Specific probiotics alleviate allergic rhinitis during the birch pollen season.

AIM To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these. METHODS Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus (L. acidophilus) NCFM (ATCC 700396) and Bifidobacterium lactis (B. lactis) Bl-04 (ATCC SD5219) or placebo in a double-blind manner for 4 mo, starting prior to onset of the birch pollen season. Symptoms were recorded in a diary. Blood samples were taken for analysis of cytokines and eosinophils. Fecal samples were analysed for microbiota components, calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils. RESULTS The pollen season induced a reduction in Bifidobacterium, Clostridium and Bacteroides which could not be prevented by the probiotic intervention. During the intervention, significantly higher numbers of B. lactis 11.2 x 10(7) +/- 4.2 x 10(7) vs 0.1 x 10(7) +/- 0.1 x 10(7) bacteria/g feces (P < 0.0001) and L. acidophilus NCFM 3.5 x 10(6) +/- 1.3 x 10(6) vs 0.2 x 10(6) +/- 0.1 x 10(6) bacteria/g feces (P < 0.0001) were observed in the probiotic group compared to the placebo group. During May, there was a tendency for fewer subjects, (76.2% vs 95.2%, P = 0.078) to report runny nose, while during June, fewer subjects, 11.1% vs 33.3%, reported nasal blocking in the probiotics group (P = 0.101). Concomitantly, fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group, 57.1% vs 95% (P = 0.013). Eye symptoms tended to be slightly more frequent in the probiotic group, 12.5 d [interquartile range (IQR) 6-18] vs 7.5 d (IQR 0-11.5) (P = 0.066) during May. Fecal IgA was increased in the placebo group during the pollen season; this increase was prevented by the probiotics (P = 0.028). CONCLUSION Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.

[1]  K. Akiyama,et al.  Effect of fermented milk prepared with two probiotic strains on Japanese cedar pollinosis in a double-blind placebo-controlled clinical study. , 2009, International journal of food microbiology.

[2]  J. Arqués,et al.  Oral delivery of Lactobacillus casei Shirota modifies allergen‐induced immune responses in allergic rhinitis , 2008, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[3]  K. Laitinen,et al.  Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double‐blind placebo‐controlled study , 2008, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[4]  A. Ouwehand,et al.  Influence of a combination of Lactobacillus acidophilus NCFM and lactitol on healthy elderly: intestinal and immune parameters. , 2008, The British journal of nutrition.

[5]  W. M. Vos,et al.  Intestinal Integrity and Akkermansia muciniphila, a Mucin-Degrading Member of the Intestinal Microbiota Present in Infants, Adults, and the Elderly , 2007, Applied and Environmental Microbiology.

[6]  S. Salminen,et al.  Probiotics during the first 7 years of life: a cumulative risk reduction of eczema in a randomized, placebo-controlled trial. , 2007, The Journal of allergy and clinical immunology.

[7]  D. Brassart,et al.  Correlation between in vitro and in vivo immunomodulatory properties of lactic acid bacteria. , 2007, World journal of gastroenterology.

[8]  M. Tamura,et al.  Effects of Probiotics on Allergic Rhinitis Induced by Japanese Cedar Pollen: Randomized Double-Blind, Placebo-Controlled Clinical Trial , 2006, International Archives of Allergy and Immunology.

[9]  P. Lackie,et al.  Reduced structural proteins in the conjunctival epithelium in allergic eye disease , 2006, Allergy.

[10]  C. Daniel,et al.  Selecting Lactic Acid Bacteria for Their Safety and Functionality by Use of a Mouse Colitis Model , 2006, Applied and Environmental Microbiology.

[11]  D. Strachan,et al.  Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys , 2006, The Lancet.

[12]  G. Rasp,et al.  Factors contributing to nasal allergic late phase eosinophilia. , 2006, American journal of otolaryngology.

[13]  N. Yamamoto,et al.  Effect of Milk Fermented with Lactobacillus acidophilus Strain L-92 on Symptoms of Japanese Cedar Pollen Allergy: A Randomized Placebo-Controlled Trial , 2005, Bioscience, biotechnology, and biochemistry.

[14]  S. Salminen,et al.  New Real-Time Quantitative PCR Procedure for Quantification of Bifidobacteria in Human Fecal Samples , 2004, Applied and Environmental Microbiology.

[15]  M. Saarinen,et al.  Combination of polydextrose and lactitol affects microbial ecosystem and immune responses in rat gastrointestinal tract. , 2004, The British journal of nutrition.

[16]  S. Salminen,et al.  Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial , 2003, The Lancet.

[17]  W. Holben,et al.  Phylogenetic Analysis of Intestinal Microflora Indicates a Novel Mycoplasma Phylotype in Farmed and Wild Salmon , 2002, Microbial Ecology.

[18]  T. Haahtela,et al.  No effect of oral treatment with an intestinal bacterial strain, Lactobacillus rhamnosus (ATCC 53103), on birch‐pollen allergy: a placebo‐controlled double‐blind study , 2002, Allergy.

[19]  S. Salminen,et al.  Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial , 2001, The Lancet.

[20]  H. Hoogsteden,et al.  Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways. , 2001, The Journal of allergy and clinical immunology.

[21]  S. Salminen,et al.  Probiotics in the management of atopic eczema , 2000, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[22]  H. Harmsen,et al.  Comparison of viable cell counts and fluorescence in situ hybridization using specific rRNA-based probes for the quantification of human fecal bacteria. , 2000, FEMS microbiology letters.

[23]  Jin-zhong Xiao,et al.  Clinical efficacy of probiotic Bifidobacterium longum for the treatment of symptoms of Japanese cedar pollen allergy in subjects evaluated in an environmental exposure unit. , 2007, Allergology international : official journal of the Japanese Society of Allergology.

[24]  M. Sakamoto,et al.  Fluctuation of fecal microbiota in individuals with Japanese cedar pollinosis during the pollen season and influence of probiotic intake. , 2007, Journal of investigational allergology & clinical immunology.

[25]  S. Salminen,et al.  Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. , 2001, The Journal of allergy and clinical immunology.

[26]  H. Hoogsteden,et al.  Segmental bronchoprovocation in allergic rhinitis patients affects mast cell and basophil numbers in nasal and bronchial mucosa. , 2001, American journal of respiratory and critical care medicine.

[27]  H. Harmsen,et al.  Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods. , 2000, Journal of pediatric gastroenterology and nutrition.

[28]  G. Settipane,et al.  Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. , 1994, Allergy proceedings : the official journal of regional and state allergy societies.