Topical Probiotics as a Therapeutic Alternative for Chronic Rhinosinusitis: A Preclinical Proof of Concept

Schwartz, Jacob; Peres, Adam G.; Endam, Léandra Mfuna; Cousineau, Benoit; Madrenas, Joaquı́n; Desrosiers, Martin

doi:10.2500/ajra.2016.30.4372

Cited by 36 publications

(30 citation statements)

References 25 publications

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“…In another study, Bifidobacterium lactis AD011 increased the production of IL‐10 in a co‐culture with DCs and IECs, whereas L. casei IBS041 and Lactobacillus acidophilus AD031 increased TGF‐β secretion in this co‐culture system . Similar results were obtained in another co‐culture system containing peripheral blood mononuclear cells and L. lactis , that is, an increased secretion of the anti‐inflammatory cytokine IL‐10 . The in vitro data are further supported by in vivo studies in mouse models of allergic airway disease.…”

Section: Probiotic Interactions With the Immune Systemsupporting

confidence: 66%

Probiotics for the airways: Potential to improve epithelial and immune homeostasis

Martens

Pugin

Boeck

et al. 2018

Allergy

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Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefit on the host. The therapeutic effects of probiotics have been mostly studied in the gastrointestinal tract, but recent evidence points toward the potential of these bacteria to prevent and/or treat chronic airway diseases. In this review, possible mechanisms of action of probiotics in the airways are described, with a particular focus on their capacity to modulate the epithelial barrier function and their mode of interaction with the immune system. Indeed, probiotic bacteria, mostly lactobacilli, can promote the expression and regulation of tight junctions and adherence junctions, resulting in the restoration of a defective epithelial barrier. These bacteria interact with the epithelial barrier and immune cells through pattern recognition receptors, such as Toll-like receptors, which upon activation can stimulate or suppress various immune responses. Finally, the clinical potential of probiotics to treat inflammatory diseases of the upper and lower respiratory tract, and the difference between their mode of application (eg, oral or nasal) are discussed here.

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Section: Probiotic Interactions With the Immune Systemsupporting

confidence: 66%

Probiotics for the airways: Potential to improve epithelial and immune homeostasis

Martens

Pugin

Boeck

et al. 2018

Allergy

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“…To complicate matters further some species may act as commensal under certain circumstances, for example in low abundance or in concert with other microbes, where under different circumstance the same species may induce an inflammatory response. This seems to be the case with S. Aureus where in low abundance it may act as a commensal (Schwartz et al, 2016 ). Our own experiments confirm that certain strains of Propionibacterium , may act as a commensal, but under certain circumstances enhance the growth of pathogens (unpublished data).…”

Section: The Role Of the Commensal Microbiome In The Upper Airwaymentioning

confidence: 99%

The Potential for Topical Probiotic Treatment of Chronic Rhinosinusitis, a Personal Perspective

Cervin

2018

Front. Cell. Infect. Microbiol.

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This review describes the rationale for topical probiotic intervention, the obstacles we are facing and a strategy for future research in the use of probiotics to modify CRS symptoms and disease expression. Recent advances in molecular microbiology has revealed a plethora of microbial DNA in the nasal cavity and sinuses of healthy subjects as well as in chronic sinusitis (CRS) patients. An infection is today rather seen as an imbalance between the commensal microbiome and the bacterial pathogens, resulting in a reduction in commensal bacterial diversity, combined with an increase in the growth of microbes eliciting an inflammatory response. This will in turn lead to the clinical symptoms of sinusitis. Probiotics (microorganisms that confer a health benefit) can be used either as a form of living antibiotics treatment, or as an immune-modulatory intervention. Topical probiotics, which is the focus of this review, have shown efficacy in a limited number of trials in otitis media and tonsillitis, but to date not in CRS. Although bacterial interference capacity against pathogens can be determined in in vitro experiments, it may not translate to a health benefit. This limits the role of laboratory research in identifying probiotic strains with a clinical benefit. To gain more clinical experience without further delay, I recommend future research to focus on empirical clinical trials in well-defined CRS patient populations and study the underlying mechanisms in more detail once a clinical benefit has been established.

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“…In 2018, Cervin analyzed probiotics as treatment of chronic sinus infections and pointed out that, although the potential of probiotics has been shown in vitro and in other studies (Table ), it had yet not shown clinical benefit or efficacy in CRS. Further studies were recommended focusing on empirical trials in well‐defined CRS in advance of detailing the underlying mechanism.…”

Section: Resultsmentioning

confidence: 99%

Future topical medications in chronic rhinosinusitis

Miyake

Bleier

2019

Int Forum Allergy Rhinol

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Background:Research has progressed rapidly in recent decades to be er understand the etiopathogenesis and management paradigms of chronic rhinosinusitis (CRS). Although oral antibiotics o en mitigate symptoms in acute CRS exacerbations, eradication of polymicrobial biofilms and multidrug-resistant bacteria remains a challenge. The goal of this review is to summarize and discuss the potential and pitfalls of topical medications in the treatment of CRS. Methods:A related literature review was performed using PubMed and Scopus, with only the English database included. Results:The main therapies were selected and separated in sections. Details regarding future topical treatments of CRS were summarized and discussed. Conclusion:The ease of access of the sinonasal mucosa positions CRS as a disease with high potential for local topical treatment. The ultimate adoption of topical agents will require continued expansion of our understanding of novel local targets in CRS as well as improved methods to deliver and retain the drug of interest at the site of activity. C 2019 ARS-AAOA, LLC.

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Topical Probiotics as a Therapeutic Alternative for Chronic Rhinosinusitis: A Preclinical Proof of Concept

Abstract: We identified well-tolerated, nonpathogenic, "generally recognized as safe" status gram-positive probiotics with anti-inflammatory properties. Topical probiotics represented a potential novel topical therapeutic strategy for CRS relevant for further clinical evaluation.

Cited by 36 publications

References 25 publications

Probiotics for the airways: Potential to improve epithelial and immune homeostasis

Probiotics for the airways: Potential to improve epithelial and immune homeostasis

The Potential for Topical Probiotic Treatment of Chronic Rhinosinusitis, a Personal Perspective

Future topical medications in chronic rhinosinusitis

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