Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. Probiotics in Treatment of Allergic Rhinitis Effect of probiotics on allergic rhinitis in Df, Dp or dust-sensitive children: A randomized double blind controlled trial Treatment of perennial allergic rhinitis with lactic acid bacteria. Efficacy and safety of the probiotic Lactobacillus paracasei LP-33 in allergic rhinitis: a double-blind, randomized, placebo-controlled trial (GA2LEN Study) Frequency of diagnosis and treatment of allergic rhinitis among adults with asthma in Germany, France, and the UK: National Health and Wellness Survey Clinical and Immunological Benefits of OM-85 Bacterial Lysate in Patients with Allergic Rhinitis, Asthma, and COPD and Recurrent Respiratory Infections A survey of the burden of allergic rhinitis in the USA Preventing progression of allergic rhinitis: the role of specific immunotherapy Simultaneous treatment of asthma and allergic rhinitis. Poster 1014: Omalizumab efficiency in patients with allergic rhinitis and chronic sinusitis ‘Help for Hay Fever’, a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial No effect of probiotics on respiratory allergies: a seven-year follow-up of a randomized controlled trial in infancy. Obtaining concomitant control of allergic rhinitis and asthma with a nasally inhaled corticosteroid Intranasal Corticosteroid Administration Reduces Nonspecific Bronchial Hyperresponsiveness and Improves Asthma Symptoms Prediction of the incidence and persistence of allergic rhinitis in adolescence: a prospective cohort study. Effects of Probiotics on Allergic Rhinitis Induced by Japanese Cedar Pollen: Randomized Double-Blind, Placebo-Controlled Clinical Trial
Previous studies have suggested that probiotic administration may have therapeutic and /or preventive effects on atopic dermatitis in infants ; however , its role in allergic airway diseases remains controversial . To determine whether daily supplementation with specific Lactobacillus gasseri A5 for 8 weeks can improve the clinical symptoms and immunoregulatory changes in school children suffering from asthma and allergic rhinitis ( AR ) . We conducted a r and omized , double-blind , placebo-controlled study on school children ( age , 6 - 12 years ) with asthma and AR . The eligible study subjects received either L. gasseri A5 ( n = 49 ) or a placebo ( n = 56 ) daily for 2 months . Pulmonary function tests were performed , and the clinical severity of asthma and AR was evaluated by the attending physicians in the study period . Diary cards with records of the day- and nighttime peak expiratory flow rates ( PEFR ) , symptoms of asthma , and AR scores of the patients were used for measuring the outcome of the treatment . Immunological parameters such as the total IgE and cytokine production by the peripheral blood mononuclear cells ( P BMC s ) were determined before and after the probiotic treatments . Our results showed the pulmonary function and PEFR increased significantly , and the clinical symptom scores for asthma and AR decreased in the probiotic-treated patients as compared to the controls . Further , there was a significant reduction in the TNF-α , IFN-γ , IL-12 , and IL-13 production by the P BMC s following the probiotic treatment . In conclusion , probiotic supplementation may have clinical benefits for school children suffering from allergic airway diseases such as asthma and AR Many r and omized controlled trials ( RCTs ) have been done on role of probiotics as a treatment modality in allergic rhinitis . We conducted a review on the same . A systematic search of published literature was done . RCTs comparing effect of probiotics with placebo were included . A predefined set of outcome measures were assessed . Continuous data were expressed as pooled st and ardized mean difference ( SMD ) with 95 % confidence interval ( CI ) . Dichotomous data were expressed as odds ratio with 95 % CI . P value < 0.05 was considered significant . RevMan version 5 was used for all the analyses . Seven RCTs were eligible for inclusion .  Probiotic intake  improved quality of life score in patients with allergic rhinitis [ SMD -1.17 ( 95 % CI -1.47 , -0.86 ; P < 0.00001 ) ] . Other parameter that improved with probiotic intake was decrease in the number of episodes of rhinitis per year . There was no significant change in blood or immunologic parameters in the probiotic group , SMD -0.10 ( 95 % CI -0.26 , 0.06 ; P = 0.22 ) . Adverse events were not significant . Probiotic therapy might be useful in rhinitis , but the present data do not allow any treatment recommendations Objective To study , we examined the effect of Lactobacillus salivarius on the clinical symptoms and medication use among children with established allergic rhinitis ( AR ) . Design Double blind , r and omized , controlled trial . Setting Hualien Tzu-Chi General Hospital . Methods Atopic children with current allergic rhinitis received 4 × 109 colony forming units/g of Lactobacillus salivarius ( n=99 ) or placebo ( n=100 ) daily as a powder mixed with food or water for 12 weeks . The SCORing Allergic rhinitis index ( specific symptoms scores [ SSS ] and symptom medication scores [ SMS ] ) , which measures the extent and severity of AR , was assessed in each subject at each of the visits — 2 weeks prior to treatment initiation ( visit 0 ) , at the beginning of the treatment ( visit 1 ) , then at 4 ( visit 2 ) , 8 ( visit 3 ) and 12 weeks ( visit 4 ) after starting treatment . The WBC , RBC , platelet and , eosinophil counts as well as the IgE antibody levels of the individuals were evaluated before and after 3 months of treatment . Results The major outcome , indicating the efficacy of Lactobacillus salivarius treatment , was the reduction in rhinitis symptoms and drug scores . No significant statistical differences were found between baseline or 12 weeks in the probiotic and placebo groups for any immunological or blood cell variables . Conclusions Our study demonstrates that Lactobacillus salivarius treatment reduces rhinitis symptoms and drug usage in children with allergic rhinitis Probiotics are perceived to exert beneficial effects in the prevention and treatment of allergic diseases via modifying the gut ecosystem . The aim of this study was to assess whether ingestion of fermented milk containing Lactobacillus paracasei-33 ( LP-33 ) , a strain newly isolated from the human intestinal tract , can improve the quality of life of patients with perennial allergic rhinitis . In a r and omized , double-blind , placebo-controlled trial , we gave patients fermented milk with ( n = 60 ) or without ( n = 20 ) the addition of LP-33  ( 2 x 10(9 ) colony-forming units per bottle ) for 30 days . A modified question naire concerning pediatric rhinoconjunctivitis quality of life was administered to all subjects or their parents at each clinical visit . Scores for the overall quality of life significantly decreased in the LP-33 group as compared with the placebo group , in both frequency ( -16.02 + /- 2.14 vs. -7.27 + /- 3.55 , respectively ; p = 0.037 ) and level of bother ( -16.35 + /- 2.33 vs. -6.20 + /- 3.13 , respectively ; p = 0.022 ) after the 30-day treatment . Subjects reported no severe adverse effects such as fever , abdominal pain , or diarrhea . The results suggest that ingestion of LP-33-fortified fermented milk for 30 days can effectively and safely improve the quality of life of patients with allergic rhinitis , and may serve as an alternative treatment for allergic rhinitis Background / objectives : An imbalance between Th1 and Th2 cells is involved in allergic rhinitis ( AR ) that may be improved by probiotics . To test the efficacy of the probiotic Lactobacillus paracasei subsp . paracasei LP-33 , a double-blind , placebo-controlled , r and omized trial was carried out in patients with AR to grass pollen treated with loratadine and presenting altered quality of life . Subjects/ methods : Subjects with persistent AR , symptomatic during the grass pollen season , and a positive skin test or specific immunoglobulin E to grass pollens were included by general practitioners ( GPs ) . All received loratadine for 5 weeks . The primary end point was the improvement in Rhinitis Quality of Life ( RQLQ ) global score at the fifth week of LP-33 consumption compared with placebo ( in addition to loratadine ) . Secondary end points included nasal and ocular symptoms ( individual and total symptom scores ) , visual analogue scale and time of first exacerbation of the symptoms when loratadine was stopped . Results : A total of 425 subjects were included . Using intent-to-treat analysis , the RQLQ global score decreased significantly more in the LP-33 group than in the placebo group ( P=0.0255 , difference=−0.286 ( 95 % confidence interval ( CI ) : −0.536 ; −0.035 ) ) . No significant differences were noted for the change of the rhinitis total symptom score 5 global score between groups ( P=0.1288 , difference=−0.452 ( 95 % CI : −1.036 ; 0.132 ) ) . Significant differences in ocular symptoms ( RQLQ ) were observed between groups ( P=0.0029 , difference=−0.4087 ( 95 % CI : −0.6768 ; −0.1407 ) ) . Conclusions : This study performed by GPs shows that LP-33 improves the quality of life of subjects with persistent AR who are currently being treated with an oral H1-antihistamine . Whereas nasal symptoms had not changed , ocular symptoms had consistently improved ABSTRACT Background : Concomitant allergic rhinitis ( AR ) adds to the symptomatic burden of asthma . Scope : To determine the proportion of adults with concomitant asthma and AR whose AR is diagnosed and /or treated , data were derived from a cross-sectional , stratified , r and om sample of 26,468 adults from France , Germany and the UK , participants in the 2004 web-based National Health and Wellness Survey . Patients were drawn from the data base if they reported ( 1 ) experiencing asthma in the prior 12 months , ( 2 ) a physician diagnosis of asthma , and ( 3 ) ever experiencing ‘ nasal allergies/hay fever ’ ( physician diagnosed or self-reported symptoms ) . Findings : Of 1139 patients with asthma who reported AR , 203 ( 18 % ) did not have a diagnosis of AR . Of these , 86 ( 42 % ) pursued  over-the-counter self-treatment  for AR , and 117 ( 58 % ) remained untreated . Of 936 patients who reported diagnosed AR , 471 ( 50 % ) received AR prescriptions , 200 ( 21 % ) pursued over-the-counter self-treatment , and 265 ( 28 % ) remained untreated . Overall , 34 % of patients with asthma and diagnosed or self-reported AR were not treated for AR . There were no significant differences in QoL over the prior 4 weeks , nor healthcare re source use over the prior 6 months between patients treated and those not treated for AR . Conclusion : Based on self-reported data , despite global treatment guidelines recommending evaluation and treatment of AR among patients with asthma , AR was not diagnosed for 1 in 5 patients , and AR was not treated for 1 in 3 patients with asthma Purpose The aim of this study was to evaluate the efficacy of OM-85 in reducing the incidence of respiratory tract infections ( RTIs ) in patients with allergic rhinitis , asthma , or chronic obstructive pulmonary disease ( COPD ) , and its effect on immunological parameters , namely serum and secretory IgA levels . Methods This was an open-label , prospect i ve , sequential study which included 84 consecutive patients aged 16–65 years , who presented with recurrent ( three or more ) respiratory infections during the year prior to study entry . In the first year of the study , patients received st and ard optimized care ( SOC ) , according to their underlying disease condition ( asthma , allergic rhinitis , or COPD ) . In the following year , patients received treatment with OM-85 oral bacterial lysate ( one 7 mg capsule daily for ten consecutive days per month , for 3 months ) , with a 6-month follow-up . Medical history , clinical symptoms , serum , and secretory IgA levels , and the number of infections and exacerbations were evaluated before and after treatment . Results There was a decrease in the total number of RTIs before the OM-85 treatment period ( SOC only ) compared to the year before the study start [ 69/266 ( corresponding to a 74 % reduction ) ] and an additional decrease [ 38/69 ( corresponding to a 45 % reduction ) ] after OM-85 treatment ; p < 0.05 . There was also a significant reduction in the total number of exacerbations related to the patients ’ underlying medical conditions , which decreased from 55 to 35 during OM-85 ( + SOC ) treatment , corresponding to a reduction of 36 % . In addition , an increase in serum and secretory IgA levels which coincided with the administration of OM-85 was observed . Conclusions Our results showed the clinical benefits of OM-85 in reducing RTIs and exacerbations of the underlying medical condition , in patients with allergic rhinitis , asthma , or COPD Background : A prospect i ve , cross‐sectional , international survey was conducted among patients and physicians to identify symptom perception and the impact of allergic rhinitis ( AR ) on health‐related quality of life ( HRQoL ) . This paper presents the results from the USA Allergic rhinitis and asthma are examples of allergic airways disease . Despite their differing symptomatology , both disorders affect the mucosal lining of the respiratory tract and are linked by common underlying cellular processes , thus , using the ‘ united airways ’ approach , they can be considered part of the same allergic disease . The conditions are often comorbid , and there is evidence to suggest that allergic rhinitis in children is a significant risk factor for subsequent development of asthma . Management strategies that target the underlying cause of allergic rhinitis in children have the potential to offer additional symptom control above that of symptomatic medications , and prevent disease progression . Specific immunotherapy ( SIT ) is the only currently available treatment that is proven to target the disease in this way . SIT affects the underlying cause of allergic rhinitis , producing changes in antibody responses to allergens . It has been shown to be effective in the reduction of  allergic rhinitis symptoms in both children and adults , with effects being sustained for several years after treatment completion . Furthermore , a number of trials provide evidence that SIT may prevent the development of new sensitisations and asthma in children and adults with allergic rhinitis . One such open-label , r and omised controlled study in children/adolescents ( the Preventive Allergy Treatment Study ) showed that significantly fewer patients who received 3 years of  SIT  for grass/birch pollen-induced allergic rhinitis had developed asthma 10 years after treatment initiation versus controls . Some clinical guidelines acknowledge this potential asthma preventive effect in children and the need for additional data from double-blind , placebo-controlled trials to support these findings Asthma and allergic rhinitis ( AR ) form a well-recognized comorbidity . This study aims at assessing the efficacy of nasally inhaled beclomethasone dipropionate ( BDP ) in their simultaneous treatment . A r and omized controlled trial was conducted with 78 allergic rhinitis and asthma patients aged 5 - 17 years . Seventy-five individuals completed the study . During 8 weeks , 38 subjects received BDP-CFC aerosol ( > or= 500 mcg/day ) exclusively via nasal inhalation through a facemask attached to a plastic valved spacer . The control group ( 37 patients ) received 200 mcg/day of aqueous intranasal beclomethasone plus oral inhalation of BDP-CFC ( > or= 500 mcg/day ) through a mouthpiece connected to the same spacer . Primary outcomes analyzed in order to assess the response to treatment were clinical scoring for allergic rhinitis and measurements of nasal inspiratory peak flow ( NIPF ) . AR clinical scoring and NIPF did not differ in the two groups at admission or at nearly all follow-up visits . Nasal inhalation of beclomethasone dipropionate provides AR symptom relief while maintaining control of asthma by delivering it to the lungs . Therefore , this therapeutic strategy might be considered for patients suffering from this comorbidity , especially in low-re source countries , since it is less expensive than the conventional treatment Background Allergic rhinitis ( AR ) is a very common chronic respiratory disorder and has also been shown to negatively impact quality of life with many comorbiliditys like Chronic rhinosinusitis ; There is evidence that IgE antibodies play a role in chronic sinusitis . Investigations have shown that total IgE levels correlate with the severity of sinusitis , as assessed by CT scan . Allergies occur more frequently in patients with chronic sinusitis than in the general population . Omalizumab has shown to be effective for AR in allergen challenge studies and clinical trials . Multiple r and omized , double-blind , placebo-controlled studies have shown efficacy of omalizumab in seasonal and perennial AR Background Despite the availability of evidence -based guidelines for managing allergic rhinitis in primary care , management of the condition in the United Kingdom ( UK ) remains sub-optimal . Its high prevalence and negative effects on quality of life , school performance , productivity and co-morbid respiratory conditions ( in particular , asthma ) , and high health and societal costs , make this a priority for developing novel models of care . Recent Australian research demonstrated the potential of a community pharmacy-based ‘ goal -focused ’ intervention to help people with intermittent allergic rhinitis to self-manage their condition better , reduce symptom severity and improve quality of life . In this pilot study we will assess the transferability of the goal -focused intervention to a UK context , the suitability of the intervention material s , procedures and outcome measures and collect data to inform a future definitive UK r and omized controlled trial ( RCT ) . Methods / Design A pilot cluster RCT with associated preliminary economic analysis and embedded qualitative evaluation . The pilot trial will take place in two Scottish Health Board areas : Grampian and Greater Glasgow & Clyde . Twelve community pharmacies will be r and omly assigned to intervention or usual care group . Each will recruit 12 customers seeking advice or treatment for intermittent allergic rhinitis . Pharmacy staff in intervention pharmacies will support recruited customers in developing strategies for setting and achieving goals that aim to avoid/minimize triggers for , and eliminate/minimize symptoms of allergic rhinitis . Customers recruited in non-intervention pharmacies will receive usual care . The co- primary outcome measures , selected to inform a sample size calculation for a future RCT , are : community pharmacy and customer recruitment and completion rates ; and effect size of change in the vali date d mini-Rhinoconjunctivitis Quality of Life Question naire between baseline , one-week and six-weeks post-intervention . Secondary outcome measures relate to changes in symptom severity , productivity , medication adherence and self-efficacy . Quantitative data about accrual , retention and economic measures , and qualitative data about participants ’ experiences during the trial will be collected to inform the future RCT . Discussion This work will lay the foundations for a definitive RCT of a community pharmacy-based ‘ goal -focused ’ self-management intervention for people with intermittent allergic rhinitis . Results of the pilot trial are expected to be available in April 2013.Trial registration Current Controlled TrialsIS RCT BACKGROUND Supplementation with the probiotic Lactobacillus reuteri reduced the incidence of IgE-associated allergic disease in infancy . This treatment might therefore also reduce the risk of asthma and allergic rhinoconjunctivitis in school age . OBJECTIVE To evaluate whether perinatal and infant supplementation with L. reuteri reduced the prevalence of respiratory allergic disease in school age and to explore whether this supplementation was associated with any long-term side effects . METHODS A r and omized , placebo-controlled trial with oral supplementation with L. reuteri ATCC 55730 ( 1 × 10(8 ) CFU ) during the last month of gestation and through the first year of life comprising 232 families with allergic disease , of whom 184 completed a 7-yr follow-up . The primary outcomes at 7 yr of age were allergic disease and skin prick test reactivity ( Clinical Trials.gov ID NCT01285830 ) . RESULTS The prevalence of asthma ( 15 % in the probiotic vs. 16 % in placebo group ) , allergic rhinoconjunctivitis ( 27 % vs. 20 % ) , eczema ( 21 % vs. 19 % ) and skin prick test reactivity ( 29 % vs. 26 % ) was similar in the probiotic and placebo group . Growth indices and gastrointestinal symptoms were similar in the two groups . No severe adverse events were reported . CONCLUSION The effect of L. reuteri on sensitization and IgE-associated eczema in infancy did not lead to a lower prevalence of respiratory allergic disease in school age . Thus , the effect of L. reuteri on the immune system seems to be transient . Administration of L. reuteri during the last weeks of gestation and in infancy was not associated with any long-term side effects Allergic rhinitis ( AR ) and asthma coexist frequently and a dual treatment is recommended by prescribing topical nasal plus oral inhaled corticosteroids . The purpose of this study was to assess the efficacy of a nasally inhaled corticosteroid aim ing at concomitant control of AR and asthma . A controlled trial was conducted among 60 patients with AR and asthma , aged 6–18 years , who were r and omized into two groups . During 8 weeks , the experimental group ( 30 patients ) received exclusively fluticasone propionate hydrofluoroalkane ( FP‐HFA ) inhaled through the nose ( mouth closed ) using a large volume spacer attached to a face mask . The comparison group ( 30 patients ) received a nasal spray of isotonic saline plus oral inhalation of FP‐HFA through a mouthpiece attached to the same spacer . Clinical scores for AR and asthma , nasal inspiratory peak flow ( NIPF ) , and spirometry were assessed by blinded observers . There was a significant improvement in AR scores and NIPF in the experimental group ( P ≤ 0.01 ) up to week 8 , when a worsening was observed after the intervention was interrupted . Asthma symptoms score , forced expiratory volume (FEV)1 , and FEF25−75 % were not statistically different between groups at the baseline visit or along follow‐up visits ( P ≥ 0.20 ) . Prebronchodilator FEV1 ( % predicted value ) improved by 10 % in both groups , comparing values at inclusion with those obtained at the end of follow up . Our results suggest that nasally inhaled FP‐HFA through a spacer may control AR and asthma in children and adolescents . This approach is likely to result in higher compliance , lower costs , and fewer side effects Introduction . Rhinitis and asthma are currently recognized as manifestations of a single syndrome , the chronic allergic respiratory syndrome . Nearly all individuals with asthma have rhinitis , and severe rhinitis has been associated with worse outcomes in asthma patients . Intranasal treatment has been reported to be beneficial for the lower airways . Methods . This was a r and omized , double-blind , placebo-controlled study . The objective was to evaluate the effects that treatment with intranasal beclomethasone dipropionate ( BDP ; 400 μ g/d ) has on nasal and bronchial symptoms , as well as on lung function test results and bronchial responsiveness to histamine in patients with allergic rhinitis and asthma . We evaluated 33 patients , divided into two groups : treatment ( n = 17 ) ; and  placebo ( n = 16 ) . Over the course of the 125-day study period , each patient reported daily rhinitis and asthma symptoms , as well as the need for additional medication . All patients were su bmi tted to spirometry and histamine challenge at baseline and at each subsequent evaluation ( on days 50 and 75 ) . Results . In comparison with the patients in the placebo group , those in the BDP treatment group presented significantly fewer nasal symptoms on day 50 and fewer asthma symptoms on day 75 ( p < 0.01 for both ) ; required rescue medications less often ; and presented a significantly lower degree of bronchial responsiveness to histamine on day 75 ( p < 0.01 ) . Conclusion . In this study , intranasal BDP was effective in treating rhinitis as well as asthma . The benefits for the lower airways were observed only after prolonged treatment and might be better evaluated through nonspecific bronchial challenge BACKGROUND Predictive models have rarely been used in allergy research and practice . However , they might support physicians in advising patients . OBJECTIVE The aim of this study was to create predictive models for the incidence and persistence of  allergic rhinitis ( AR ) during adolescence . METHODS A prospect i ve population -based cohort study was conducted starting at age 9 to 11 years . Potential risk factors for atopic diseases obtained at baseline in 2810 subjects were used to create predictive logistic regression models for the incidence and persistence of physician-diagnosed AR with current symptoms at age 15 to 18 years . RESULTS Positive skin prick test responses to outdoor allergens at baseline were the most important determinant for both the incidence and persistence of AR until follow-up . For the incidence of AR , positive skin prick test responses to indoor allergens , parental history of asthma , female sex , and not having been breast-fed exclusively for 2 or more months were additional statistically significant independent risk factors . Depending on the number of risk factors present , the probability of the incidence of AR increased from 2 % ( no risk factors present ) to 72 % ( full model ; 95 % CI , 58 % to 85 % ) . The probability of persistence of AR ranged from 33 % ( no risk factors present ) to 83 % ( full model ; 95 % CI , 70 % to 97 % ) . CONCLUSION The course of AR over puberty can be predicted using risk factors that are easy to determine in childhood . Sensitization to outdoor allergens seems to play a much greater role for disease development than sensitization to indoor allergens . This might help pediatricians in advising patients Background : Lactobacillus casei strain Shirota ( LcS ) has been found to exert antiallergic effects in animal experiments , but there is little information about its clinical effects in human patients with allergy . Methods : We performed a r and omized double-blind , placebo-controlled study to investigate the effects of LcS in patients with allergic rhinitis triggered by Japanese cedar pollen ( JCP ) . Participants were asked to drink fermented milk containing LcS ( LcS group ) or placebo ( control group ) for 8 weeks . Clinical symptoms and immunological parameters were compared between the two groups . Results : Symptom-medication scores ( SMS ) worsened in accordance with the increase in the amount of scattered JCP . In terms of the nasal and ocular SMS , there was no significant difference between the LcS group and the placebo group during the ingestion period . In the subgroup of patients with moderate-to-severe nasal symptom scores before starting the ingestion of test sample s , supplementation with LcS tended to reduce nasal SMS . Conclusion : These results indicate that fermented milk containing LcS does not prevent allergic symptoms in patients sensitive to JCP , but may delay the occurrence of allergic symptoms in patients with moderate-to-severe nasal symptom scores
Conclusions The current evidence is not sufficiently strong to verify a preventive role of probiotics in AR , but probiotics may improve the overall quality of life and nasal symptom scores .
Background Allergic rhinitis ( AR ) is a disease of respiratory allergy , and probiotics can provide a potential strategy for its management .
The purpose of this study was to carry out a systematic review to investigate the role of probiotics in the prevention and treatment of AR .