely clear at the moment, however, a recent meta-analysis of RCTs in six databases showed in long-term follow-up that the administration of Lactobacillus rhamnosus (LGG) facilitated the prevention of asthma [138].…”

Section: Asthma Prevention I) Probioticsmentioning

confidence: 99%

“…Also, database reviews concluded that the current evidence is much stronger for probiotics being effective in eczema and allergic rhinitis rather than in prevention [154] or treatment of asthma [132,155,156]. Contrasting this, a recent meta-analysis evaluating also sub-groups for application of specific strains suggested that supplementation with explicitly LGG in the postnatal period may be beneficial in asthma prevention [138]. At the moment, it is stated by international health organizations and allergy organization guidelines that more studies are needed on whether asthma/wheezing prevention with probiotics is effective, as studies to date may "not have used the right probiotic, the right dose, the right timing or duration and/or population" [157,158].…”

Section: Asthma Prevention I) Probioticsmentioning

confidence: 99%

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Dysbiosis of the gut and lung microbiome has a role in asthma

et al. 2020

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Worldwide 300 million children and adults are affected by asthma. The development of asthma is influenced by environmental and other exogenous factors synergizing with genetic predisposition, and shaping the lung microbiome especially during birth and in very early life. The healthy lung microbial composition is characterized by a prevalence of bacteria belonging to the phyla Bacteroidetes, Actinobacteria, and Firmicutes. However, viral respiratory infections are associated with an abundance of Proteobacteria with genera Haemophilus and Moraxella in young children and adult asthmatics. This dysbiosis supports the activation of inflammatory pathways and contributes to bronchoconstriction and bronchial hyperresponsiveness. Exogenous factors can affect the natural lung microbiota composition positively (farming environment) or negatively (allergens, air pollutants). It is evident that also gut microbiota dysbiosis has a high influence on asthma pathogenesis. Antibiotics, antiulcer medications, and other drugs severely impair gut as well as lung microbiota. Resulting dysbiosis and reduced microbial diversity dysregulate the bidirectional crosstalk across the gut-lung axis, resulting in hypersensitivity and hyperreactivity to respiratory and food allergens. Efforts are undertaken to reconstitute the microbiota and immune balance by probiotics and engineered bacteria, but results from human studies do not yet support their efficacy in asthma prevention or treatment. Overall, dysbiosis of gut and lung seem to be critical causes of the increased emergence of asthma.

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Section: Asthma Prevention I) Probioticsmentioning

confidence: 99%

Section: Asthma Prevention I) Probioticsmentioning

confidence: 99%

Dysbiosis of the gut and lung microbiome has a role in asthma

et al. 2020

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“…Since atopy is a risk factor for asthma, it has been proposed that probiotics may potentially stimulate Th1 and decrease allergic asthma. Accordingly, there are some data that probiotics supplementation may be of benefit in the prevention of wheeze or asthma (49). Another potential approach is to investigate strategies that prevent viral respiratory tract infections to reduce the development of asthma.…”

Section: Virus and Allergymentioning

confidence: 99%

Preschool Wheezing: Trajectories and Long-Term Treatment

2020

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Wheezing is very common in infancy affecting one in three children during the first 3 years of life. Several wheeze phenotypes have been identified and most rely on temporal pattern of symptoms. Assessing the risk of asthma development is difficult. Factors predisposing to onset and persistence of wheezing such as breastfeeding, atopy, indoor allergen exposure, environmental tobacco smoke and viral infections are analyzed. Inhaled corticosteroids are recommended as first choice of controller treatment in all preschool children irrespective of phenotype, but they are particularly beneficial in terms of fewer exacerbations in atopic children. Other therapeutic options include the addition of montelukast or the intermittent use of inhaled corticosteroids. Overuse of inhaled steroids must be avoided. Therefore, adherence to treatment and correct administration of the medications need to be checked at every visit.

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“…138 Specifically, administration of Lactobacillus rhamnosus has been shown to prevent asthma development. 139 When asthmatic children were orally administered a combination of Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus delbrueckii subspecies Bulgaricus, an improvement in lung function and a reduction in asthma exacerbations were observed. 140 Lactobacillus paracasei, Lactobacillus fermentum, and Lactobacillus gasseri could also alleviate asthma symptoms and decrease IgE levels in children.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

<p>Dynamic Interplay Between Microbiota and Mucosal Immunity in Early Shaping of Asthma and its Implication for the COVID-19 Pandemic</p>

AlKhater¹

2020

JAA

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The crosstalk between host immunity and the external environment in the mucous membranes of the gastrointestinal and respiratory tracts in bronchial asthma has recently been scrutinized. There is compelling evidence that the microbiota at these sites may play an important role in the pathogenesis of this chronic airway disease. The appearance of bacteria early in life in the gut before dissemination to the airways plays a pivotal role in shaping mucosal immunity. Loss of microbial diversity or dysbiosis can result in aberrant immunemediated inflammation and mucosal barrier disruption, which coincides clinically with the successive development of the "allergic march" in asthma. Microbial manipulation may be effective in curbing asthma development by indirectly preserving homeostatic epithelial barrier functions. The protective effects and mechanisms of immunity-microbiome crosstalk at mucosal sites require further investigation to identify therapeutic and preventive measures in asthma. This topical review aims to highlight new evidence that compromised epithelial barrier function, which results in deregulated crosstalk between the microbiome and host mucosal immune system, is an important disease mechanism in asthma. In the light of current COVID-19 pandemic, the collective findings on the impact of mucosal microbiota on the suceptibility to SARS-CoV-2 infection and severity of COVID-19 is explored. The possible therapeutic implications to target these abnormalities are further discussed.

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Efficacy of probiotic supplementary therapy for asthma, allergic rhinitis, and wheeze: a meta-analysis of randomized controlled trials

Cited by 66 publications

References 0 publications

Dysbiosis of the gut and lung microbiome has a role in asthma

Dysbiosis of the gut and lung microbiome has a role in asthma

Preschool Wheezing: Trajectories and Long-Term Treatment

<p>Dynamic Interplay Between Microbiota and Mucosal Immunity in Early Shaping of Asthma and its Implication for the COVID-19 Pandemic</p>

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