1
|
Ghanbari F, Hasani S, Aghili ZS, Asgary S. The potential preventive effect of probiotics, prebiotics, and synbiotics on cardiovascular risk factors through modulation of gut microbiota: A review. Food Sci Nutr 2024; 12:4569-4580. [PMID: 39055176 PMCID: PMC11266939 DOI: 10.1002/fsn3.4142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/06/2024] [Accepted: 03/17/2024] [Indexed: 07/27/2024] Open
Abstract
Cardiovascular diseases (CVDs) are a significant contributor to global morbidity and death, underscoring the importance of their prevention and treatment. The association between the development and progression of CVD and several risk factors has been extensively studied. Among these risk factors, the gut microbiota has garnered considerable attention of the scientific community during the last two decades. In particular, dysbiosis is directly associated with many risk factors of CVD in the host, such as diabetes. Prior research has demonstrated a robust correlation between dysbiosis and the development of CVD. Probiotics, prebiotics, and synbiotics are considered important regulators of microbiota imbalances as they increase the colonization of beneficial bacteria and thereby alter the gut microbiota. Although these beneficial effects of biotics are now widely recognized, new evidence has demonstrated that target therapy of the microbiota affects many other organs, including the heart, through a process commonly referred to as the gut-heart axis. In this review, we will discuss the potential benefits of probiotics, prebiotics, and synbiotics for the beneficial effects on cardiovascular disease by modulating gut microbiota.
Collapse
Affiliation(s)
- Fahimeh Ghanbari
- Applied Physiology Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Samira Hasani
- Department of Plant and Animal Biology, Faculty of Biological Science and TechnologyUniversity of IsfahanIsfahanIran
| | - Zahra Sadat Aghili
- Department of Molecular Medicine, School of Advanced TechnologiesShahrekord University of Medical SciencesShahrekordIran
| | - Sedigheh Asgary
- Isfahan Cardiovascular Research Center, Cardiovascular Research InstituteIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
2
|
Strisciuglio C, Vitale A, Perna F, Garziano F, Dolce P, Vitale S, Micillo T, Oglio F, Del Giudice MM, Matarese G, Gianfrani C. Bifidobacteria modulate immune response in pediatric patients with cow's milk protein allergy. Pediatr Res 2023; 94:1111-1118. [PMID: 36959319 DOI: 10.1038/s41390-023-02534-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/15/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND In children with an allergy to cow's milk proteins (CMA), the altered composition of intestinal microbiota influences the immune tolerance to milk proteins (CMP). This study aims to investigate the effect of probiotics on the phenotype and activation status of peripheral basophils and lymphocytes in a pediatric CMA cohort. METHODS CMA children underwent 45 days of treatment with Bifidobacteria. The basophil degranulation and the immune phenotype of B cells, T helper cells, and regulatory T cells were analyzed in peripheral blood at diagnosis (T0), after a 45-day probiotic treatment (T1), and 45 days after the probiotic wash-out (T2). RESULTS We observed in probiotic-treated CMA patients a decrease in naive T lymphocytes. Among the CD3+ cell subsets, both naive and activated CD4+ cells resulted markedly reduced after taking probiotics, with the lowest percentages at T2. A decreased basophil degranulation was observed in response to all analyzed CMP at T1 compared to T0. CONCLUSIONS The probiotic treatment resulted in a decrease of circulating naive and activated CD4+ T cells, as well as degranulating basophils. These data suggest that the Bifidobacteria could have a beneficial effect in the modulation of oral tolerance to CMP. TRIAL REGISTRATION ISRCTN69069358. URL of registration: https://www.isrctn.com/ISRCTN69069358 . IMPACT Probiotic treatment with Bifidobacteria induces a reduction of both naive and activated circulating CD4+ T cells in pediatric patients with cow's milk allergy (CMA). The probiotic supplementation induces a decreased basophil degranulation. The immunological tolerance persists even after 45 days of the probiotic wash-out. Bifidobacteria in vivo supplementation down-modulates the activation of innate and adaptive immunity in pediatric patients with cow's milk allergy. Bifidobacteria contribute to the development of immune tolerance in CMA patients.
Collapse
Affiliation(s)
- Caterina Strisciuglio
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Alessandra Vitale
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Perna
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Federica Garziano
- U.O.C Clinical Biochemistry, A.O.R.N. Ospedale dei Colli, Naples, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Serena Vitale
- Institute of Biochemistry and Cell Biology, CNR, Naples, Italy
| | - Teresa Micillo
- Neuroimmunology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Franca Oglio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Matarese
- Department of Molecular Medicine and Biotechnology Science, University of Naples "Federico II", Naples, Italy
| | | |
Collapse
|
3
|
Nahm DH. Regulatory T Cell-Targeted Immunomodulatory Therapy for Long-Term Clinical Improvement of Atopic Dermatitis: Hypotheses and Perspectives. Life (Basel) 2023; 13:1674. [PMID: 37629531 PMCID: PMC10455293 DOI: 10.3390/life13081674] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023] Open
Abstract
Atopic dermatitis (AD) is a chronically relapsing inflammatory skin disorder characterized by itching and eczematous lesions. It is often associated with a personal or familial history of allergic diseases. Allergic inflammation induced by immunoglobulin E and T-helper type 2 (Th2) cell responses to common environmental agents has been suggested to play an essential role in AD pathogenesis. The standard therapies for AD, including topical or systemic agents, focus on controlling skin inflammation. Recently developed monoclonal antibody to interleukin-4 receptor alpha or Janus kinase inhibitors can provide significant clinical improvements in patients with AD by inhibiting Th2 cell-mediated skin inflammation. However, the clinical efficacy of the Th2 cell-targeted therapy is transient and incomplete in patients with AD. Patients with AD are seeking a permanent cure. Therefore, the development of novel immunomodulatory strategies that can improve a long-term clinical outcome and provide a long-term treatment-free clinical remission of AD (disease-modifying therapy) is needed. Regulatory T (Treg) cells play a critical role in the maintenance of immune tolerance and suppress the development of autoimmune and allergic diseases. This review provides three working hypotheses and perspectives for the treatment of AD by Treg cell activation. (1) A decreased number or function of Treg cells is a critical event that causes the activation of Th2 cells, leading to the development and maintenance of AD. (2) Activation of Treg cells is an effective therapeutic approach for AD. (3) Many different immunomodulatory strategies activating Treg cells can provide a long-term clinical improvement of AD by induction of immune tolerance. The Treg cell-targeted immunomodulatory therapies for AD include allergen immunotherapy, microbiota, vitamin D, polyvalent human immunoglobulin G, monoclonal antibodies to the surface antigens of T cell or antigen-presenting cell, and adoptive transfer of autologous Treg cells or genetically engineered Treg cells expanded in vitro.
Collapse
Affiliation(s)
- Dong-Ho Nahm
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| |
Collapse
|
4
|
Li Y, Zhang B, Guo J, Cao Z, Shen M. The efficacy of probiotics supplementation for the treatment of atopic dermatitis in adults: a systematic review and meta-analysis. J DERMATOL TREAT 2022; 33:2800-2809. [PMID: 35670101 DOI: 10.1080/09546634.2022.2080170] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is a lack of certain evidence for the therapeutic efficacy of probiotics for adult atopic dermatitis (AD). METHODS PubMed, EMBASE, and the Cochrane Database were searched for relevant studies, and randomized controlled trials of AD describing treatment with single/mixed probiotic therapy were included. Changes in outcomes were calculated by standard mean difference (SMD) and 95% confidence interval (CI). Relative efficacies of the probiotics were ranked by the surface under the cumulative ranking (SUCRA). RESULTS Nine studies with a total of 402 participants, including 208 AD patients who received probiotic treatments and 194 controls, were considered during the current analysis. A reduction in disease severity for probiotic supplementation compared to controls in both the short term (SMD: 0.63; 95% CI: 0.02-1.25) and the long term (SMD: 1.57; 95% CI: 0.66-2.49). There was a significant improvement in long-term quality of life after probiotic supplementation compared with controls (SMD: 0.74; 95% CI: 0.39-1.09). A mixture of L. salivarius (LS01) and Bifidobacterium (BR03) was found the highest probability of the best supplementation. CONCLUSIONS Probiotic supplementation decreases clinical severity and improves the quality of life among adult AD patients. The mixture of LS01 and BR03 appeared optimal.
Collapse
Affiliation(s)
- Yajia Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Beisi Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jia Guo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Ziqin Cao
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| |
Collapse
|
5
|
Ayasse MT, Ahmed A, Espinosa ML, Walker CJ, Yousaf M, Thyssen JP, Silverberg JI. What are the highest yielding search strategy terms for systematic reviews in atopic dermatitis? A systematic review. Arch Dermatol Res 2021; 313:737-750. [PMID: 33221950 DOI: 10.1007/s00403-020-02165-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 12/30/2022]
Abstract
The impact of search strategies on systematic reviews (SR) of atopic dermatitis (AD) is unknown. The purpose of this review was to evaluate search strategies used in SR of AD and their impact on the frequency of manuscripts identified. MEDLINE and EMBASE were searched for SR related to AD. Simulations were performed by running combinations of search terms in MEDLINE and EMBASE. Overall, 250 SR met inclusion criteria, of which 225 specified search strategies. SR using 5-6 terms (20.0% to 12.1%) or ≥ 7 (40.0% to 18.8%) terms decreased, whereas SR using 3-4 terms numerically increased (18.8% to 30.2%) and 1-2 terms remained similar (37.5% to 38.9%) from 1999-2009 to 2015-2019. The most commonly searched terms were "atopic dermatitis" (n = 166), followed by "eczema" (n = 156), "dermatitis atopic'" (n = 81), "atopic eczema" (n = 74), "neurodermatitis" (n = 59), "Besniers prurigo" (n = 29), "infantile eczema" (n = 27), and "childhood eczema" (n = 19). Simulations revealed that "eczema" and "atopic dermatitis" yielded the most hits. The number of search terms that maximized hits in MEDLINE and EMBASE was 5 and 4, respectively. Search strategies for AD were heterogeneous, with high proportions of search strategies providing few search hits. Future studies should use standardized and optimized search terms.
Collapse
Affiliation(s)
- Marissa T Ayasse
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Suite 2B-425, Washington, DC, 20037, USA
| | - Adnan Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Maria L Espinosa
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Christina J Walker
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Muhammad Yousaf
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Suite 2B-425, Washington, DC, 20037, USA.
| |
Collapse
|
6
|
|
7
|
Tan-Lim CSC, Esteban-Ipac NAR, Mantaring JBV, Chan Shih Yen E, Recto MST, Sison OT, Alejandria MM. Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: A systematic review and network meta-analysis. Pediatr Allergy Immunol 2021; 32:124-136. [PMID: 32524647 DOI: 10.1111/pai.13305] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The current evidence on the use of probiotics in treating atopic dermatitis is inconclusive. This study determined the comparative effectiveness of the different types of probiotic strains in treating pediatric atopic dermatitis. METHODOLOGY Systematic and manual search for all randomized controlled trials available from inception until January 31, 2020, was done. Two independent authors conducted the search, screening, appraisal, and data abstraction. Network meta-analysis was conducted using STATA 14 software. RESULTS Twenty-two studies involving 28 different probiotic strains were included. The top three ranked probiotic strains in terms of efficacy are Mix1 (Bifidobacterium animalis subsp lactis CECT 8145, Bifidobacterium longum CECT 7347, and Lactobacillus casei CECT 9104); Lactobacillus casei DN-114001; and Mix6 (Bifidobacterium bifidum, Lactobacillus acidophilus, Lactobacillus casei, and Lactobacillus salivarius). Compared with placebo, Mix1 reduces atopic dermatitis symptoms with high certainty evidence (SMD -1.94, 95% CI -2.65 to -1.24; 47 participants). Mix6 compared with placebo probably reduces atopic dermatitis symptoms based on moderate certainty evidence (SMD -0.85, 95% CI -1.50 to -0.20; 40 participants). Lactobacillus casei DN-114001 compared with placebo may reduce atopic dermatitis symptoms based on low certainty evidence (SMD -1.35, 95% CI -2.04 to -0.65). In terms of safety, the highest ranked strain is Lactobacillus fermentum VRI-003, while the lowest ranked strain is Lactobacillus rhamnosus GG. CONCLUSION Certain probiotic preparations show benefit in reducing allergic symptoms in pediatric atopic dermatitis.
Collapse
Affiliation(s)
- Carol Stephanie C Tan-Lim
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Natasha Ann R Esteban-Ipac
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Jacinto Blas V Mantaring
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | | | - Marysia Stella T Recto
- Section of Allergy and Immunology, Department of Pediatrics, Philippine General Hospital, Manila, Philippines
| | - Olivia T Sison
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Marissa M Alejandria
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| |
Collapse
|
8
|
Park JG, Park HJ, Chae Y, Kim YK, Lee H, Kim K. Acupuncture Treatment for Symptom Management in Atopic Dermatitis: A Study Protocol for a Randomized, Participant- and Assessor-Blind, Sham-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:1907578. [PMID: 31186656 PMCID: PMC6521562 DOI: 10.1155/2019/1907578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/09/2019] [Indexed: 12/14/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with persistent itching, which impairs quality of life (QoL). Although various conventional treatments for AD exist, patients with AD often seek complementary and alternative therapies when conventional therapy has failed to relieve their AD symptoms or has had adverse effects. Acupuncture treatment may relieve AD symptoms, but controlled trials are needed to confirm this. Following our pilot study, which found that acupuncture treatment improves AD symptoms in mild-to-moderate AD patients, we will assess the effect of acupuncture treatment for symptom relief of AD using a trial with a complemented protocol. This is a two-arm, randomized, participant- and assessor-blinded, sham-controlled trial. A total of 36 mild-to-moderate AD patients will be randomly assigned in a 1:1 ratio to receive eight sessions twice weekly of either verum acupuncture (VA) or nonpenetrating sham acupuncture (SA) over four weeks. The primary outcome measured will be the change in the total Scoring Atopic Dermatitis (SCORAD) score. Secondary outcomes will be (1) changes in AD symptoms, QoL, dyspepsia symptoms, and electroencephalography (EEG) between baseline and week 4 and (2) changes in AD symptoms and QoL at baseline and at weeks 2, 4, and 8. This study will assess acupuncture treatment for the alleviation of AD symptoms in patients with mild-to-moderate AD. This clinical trial gas been registered in Korean Clinical Trial Registry (registration number: KCT0002796; date of registration: April 13, 2018).
Collapse
Affiliation(s)
- Jung Gun Park
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, Graduate School of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Hi-Joon Park
- Department of Korean Medical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Acupuncture & Meridian Science Research Centre, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Younbyoung Chae
- Department of Korean Medical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Acupuncture & Meridian Science Research Centre, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yu-Kang Kim
- Department of Korean Medical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Acupuncture & Meridian Science Research Centre, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Hyangsook Lee
- Department of Korean Medical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Acupuncture & Meridian Science Research Centre, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Kyuseok Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| |
Collapse
|
9
|
Nakata J, Hirota T, Umemura H, Nakagawa T, Kando N, Futamura M, Nakamura Y, Ito K. Additive effect of Lactobacillus acidophilus L-92 on children with atopic dermatitis concomitant with food allergy. Asia Pac Allergy 2019; 9:e18. [PMID: 31089460 PMCID: PMC6494655 DOI: 10.5415/apallergy.2019.9.e18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/21/2019] [Indexed: 11/17/2022] Open
Abstract
Background Atopic dermatitis (AD) in infants is often related to food allergies (FA). The beneficial effects of lactic acid bacteria towards allergic diseases have been reported, but there are few reports on their effect and preferable dosages on AD in young children with concomitant FA. Objective To examine additional effects of two different dose of paraprobiotic Lactobacillus acidophilus L-92 (L-92) on the clinical treatment in young children afflicted by AD with diagnosed or suspected FA. Methods Fifty-nine AD young children from 10 months to 3 years old, with FA or who had not started to ingest specific food(s) because of high specific IgE levels, were recruited and randomly allocated into L-92 group (daily intake of 20 mg L-92/day) and placebo group. Participants were given test sample with conventional treatment for AD over a 24-week period. The severity of eczema was evaluated using SCORing Atopic Dermatitis (SCORAD) index before intervention, and at 4, 12, and 24 weeks after intervention. Results After 24 weeks of intervention, a significant decrease in SCORAD was observed only in the L-92 group when compared with the baseline values. Significant decreases in thymus and activation-regulated chemokine (TARC) and total IgE were also detected 24 weeks after intake in the L-92 group compared with the placebo group. Conclusion It was suggested that intake of sufficient amounts of L-92 works as an adjunctive treatment of young children afflicted by AD with diagnosed or suspected FA.
Collapse
Affiliation(s)
- Joan Nakata
- Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan
| | - Tatsuhiko Hirota
- Core Technology Laboratories, Asahi Group Holdings, Ltd., Sagamihara 252-0206, Japan
| | - Harue Umemura
- Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan
| | - Tomoko Nakagawa
- Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan
| | - Naoyuki Kando
- Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan
| | - Masaki Futamura
- Division of Allergy, National Center for Child Health and Development, Setagaya 157-8535, Japan
| | - Yasunori Nakamura
- Core Technology Laboratories, Asahi Group Holdings, Ltd., Sagamihara 252-0206, Japan
| | - Komei Ito
- Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan
| |
Collapse
|
10
|
|
11
|
Spacova I, Ceuppens JL, Seys SF, Petrova MI, Lebeer S. Probiotics against airway allergy: host factors to consider. Dis Model Mech 2018; 11:11/7/dmm034314. [PMID: 30037806 PMCID: PMC6078401 DOI: 10.1242/dmm.034314] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The worldwide prevalence of allergic diseases has drastically increased in the past decades. Recent studies underline the importance of microbial exposure for the development of a balanced immune system. Consequently, probiotic bacteria are emerging as a safe and natural strategy for allergy prevention and treatment. However, clinical probiotic intervention studies have so far yielded conflicting results. There is increasing awareness about the importance of host-associated factors that determine whether an individual will respond to a specific probiotic treatment, and it is therefore crucial to promote a knowledge-based instead of an empirical selection of promising probiotic strains and their administration regimen.In this Review, we summarize the insights from animal model studies of allergic disease, which reveal how host-related factors - such as genetic makeup, sex, age and microbiological status - can impact the outcomes of preventive or curative probiotic treatment. We explore why and how these factors can influence the results of probiotic studies and negatively impact the reproducibility in animal experiments. These same factors might profoundly influence the outcomes of human clinical trials, and can potentially explain the conflicting results from probiotic intervention studies. Therefore, we also link these host-related factors to human probiotic study outcomes in the context of airway allergies.
Collapse
Affiliation(s)
- Irina Spacova
- Research Group Environmental Ecology and Applied Microbiology, Department of Bioscience Engineering, University of Antwerp, 2020 Antwerp, Belgium.,Centre of Microbial and Plant Genetics, Department of Microbial and Molecular Systems (M²S), KU Leuven, Belgium
| | - Jan L Ceuppens
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, 3000 Leuven, Belgium
| | - Sven F Seys
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, 3000 Leuven, Belgium
| | - Mariya I Petrova
- Centre of Microbial and Plant Genetics, Department of Microbial and Molecular Systems (M²S), KU Leuven, Belgium
| | - Sarah Lebeer
- Research Group Environmental Ecology and Applied Microbiology, Department of Bioscience Engineering, University of Antwerp, 2020 Antwerp, Belgium .,Centre of Microbial and Plant Genetics, Department of Microbial and Molecular Systems (M²S), KU Leuven, Belgium
| |
Collapse
|
12
|
Ibáñez MD, Rodríguez del Río P, González-Segura Alsina D, Villegas Iglesias V. Effect of synbiotic supplementation on children with atopic dermatitis: an observational prospective study. Eur J Pediatr 2018; 177:1851-1858. [PMID: 30259127 PMCID: PMC6244656 DOI: 10.1007/s00431-018-3253-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 12/29/2022]
Abstract
The objective of this observational single-cohort prospective study was to assess the effect of synbiotic supplementation for 8 weeks in children with atopic dermatitis (AD). The synbiotic product contained Lactobacillus casei, Bifidobacterium lactis, Lactobacillus rhamnosus, Lactobacillus plantarum, fructooligosaccharide, galactooligosaccharide, and biotin. Patients were examined at baseline and at 8 weeks. Effectiveness of treatment was assessed with the Scoring Atopic Dermatitis (SCORAD) index. A total of 320 children (mean age 5.1 years, range 0-12 years) were included. The mean (SD) SCORAD index decreased from 45.5 (15.5) at baseline to 19.4 (14.6) at the end of treatment (P < 0.001), VAS score for pruritus decreased from 5.7 (2.2) to 2.3 (2.2) (P < 0.001), and VAS score for sleep decreased from 3.1 (2.5) to 1.1 (1.8) (P < 0.001). Percentage of children with moderate-severe disease decreased from 92.4% at baseline to 28.1% at week 8. In the multiple linear regression analysis, higher baseline SCORAD index (OR 0.51; 95% CI 0.41-0.61) and higher adherence (OR 7.29; 95% CI 1.85-12.73) were significantly associated with greater decrease in SCORAD index.Conclusion: Supplementation with the multistrain synbiotic product may improve AD in children. What is known: • Pediatric atopic dermatitis (AD) is a common, troublesome condition with limited treatment options, which has been shown to be associated with dysbiosis in the intestinal microflora. • Results of controlled clinical trials (RCTs) on the effect of probiotics in children with AD have been disparate, although overall, the data favor probiotics over placebo, with multistrain supplements associated with better improvements in AD. What is new: • The results of this observational, prospective, open-label, single-cohort study on 320 children with AD younger than 12 years old suggest that supplementation with multistrain synbiotics (Lactobacillus casei, Bifidobacterium lactis, Lactobacillus rhamnosus, Lactobacillus plantarum, fructooligosaccharide, galactooligosaccharide, and biotin) helps to improve AD symptoms in children. • More than 80% of children experienced improvement in AD symptoms, as measured by Severity Scoring of Atopic Dermatitis (SCORAD) index and assessed by parents and physicians. The main predictive factors for improvement was adherence to synbiotic treatment and high baseline SCORE index; the change in SCORAD did not depend on age, gender, presence of concomitant treatment, duration, and type of AD (persistent vs with flares), other concomitant allergies or history of parental allergy.
Collapse
Affiliation(s)
- M. Dolores Ibáñez
- Allergy Department and Biomedical Research Foundation (FIB), Hospital Infantil Universitario Niño Jesús, Avda. Menéndez Pelayo 56, E-28009 Madrid, Spain ,Health Research Institute, IIS Princesa, Madrid, Spain ,Allergy National Network (ARADyAL), Institute Carlos III, Madrid, Spain
| | - Pablo Rodríguez del Río
- Allergy Department and Biomedical Research Foundation (FIB), Hospital Infantil Universitario Niño Jesús, Avda. Menéndez Pelayo 56, E-28009 Madrid, Spain ,Health Research Institute, IIS Princesa, Madrid, Spain ,Allergy National Network (ARADyAL), Institute Carlos III, Madrid, Spain
| | | | | |
Collapse
|
13
|
Fu L, Song J, Wang C, Fu S, Wang Y. Bifidobacterium infantis Potentially Alleviates Shrimp Tropomyosin-Induced Allergy by Tolerogenic Dendritic Cell-Dependent Induction of Regulatory T Cells and Alterations in Gut Microbiota. Front Immunol 2017; 8:1536. [PMID: 29176981 PMCID: PMC5686061 DOI: 10.3389/fimmu.2017.01536] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/27/2017] [Indexed: 12/17/2022] Open
Abstract
Shellfish is one of the major allergen sources worldwide, and tropomyosin (Tm) is the predominant allergic protein in shellfish. Probiotics has been appreciated for its beneficial effects on the host, including anti-allergic and anti-inflammatory effects, although the underlying mechanisms were not fully understood. In this study, oral administration of probiotic strain Bifidobacterium infantis 14.518 (Binf) effectively suppressed Tm-induced allergic response in a mouse model by both preventive and therapeutic strategies. Further results showed that Binf stimulated dendritic cells (DCs) maturation and CD103+ tolerogenic DCs accumulation in gut-associated lymphoid tissue, which subsequently induced regulatory T cells differentiation for suppressing Th2-biased response. We also found that Binf regulates the alterations of gut microbiota composition. Specifically, the increase of Dorea and decrease of Ralstonia is highly correlated with Th2/Treg ratio and may contribute to alleviating Tm-induced allergic responses. Our findings provide molecular insight into the application of Binf in alleviating food allergy and even gut immune homeostasis.
Collapse
Affiliation(s)
- Linglin Fu
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China.,Laboratory of Mucosal Immunology and Food Research, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Jinyu Song
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Chong Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China.,Laboratory of Mucosal Immunology and Food Research, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Shujie Fu
- Laboratory of Mucosal Immunology and Food Research, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Yanbo Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China.,Laboratory of Mucosal Immunology and Food Research, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| |
Collapse
|
14
|
Reid G, Abrahamsson T, Bailey M, Bindels L, Bubnov R, Ganguli K, Martoni C, O’Neill C, Savignac H, Stanton C, Ship N, Surette M, Tuohy K, van Hemert S. How do probiotics and prebiotics function at distant sites? Benef Microbes 2017; 8:521-533. [DOI: 10.3920/bm2016.0222] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The realisation that microbes regarded as beneficial to the host can impart effects at sites distant from their habitat, has raised many possibilities for treatment of diseases. The objective of a workshop hosted in Turku, Finland, by the International Scientific Association for Probiotics and Prebiotics, was to assess the evidence for these effects and the extent to which early life microbiome programming influences how the gut microbiota communicates with distant sites. In addition, we examined how probiotics and prebiotics might affect the skin, airways, heart, brain and metabolism. The growing levels of scientific and clinical evidence showing how microbes influence the physiology of many body sites, leads us to call for more funding to advance a potentially exciting avenue for novel therapies for many chronic diseases.
Collapse
Affiliation(s)
- G. Reid
- Lawson Health Research Institute, F3-106, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada
- Departments of Microbiology & Immunology and Surgery, The University of Western Ontario, London, Canada
| | - T. Abrahamsson
- Department of Clinical and Experimental Medicine, Division of Paediatrics, Linköping University, Linköping, Sweden
| | - M. Bailey
- Department of Pediatrics, Ohio State University, College of Medicine, Columbus, OH, USA
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - L.B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Avenue Mounier 73, P.O. Box B1.73.11, 1200 Brussels, Belgium
| | - R. Bubnov
- Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - K. Ganguli
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital for Children and Harvard Medical School, Charlestown, MA, 02114, USA
| | - C. Martoni
- UAS Laboratories, 4027 Owl Creek Drive, Madison, WI 53718, USA
| | - C. O’Neill
- Centre for Dermatology, Faculty of Biology Medicine and Health, The University of Manchester, UK
| | - H.M. Savignac
- Former (during ISAPP): Clasado Research Services Ltd, Reading, United Kingdom; present: 4D Pharma PLC, Life Sciences Innovation Building, Cornhill Road, Aberdeen, AB25 2ZS, United Kingdom
| | - C. Stanton
- APC Microbiome Institute, Biosciences Building, University College Cork, Ireland
| | - N. Ship
- Bio-K+ Pharma Inc., 495 Boulevard Armand-Frappier, Laval QC, H7V 4B3 Canada
| | - M. Surette
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton ON, L8S 4K1 Canada
| | - K. Tuohy
- Nutrition and Nutrigenomics Unit, Department of Food Quality and Nutrition, Fondazione Edmund Mach, San Michele all’Adige, Trento, 38010, Italy
| | - S. van Hemert
- Winclove Probiotics, Hulstweg 11, 1032 LB Amsterdam, the Netherlands
| |
Collapse
|
15
|
Lactic acid bacteria-specific induction of CD4 +Foxp3 +T cells ameliorates shrimp tropomyosin-induced allergic response in mice via suppression of mTOR signaling. Sci Rep 2017; 7:1987. [PMID: 28512288 PMCID: PMC5434066 DOI: 10.1038/s41598-017-02260-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/10/2017] [Indexed: 12/24/2022] Open
Abstract
The beneficial effects of probiotics have been described in allergic sensitization and diseases; however, many questions remain unanswered, such as characteristics of the most effective strains in modulation of allergic responses and how orally administered probiotics affect the systemic immune system. In the present work, oral administration of five lactic acid bacteria strains showed variable effects on protection against the allergic reaction in a mouse model of food allergy to shrimp tropomyosin (ST). The most effective anti-allergic strain, Bacillus coagulans 09.712 (Bc), greatly improved epithelial barrier function and increased lymphocytes proliferation. Moreover, Bc suppresses ST sensitization by altering Th1/Th2/Treg balance as a result of strong induction of CD4+Foxp3+Tregs in combination with IL-10 producing. Bc-specific induction of CD4+Foxp3+ Tregs also suppresses Th17 pro-inflammatory response in this mouse model. Finally, the intake of Bc suppresses mTOR activation and thus the phosphorylation of downstream factors. Inhibition of mTOR signaling by Bc further results in FOXP3 up-regulation and GATA-3 down-regulation, which, in turn, facilitate to control Th2-predominant and Th17 pro-inflammatory responses caused by ST. Our work provides further characterization of the anti-allergic effects of probiotic LAB strains, and identifies new targets for preventive and curative treatment of food allergies.
Collapse
|
16
|
Celiberto LS, Bedani R, Rossi EA, Cavallini DCU. Probiotics: The scientific evidence in the context of inflammatory bowel disease. Crit Rev Food Sci Nutr 2017; 57:1759-1768. [PMID: 25996176 DOI: 10.1080/10408398.2014.941457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Inflammatory bowel disease (IBD) generally comprises Crohn's disease (CD) and ulcerative colitis (UC), and their main characteristic is the intestinal mucosa inflammation. Although its origin is not yet fully known, there is growing evidence related to genetics, intestinal microbiota composition, and the immune system factors such as precursors for the initiation and progression of intestinal conditions. The use of certain probiotic microorganisms has been touted as a possible and promising therapeutic approach in reducing the risk of inflammatory bowel disease, specifically ulcerative colitis. Several mechanisms have been proposed to explain the benefits of probiotics, indicating that some bacterial strains are able to positively modulate the intestinal microbiota and the immune system, and to produce metabolites with anti-inflammatory properties. The aim of this paper is to bring together the various results and information, based on scientific evidence, that are related to probiotics and inflammatory bowel disease, emphasizing the possible mechanisms involved in this action.
Collapse
Affiliation(s)
- Larissa Sbaglia Celiberto
- a Department of Food & Nutrition , Faculty of Pharmaceutical Sciences, São Paulo State University (UNESP) , Araraquara , SP , Brazil
| | - Raquel Bedani
- b Departament of Biochemical and Pharmaceutical Technology , Faculty of Pharmaceutical Sciences, University of São Paulo (USP) Properties , SP , Brazil
| | - Elizeu Antonio Rossi
- a Department of Food & Nutrition , Faculty of Pharmaceutical Sciences, São Paulo State University (UNESP) , Araraquara , SP , Brazil
| | | |
Collapse
|
17
|
Nankervis H, Thomas K, Delamere F, Barbarot S, Smith S, Rogers N, Williams H. What is the evidence base for atopic eczema treatments? A summary of published randomized controlled trials. Br J Dermatol 2017; 176:910-927. [DOI: 10.1111/bjd.14999] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2016] [Indexed: 12/23/2022]
Affiliation(s)
- H. Nankervis
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - K.S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - F.M. Delamere
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - S. Barbarot
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - S. Smith
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - N.K. Rogers
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| | - H.C. Williams
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| |
Collapse
|
18
|
Zhang J, Su H, Li Q, Wu H, Liu M, Huang J, Zeng M, Zheng Y, Sun X. Oral administration of Clostridium butyricum CGMCC0313-1 inhibits β-lactoglobulin-induced intestinal anaphylaxis in a mouse model of food allergy. Gut Pathog 2017; 9:11. [PMID: 28250847 PMCID: PMC5322677 DOI: 10.1186/s13099-017-0160-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/16/2017] [Indexed: 01/14/2023] Open
Abstract
Background Probiotic bacteria can induce immune regulation or immune tolerance in patients with allergic diseases, but the underlying mechanisms are still unclear. There has been a growing interest in the use of beneficial bacteria for allergic diseases recently. This study aimed at exploring whether Clostridium butyricum CGMCC0313-1 (C. butyricum) can reduce β-lactoglobulin(BLG)-induced intestinal anaphylaxis in a murine model of food allergy. Methods The preventive and therapeutic effects of oral C. butyricum on anaphylactic symptoms induced via BLG in food allergy mice were investigated. Intestinal anaphylaxis, T helper (Th)-specific cytokines and transcription factors, secretory IgA (sIgA), CD4+ CD25+ Foxp3Treg cell and histopathological alterations were examined. Results Clostridium butyricum significantly ameliorated intestinal anaphylaxis symptoms in the food allergy mice. sIgA and CD4+ CD25+ Foxp3Treg cell were increased by oral C. butyricum. It also reversed the imbalance of Th1/Th2 andTh17/Treg. Conclusions Clostridium butyricum reduces BLG-induced intestinal anaphylaxis in mice and might be an additional or supplementary therapy for food allergy.
Collapse
Affiliation(s)
- Juan Zhang
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| | - Hui Su
- Department of Geratology, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| | - Qiuhong Li
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| | - Haixia Wu
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| | - Mengyun Liu
- Respiratory Department, Shenzhen Children's Hospital, Shenzhen, 518036 China
| | - Jianqiong Huang
- Respiratory Department, Shenzhen Children's Hospital, Shenzhen, 518036 China
| | - Minghua Zeng
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| | - Yuejie Zheng
- Respiratory Department, Shenzhen Children's Hospital, Shenzhen, 518036 China
| | - Xin Sun
- Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 China
| |
Collapse
|
19
|
Martini N. Potion or Poison? Probiotics in eczema. J Prim Health Care 2017. [DOI: 10.1071/hc15921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
20
|
Holvoet S, Doucet-Ladevèze R, Perrot M, Barretto C, Nutten S, Blanchard C. Beneficial effect of Lactococcus lactis NCC 2287 in a murine model of eosinophilic esophagitis. Allergy 2016; 71:1753-1761. [PMID: 27259693 DOI: 10.1111/all.12951] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Eosinophilic esophagitis (EoE) is a severe inflammatory disease of the esophagus which is characterized histologically by an eosinophilic infiltration into the esophageal tissue. The efficacy of probiotics in the context of atopic diseases has been well investigated but, to date, there has been no study which has evaluated probiotic effects on EoE inflammation. This study sought to identify a probiotic which improves esophageal inflammation in experimental EoE. METHODS Two candidate probiotics, Lactococcus lactis NCC 2287 and Bifidobacterium lactis NCC 2818, were tested in a murine model of EoE elicited by epicutaneous sensitization with Aspergillus fumigatus protein extract. Administration of bacterial strains in drinking water was used, respectively, as a preventive or treatment measure, or continuously throughout the study. Inflammatory parameters were assessed in the esophagus, skin, and lungs after allergen challenge. RESULTS In this EoE model, supplementation with L. lactis NCC 2287 significantly decreased esophageal and bronchoalveolar eosinophilia but only when given as a therapeutic treatment. No significant effect on eosinophilia was observed when NCC 2287 was given as a preventive or a continuous intervention. NCC 2287 supplementation had no significant effect on immunoglobulin levels, skin symptom scores, or on transepidermal water loss. Supplementation with another probiotic, B. lactis NCC 2818, had no significant effect on esophageal eosinophilia. CONCLUSION We identified a L. lactis strain, able to attenuate esophageal eosinophilic inflammation in a preclinical model of EoE. This effect is strain specific and depends on the timing and duration of bacterial supplementation. Confirmation of these observations in human clinical trials is warranted.
Collapse
Affiliation(s)
- S. Holvoet
- Nutrition and Health Research; Allergy Group; Nestle Research Center; Lausanne Switzerland
| | - R. Doucet-Ladevèze
- Nutrition and Health Research; Allergy Group; Nestle Research Center; Lausanne Switzerland
| | - M. Perrot
- Data Science Group; Nestle Research Center; Lausanne Switzerland
| | - C. Barretto
- Data Science Group; Nestle Research Center; Lausanne Switzerland
| | - S. Nutten
- Nutrition and Health Research; Allergy Group; Nestle Research Center; Lausanne Switzerland
| | - C. Blanchard
- Nutrition and Health Research; Allergy Group; Nestle Research Center; Lausanne Switzerland
| |
Collapse
|
21
|
Thandar Y, Gray A, Botha J, Mosam A. Topical herbal medicines for atopic eczema: a systematic review of randomized controlled trials. Br J Dermatol 2016; 176:330-343. [DOI: 10.1111/bjd.14840] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Y. Thandar
- Department of Basic Medical Sciences Faculty of Heath Sciences Durban University of Technology Durban South Africa
| | - A. Gray
- Division of Pharmacology Discipline of Pharmaceutical Sciences University of KwaZulu‐Natal Durban South Africa
| | - J. Botha
- Division of Pharmacology Discipline of Pharmaceutical Sciences University of KwaZulu‐Natal Durban South Africa
| | - A. Mosam
- Department of Dermatology Nelson R. Mandela School of Medicine University of KwaZulu‐Natal Durban South Africa
| |
Collapse
|
22
|
Schlichte MJ, Vandersall A, Katta R. Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatol Pract Concept 2016. [PMID: 27648380 DOI: 10.5826/dpc.0603a06.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2022] Open
Abstract
In the context of increasing popularity of "natural" alternatives to conventional medicine, several dietary supplements have gained the attention of researchers and consumers alike in the treatment of atopic dermatitis (AD). Readily available without a prescription and frequently perceived to have fewer side effects than traditional medications, these "natural" remedies may be featured in discussions with patients, and clinicians should therefore be familiar with their efficacy and safety. Based on trials to date, no dietary supplements can be recommended for routine use in the treatment of AD. However, some promising results have been noted from the use of probiotics and prebiotics taken in combination. Given significant differences in study design to date, however, further studies would be needed to clarify dose and strains of probiotics. Studies of vitamin D have been limited and have produced conflicting results, although further trials in selected subsets of patients may be indicated. Very limited data is available on fish oil supplements, while future studies on Chinese herbal medicine would require evaluation of comparable herbs and formulations. Finally, multiple trials of evening primrose oil and borage seed oil have shown improvement similar to placebo, and neither is currently recommended in eczema therapy.
Collapse
Affiliation(s)
- Megan J Schlichte
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Abbey Vandersall
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Rajani Katta
- Division of Dermatology, Houston Methodist Hospital, Houston, TX, USA
| |
Collapse
|
23
|
Grimm V, Riedel CU. Manipulation of the Microbiota Using Probiotics. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 902:109-17. [PMID: 27161354 DOI: 10.1007/978-3-319-31248-4_8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A number of diseases are associated with alterations in the composition of the microbiota of various niches of the human body. Although, in most cases, it is unclear if these alterations are the cause or the consequence of disease, they provide a rationale for therapeutic or prophylactic manipulation of a dysbiotic microbiota. Approaches to manipulate the microbiome include administration of either live bacteria, which are underrepresented in the diseased individual, substances that aim at increasing the populations of these bacteria, or a combination of the two. This chapter summarizes the available data in therapeutic manipulation of a various diseased states including irritable bowel syndrome, inflammatory bowel disease, necrotizing enterocolitis, atopic and allergic diseases, and antibiotic-associated and infectious diarrhoea.
Collapse
Affiliation(s)
- Verena Grimm
- Institute of Microbiology and Biotechnology, University of Ulm, Albert-Einstein-Allee 11, 89069, Ulm, Germany.
| | - Christian U Riedel
- Institute of Microbiology and Biotechnology, University of Ulm, Albert-Einstein-Allee 11, 89069, Ulm, Germany
| |
Collapse
|
24
|
Schlichte MJ, Vandersall A, Katta R. Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatol Pract Concept 2016; 6:23-9. [PMID: 27648380 PMCID: PMC5006549 DOI: 10.5826/dpc.0603a06] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/23/2016] [Indexed: 10/31/2022] Open
Abstract
In the context of increasing popularity of "natural" alternatives to conventional medicine, several dietary supplements have gained the attention of researchers and consumers alike in the treatment of atopic dermatitis (AD). Readily available without a prescription and frequently perceived to have fewer side effects than traditional medications, these "natural" remedies may be featured in discussions with patients, and clinicians should therefore be familiar with their efficacy and safety. Based on trials to date, no dietary supplements can be recommended for routine use in the treatment of AD. However, some promising results have been noted from the use of probiotics and prebiotics taken in combination. Given significant differences in study design to date, however, further studies would be needed to clarify dose and strains of probiotics. Studies of vitamin D have been limited and have produced conflicting results, although further trials in selected subsets of patients may be indicated. Very limited data is available on fish oil supplements, while future studies on Chinese herbal medicine would require evaluation of comparable herbs and formulations. Finally, multiple trials of evening primrose oil and borage seed oil have shown improvement similar to placebo, and neither is currently recommended in eczema therapy.
Collapse
Affiliation(s)
- Megan J Schlichte
- Department of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Abbey Vandersall
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Rajani Katta
- Division of Dermatology, Houston Methodist Hospital, Houston, TX, USA
| |
Collapse
|
25
|
Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol 2016; 13:15-26. [PMID: 27417220 DOI: 10.1080/1744666x.2016.1212660] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.
Collapse
Affiliation(s)
- Robert Kantor
- a Department of Dermatology , Northwestern University , Chicago , IL , USA
| | - Jonathan I Silverberg
- b Departments of Dermatology, Preventive Medicine and Medical Social Sciences , Northwestern University , Chicago , IL , USA
| |
Collapse
|
26
|
Nankervis H, Thomas KS, Delamere FM, Barbarot S, Rogers NK, Williams HC. Scoping systematic review of treatments for eczema. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04070] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
Collapse
Affiliation(s)
- Helen Nankervis
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Kim S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Finola M Delamere
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Sébastien Barbarot
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Natasha K Rogers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| |
Collapse
|
27
|
Roudsari MR, Karimi R, Sohrabvandi S, Mortazavian AM. Health effects of probiotics on the skin. Crit Rev Food Sci Nutr 2016; 55:1219-40. [PMID: 24364369 DOI: 10.1080/10408398.2012.680078] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Skin is the largest organ of the body and is constantly exposed to physical, chemical, bacterial, and fungal challenges. It is well known that probiotics are helpful for specific disorders and different clinical studies have indicated that probiotics have special effects in cutaneous apparatus directly or indirectly that can be considerable from versatile aspects. Probiotic bacteriotherapy can have great potential in preventing and treating the skin diseases including eczema, atopic dermatitis, acne, and allergic inflammation or in skin hypersensitivity, UV-induced skin damage, wound protection, and as a cosmetic product. The current paper comprehensively reviews the different health effects of probiotics on the skin.
Collapse
Affiliation(s)
- M Rahmati Roudsari
- a Skin Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | | | | | | |
Collapse
|
28
|
Hendaus MA, Jomha FA, Ehlayel M. Allergic diseases among children: nutritional prevention and intervention. Ther Clin Risk Manag 2016; 12:361-72. [PMID: 27022267 PMCID: PMC4788360 DOI: 10.2147/tcrm.s98100] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Allergic diseases comprise a genetically heterogeneous group of chronic, immunomediated diseases. It has been clearly reported that the prevalence of these diseases has been on the rise for the last few decades, but at different rates, in various areas of the world. This paper discusses the epidemiology of allergic diseases among children and their negative impact on affected patients, their families, and societies. These effects include the adverse effects on quality of life and economic costs. Medical interest has shifted from tertiary or secondary prevention to primary prevention of these chronic diseases among high-risk infants in early life. Being simple, practical, and cost-effective are mandatory features for any candidate methods delivering these strategies. Dietary therapy fits this model well, as it is simple, practical, and cost-effective, and involves diverse methods. The highest priority strategy is feeding these infants breast milk. For those who are not breast-fed, there should be a strategy to maintain beneficial gut flora that positively influences intestinal immunity. We review the current use of probiotics, prebiotics, and synbiotics, and safety and adverse effects. Other dietary modalities of possible potential in achieving this primary prevention, such as a Mediterranean diet, use of milk formula with modified (hydrolyzed) proteins, and the role of micronutrients, are also explored. Breast-feeding is effective in reducing the risk of asthma, allergic rhinitis, and atopic eczema among children. In addition, breast milk constitutes a major source of support for gut microbe colonization, due to its bifidobacteria and galactooligosaccharide content. The literature lacks consensus in recommending the addition of probiotics to foods for prevention and treatment of allergic diseases, while prebiotics may prove to be effective in reducing atopy in healthy children. There is insufficient evidence to support soy formulas or amino acid formulas for prevention of allergic disease. A healthy diet, such as the Mediterranean diet, may have a protective effect on the development of asthma and atopy in children. In children with asthma and allergic diseases, vitamin D deficiency correlates strongly with asthma, allergic rhinitis, and wheezing.
Collapse
Affiliation(s)
- Mohamed A Hendaus
- Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | - Fatima A Jomha
- School of Pharmacy, Lebanese International University, Khiara, Lebanona
| | - Mohammad Ehlayel
- Weill Cornell Medical College, Doha, Qatar
- Department of Pediatrics, Section of Pediatric Allergy-Immunology, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
29
|
Stiemsma LT, Reynolds LA, Turvey SE, Finlay BB. The hygiene hypothesis: current perspectives and future therapies. Immunotargets Ther 2015; 4:143-57. [PMID: 27471720 PMCID: PMC4918254 DOI: 10.2147/itt.s61528] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Developed countries have experienced a steady increase in atopic disease and disorders of immune dysregulation since the 1980s. This increase parallels a decrease in infectious diseases within the same time period, while developing countries seem to exhibit the opposite effect, with less immune dysregulation and a higher prevalence of infectious disease. The “hygiene hypothesis”, proposed by Strachan in 1989, aimed to explain this peculiar generational rise in immune dysregulation. However, research over the past 10 years provides evidence connecting the commensal and symbiotic microbes (intestinal microbiota) and parasitic helminths with immune development, expanding the hygiene hypothesis into the “microflora” and “old friends” hypotheses, respectively. There is evidence that parasitic helminths and commensal microbial organisms co-evolved with the human immune system and that these organisms are vital in promoting normal immune development. Current research supports the potential for manipulation of the bacterial intestinal microbiota to treat and even prevent immune dysregulation in the form of atopic disease and other immune-mediated disorders (namely inflammatory bowel disease and type 1 diabetes). Both human and animal model research are crucial in understanding the mechanistic links between these intestinal microbes and helminth parasites, and the human immune system. Pro-, pre-, and synbiotic, as well as treatment with live helminth and excretory/secretory helminth product therapies, are all potential therapeutic options for the treatment and prevention of these diseases. In the future, therapeutics aimed at decreasing the prevalence of inflammatory bowel disease, type 1 diabetes, and atopic disorders will likely involve personalized microbiota and/or helminth treatments used early in life.
Collapse
Affiliation(s)
- Leah T Stiemsma
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; The Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Lisa A Reynolds
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Stuart E Turvey
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; The Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - B Brett Finlay
- Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
30
|
Abstract
PURPOSE OF REVIEW Allergic rhinitis due its high prevalence and burden needs to be properly treated. The disease's clinical features impose well tolerated drugs usable for long-term treatment. Nowadays, second-generation antihistamines and inhaled steroids represent the milestone of rhinitis therapy. The aim of the present review is to provide an update on allergic rhinitis treatment. A particular attention has been deserved to clinical trials, published in the last year that assess the efficacy and safety of new formulation of available drugs or new molecules. RECENT FINDINGS Available and new drugs under investigation seem able to control rhinitis symptoms without a significant patient's burden. The challenge for the next years will be to improve treatment adherence rather than to introduce new drugs. SUMMARY Allergic Rhinitis and its Impact on Asthma guidelines have brought attention to allergic rhinitis and its impact on asthma, but have also proposed a new classification in terms of symptoms severity and persistence useful for tailoring treatment on patients' phenotypes. Their further dissemination is needed; furthermore, they represent a cornerstone for the scientific community through a continuous update on relevant issues such as rhinitis phenotypes, disease management on the basis of new treatments, clinical trials transferability in real life, and allergic rhinitis management in public health programs.
Collapse
|
31
|
Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014; 71:1218-33. [PMID: 25264237 DOI: 10.1016/j.jaad.2014.08.038] [Citation(s) in RCA: 202] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/06/2014] [Accepted: 08/22/2014] [Indexed: 01/27/2023]
Abstract
Atopic dermatitis is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on use are given based on available evidence.
Collapse
|
32
|
Fijan S. Microorganisms with claimed probiotic properties: an overview of recent literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:4745-67. [PMID: 24859749 PMCID: PMC4053917 DOI: 10.3390/ijerph110504745] [Citation(s) in RCA: 490] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/17/2014] [Accepted: 03/25/2014] [Indexed: 12/14/2022]
Abstract
Probiotics are defined as live microorganisms, which when administered in adequate amounts, confer a health benefit on the host. Health benefits have mainly been demonstrated for specific probiotic strains of the following genera: Lactobacillus, Bifidobacterium, Saccharomyces, Enterococcus, Streptococcus, Pediococcus, Leuconostoc, Bacillus, Escherichia coli. The human microbiota is getting a lot of attention today and research has already demonstrated that alteration of this microbiota may have far-reaching consequences. One of the possible routes for correcting dysbiosis is by consuming probiotics. The credibility of specific health claims of probiotics and their safety must be established through science-based clinical studies. This overview summarizes the most commonly used probiotic microorganisms and their demonstrated health claims. As probiotic properties have been shown to be strain specific, accurate identification of particular strains is also very important. On the other hand, it is also demonstrated that the use of various probiotics for immunocompromised patients or patients with a leaky gut has also yielded infections, sepsis, fungemia, bacteraemia. Although the vast majority of probiotics that are used today are generally regarded as safe and beneficial for healthy individuals, caution in selecting and monitoring of probiotics for patients is needed and complete consideration of risk-benefit ratio before prescribing is recommended.
Collapse
Affiliation(s)
- Sabina Fijan
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia.
| |
Collapse
|
33
|
Nakatsuji T, Gallo RL. Dermatological therapy by topical application of non-pathogenic bacteria. J Invest Dermatol 2014; 134:11-14. [PMID: 24352078 DOI: 10.1038/jid.2013.379] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The microbial community inhabiting skin is an important part of its defense, acting to control immune responses and to influence susceptibility to pathogens. In this issue, Volz et al. report that Vitreoscilla filiformis extracts modulate mouse cutaneous inflammatory responses induces of interleukin-10 production in dendritic cells and priming of regulatory T cells. These findings in a mouse model of atopic dermatitis advance observations of links between bacteria and host immunity, and they provide further evidence for novel therapeutic strategies to treat inflammation in skin.
Collapse
Affiliation(s)
- Teruaki Nakatsuji
- Division of Dermatology, Department of Medicine, University of California, San Diego, San Diego, California, USA
| | - Richard L Gallo
- Division of Dermatology, Department of Medicine, University of California, San Diego, San Diego, California, USA.
| |
Collapse
|
34
|
Evidence of preventive effect of probiotics and prebiotics for infantile eczema. Curr Opin Allergy Clin Immunol 2014; 13:426-31. [PMID: 23799337 DOI: 10.1097/aci.0b013e3283630bad] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Infantile eczema, and in particular atopic dermatitis are, in many children, the first manifestation of their predisposition to an atopic disease. Among existing prevention strategies, supplementation with probiotics and prebiotics belong to the most promising beneficial interventions. Highlighting the most recent literature, we review here the most recent studies on probiotics and prebiotics and hypothesize on the most efficient intervention strategies. RECENT FINDINGS Various probiotics and prebiotics, either alone or in combinations, have been administered, in general, during the late phase of pregnancy and up to 6 months of age. In general, a combination of probiotics and prebiotics given from pregnancy until early infancy has a higher potential for protecting the infant from developing early manifestations of eczema than short administration of one specific microorganism. SUMMARY The effect of probiotics and prebiotic supplementations on early manifestations of atopy such as infantile eczema are conflicting. Nevertheless, prevention strategies should aim for an enhanced efficacy by addressing not only interventions on the microbiota, but by combining them to other interventions, for example, to those aiming at actively inducing antigen-specific tolerance.
Collapse
|
35
|
Affiliation(s)
- Bengt Björkstén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
| |
Collapse
|
36
|
Tsilochristou OA, Douladiris N, Makris M, Papadopoulos NG. Pediatric allergic rhinitis and asthma: can the march be halted? Paediatr Drugs 2013; 15:431-40. [PMID: 23955538 DOI: 10.1007/s40272-013-0043-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The strong epidemiologic and pathophysiologic link between allergic rhinitis (AR) and asthma has led to the concept of 'united airways disease' or 'respiratory allergy', implying that allergy, in its widest sense, underlies this clinical syndrome. Progression from AR to asthma is frequent and part of the 'atopic march'. Since pediatric immune responses are more adaptable and therefore may be more amenable to treatment, interventions at early childhood are characterized by a higher chance to affect the natural history of respiratory allergy. Although current treatments are quite effective in alleviating respiratory allergy symptoms, it has proven much more difficult to confirm any influence on the progression of the disease. Much more promising is the field of specific allergen immunotherapy, where current evidence, although not yet of ideal robustness, points towards a disease-modifying effect. In addition, newer or emerging, possibly more effective or more targeted interventions are promising in the preventive sense.
Collapse
Affiliation(s)
- Olympia A Tsilochristou
- Allergy Unit "D. Kalogeromitros," Medical School, "Attikon" University Hospital, 1, Rimini str, 124 62, Chaidari, Athens, Greece,
| | | | | | | |
Collapse
|
37
|
DiNicola C, Kekevian A, Chang C. Integrative medicine as adjunct therapy in the treatment of atopic dermatitis--the role of traditional Chinese medicine, dietary supplements, and other modalities. Clin Rev Allergy Immunol 2013; 44:242-53. [PMID: 22661238 DOI: 10.1007/s12016-012-8315-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Atopic dermatitis (AD) is becoming increasingly prevalent in the pediatric population, with rates reportedly as high as 18-25 %. Westernized medicine has traditionally used a combination of emollients, antihistamines, corticosteroids, and immunomodulating agents to combat this often frustrating disease. Of late, integrative medicine has become the subject of more research as concerns grow regarding prolonged use of corticosteroids and their side effects in pediatric patients. Probiotics have been extensively studied to define their role in the treatment and prevention of AD in children. Unfortunately, results are varying showing significant improvement in some patients but not all. With regard to prevention, studies show that the use of probiotics during pregnancy does decrease the incidence of AD in children. Prebiotics and synbiotics are also a conceivable option for prevention of AD. A number of studies on Chinese herbal medicine have been performed, with a collective result of symptom improvement and decreased levels of inflammatory cytokines. However, there were reports of asymptomatic transaminitis in a few patients that warrant further testing. While the herbs tested in more recent randomized clinical trials were free from corticosteroids, a previous study showed high levels of dexamethasone in unlabeled herbal eczema creams. Vitamins and minerals have also been suggested as an alternative treatment of AD. Studies however have not yet demonstrated improvement of AD with vitamin or mineral supplementation. Topical vitamin B(12) is the exception to this; however, no topical vitamin B(12) preparation is available for use. Finally, relaxation techniques are also being investigated as adjunctive methods of treatment, but well-designed scientific studies are lacking.
Collapse
Affiliation(s)
- C DiNicola
- Division of Allergy, Asthma and Immunology, Thomas Jefferson University, Wilmington, DE, USA
| | | | | |
Collapse
|
38
|
Angelakis E, Merhej V, Raoult D. Related actions of probiotics and antibiotics on gut microbiota and weight modification. THE LANCET. INFECTIOUS DISEASES 2013; 13:889-99. [PMID: 24070562 DOI: 10.1016/s1473-3099(13)70179-8] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antibiotics and probiotics are widely used as growth promoters in agriculture. Most antibiotics prescribed in clinical practice are natural products that originate from Streptomyces spp, which were first used as agricultural probiotics. Antibiotics and probiotics both modify the gut microbiota. The effect of a probiotic species on the digestive flora depends on the strain and is largely determined by bacteriocin production. In human beings, as in animals, specific probiotics are associated with weight gain or loss. Improved understanding of the ability of specific probiotics to harvest energy from the host diet might lead to development of new treatments for obesity and malnutrition. In this Review, we present the effects of probiotics and antibiotics on the gut microbiota of human beings and animals and discuss their potential therapeutic use as interventions for weight gain and loss in human beings.
Collapse
Affiliation(s)
- Emmanouil Angelakis
- Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Marseille, France
| | | | | |
Collapse
|
39
|
Abstract
We report that establishment and maintenance of the Drosophila melanogaster microbiome depend on ingestion of bacteria. Frequent transfer of flies to sterile food prevented establishment of the microbiome in newly emerged flies and reduced the predominant members, Acetobacter and Lactobacillus spp., by 10- to 1,000-fold in older flies. Flies with a normal microbiome were less susceptible than germfree flies to infection by Serratia marcescens and Pseudomonas aeruginosa. Augmentation of the normal microbiome with higher populations of Lactobacillus plantarum, a Drosophila commensal and probiotic used in humans, further protected the fly from infection. Replenishment represents an unexplored strategy by which animals can sustain a gut microbial community. Moreover, the population behavior and health benefits of L. plantarum resemble features of certain probiotic bacteria administered to humans. As such, L. plantarum in the fly gut may serve as a simple model for dissecting the population dynamics and mode of action of probiotics in animal hosts. Previous studies have defined the composition of the Drosophila melanogaster microbiome in laboratory and wild-caught flies. Our study advances current knowledge in this field by demonstrating that Drosophila must consume bacteria to establish and maintain its microbiome. This finding suggests that the dominant Drosophila symbionts remain associated with their host because of repeated reintroduction rather than internal growth. Furthermore, our study shows that one member of the microbiome, Lactobacillus plantarum, protects the fly from intestinal pathogens. These results suggest that, although not always present, the microbiota can promote salubrious effects for the host. In sum, our work provides a previously unexplored mechanism of microbiome maintenance and an in vivo model system for investigating the mechanisms of action of probiotic bacteria.
Collapse
|
40
|
Stone S, Edmonds R, Rosenthal KS. Probiotics. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2013. [DOI: 10.1097/ipc.0b013e318297d780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
41
|
Preventative and therapeutic probiotic use in allergic skin conditions: experimental and clinical findings. BIOMED RESEARCH INTERNATIONAL 2013; 2013:932391. [PMID: 24078929 PMCID: PMC3773919 DOI: 10.1155/2013/932391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 07/18/2013] [Indexed: 01/19/2023]
Abstract
Probiotics are ingested live microbes that can modify intestinal microbial populations in a way that benefits the host. The interest in probiotic preventative/therapeutic potential in allergic diseases stemmed from the fact that probiotics have been shown to improve intestinal dysbiosis and permeability and to reduce inflammatory cytokines in human and murine experimental models. Enhanced presence of probiotic bacteria in the intestinal microbiota is found to correlate with protection against allergy. Therefore, many studies have been recently designed to examine the efficacy of probiotics, but the literature on the allergic skin disorders is still very scarce. Here, our objective is to summarize and evaluate the available knowledge from randomized or nonrandomized controlled trials of probiotic use in allergic skin conditions. Clinical improvement especially in IgE-sensitized eczema and experimental models such as atopic dermatitis-like lesions (trinitrochlorobenzene and picryl chloride sensitizations) and allergic contact dermatitis (dinitrofluorobenzene sensitization) has been reported. Although there is a very promising evidence to recommend the addition of probiotics into foods, probiotics do not have a proven role in the prevention or the therapy of allergic skin disorders. Thus, being aware of possible measures, such as probiotics use, to prevent/heal atopic diseases is essential for the practicing allergy specialist.
Collapse
|
42
|
Barletta B, Rossi G, Schiavi E, Butteroni C, Corinti S, Boirivant M, Di Felice G. Probiotic VSL#3-induced TGF-β ameliorates food allergy inflammation in a mouse model of peanut sensitization through the induction of regulatory T cells in the gut mucosa. Mol Nutr Food Res 2013; 57:2233-44. [PMID: 23943347 DOI: 10.1002/mnfr.201300028] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/09/2013] [Accepted: 06/01/2013] [Indexed: 12/18/2022]
Abstract
SCOPE Among food allergies, peanut allergy is frequently associated with severe anaphylactic reactions. In the need for safe and effective therapeutic strategies, probiotics may be considered on the basis of their immunomodulatory properties. The aim of the present study was to investigate the immunological mediators involved in the effects of probiotic VSL#3 oral supplementation on Th2 inflammation and anaphylaxis in a mouse model of peanut allergy. METHODS AND RESULTS VSL#3 supplementation to peanut-sensitized mice was effective in ameliorating anaphylaxis and Th2-mediated inflammation, by promoting regulatory responses in the jejunum mucosa and in the mesenteric lymph node, as evaluated by ELISA, real-time PCR, histologic, and immunohistochemical analysis. Probiotic-induced TGF-β mediates its protective effects through the induction of regulatory T cells expressing FOXP3 and/or latency-associated peptide, as proven by in vivo blockade of TGF-β in VSL#3-treated mice with a neutralizing monoclonal antibody one day before challenge. CONCLUSION TGF-β, induced in the gut by VSL#3 supplementation, is capable of reducing the Th2 inflammation associated with food anaphylaxis in a mouse model of peanut sensitization. TGF-β acts through the induction/maintenance of regulatory T cells expressing FOXP3 and/or latency-associated peptide. Probiotics supplementation may represent an effective and safe strategy for treating food allergies in adult population.
Collapse
Affiliation(s)
- Bianca Barletta
- Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
43
|
Volz T, Skabytska Y, Guenova E, Chen KM, Frick JS, Kirschning CJ, Kaesler S, Röcken M, Biedermann T. Nonpathogenic bacteria alleviating atopic dermatitis inflammation induce IL-10-producing dendritic cells and regulatory Tr1 cells. J Invest Dermatol 2013; 134:96-104. [PMID: 23812300 DOI: 10.1038/jid.2013.291] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/22/2013] [Accepted: 06/01/2013] [Indexed: 12/17/2022]
Abstract
The beneficial effects of nonpathogenic bacteria are increasingly being recognized. We reported in a placebo-controlled study with atopic dermatitis (AD) patients that cutaneous exposure to lysates of nonpathogenic bacteria alleviates skin inflammation. To now unravel underlying mechanisms, immune consequences of sensing nonpathogenic bacterium Vitreoscilla filiformis lysate (Vf) were characterized analyzing (1) differentiation of dendritic cells (DCs) and, consecutively, (2) effector functions of DCs and T helper (Th) cells in vitro and in a murine model of AD in NC/Nga mice in vivo. Topical treatment with Vf significantly reduced AD-like inflammation in NC/Nga mice. Importantly, cutaneous exposure to Vf in combination with the allergen FITC significantly also reduced subsequent allergen-induced dermatitis indicating active immune modulation. Indeed, innate sensing of Vf predominantly induced IL-10-producing DCs, which was dependent on Toll-like receptor 2 (TLR2) activation. Vf-induced IL-10+ DCs primed naive CD4+ T helper cells to become regulatory IFN-γ(low) IL-10(high) Tr1 (type 1 regulatory T) cells. These IL-10(high) Tr1 cells were also induced by Vf in vivo and strongly suppressed T effector cells and inflammation. In conclusion, we show that innate sensing of nonpathogenic bacteria by TLR2 induces tolerogenic DCs and regulatory Tr1 cells suppressing T effector cells and cutaneous inflammation. These findings indicate a promising therapeutic strategy for inflammatory skin diseases like AD.
Collapse
Affiliation(s)
- Thomas Volz
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Yuliya Skabytska
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Emmanuella Guenova
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Ko-Ming Chen
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Julia-Stefanie Frick
- Institute for Medical Microbiology and Hygiene, University Hospital of Tübingen, Tübingen, Germany
| | | | - Susanne Kaesler
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Martin Röcken
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Tilo Biedermann
- Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany.
| |
Collapse
|
44
|
Abstract
Food allergy continues to be a challenging health problem, with prevalence continuing to increase and anaphylaxis still an unpredictable possibility. While improvements in diagnosis are more accurately identifying affected individuals, treatment options remain limited. The cornerstone of treatment relies on strict avoidance of the offending allergens and education regarding management of allergic reactions. Despite vigilance in avoidance, accidental ingestions and reactions continue to occur. With recent advances in the understanding of humoral and cellular immune responses in food allergy and mechanisms of tolerance, several therapeutic strategies for food allergies are currently being investigated with the hopes of providing a cure or long-term remission from food allergy.
Collapse
|
45
|
Hemert SV, Verwer J, Schütz B. Clinical Studies Evaluating Effects of Probiotics on Parameters of Intestinal Barrier Function. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/aim.2013.32032] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
46
|
Fontana L, Bermudez-Brito M, Plaza-Diaz J, Muñoz-Quezada S, Gil A. Sources, isolation, characterisation and evaluation of probiotics. Br J Nutr 2013; 109 Suppl 2:S35-S50. [PMID: 23360880 DOI: 10.1017/s0007114512004011] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
According to the FAO and the WHO, probiotics are 'live microorganisms which, when administered in adequate amounts, confer a health benefit on the host'. The strains most frequently used as probiotics include lactic acid bacteria and bifidobacteria, which are isolated from traditional fermented products and the gut, faeces and breast milk of human subjects. The identification of microorganisms is the first step in the selection of potential probiotics. The present techniques, including genetic fingerprinting, gene sequencing, oligonucleotide probes and specific primer selection, discriminate closely related bacteria with varying degrees of success. Additional molecular methods, such as denaturing gradient gel electrophoresis/temperature gradient gel electrophoresis and fluorescence in situ hybridisation, are employed to identify and characterise probiotics. The ability to examine fully sequenced genomes has accelerated the application of genetic approaches to the elucidation of the functional roles of probiotics. One of the best-demonstrated clinical benefits of probiotics is the prevention and treatment of acute and antibiotic-associated diarrhoea;however, there is mounting evidence for a potential role for probiotics in the treatment of allergies and intestinal, liver and metabolic diseases. There are various mechanisms by which probiotics exert their beneficial effects: regulation of intestinal permeability, normalisation of host intestinal microbiota, improvement of gut immune barrier function, and adjustment between pro- and anti-inflammatory cytokines. The number of studies carried out to test the effects of probiotics in vitro and in animals is enormous. However, the most reliable method of assessing the therapeutic benefits of any probiotic strain is the use of randomised, placebo-controlled trials, which are reviewed in this article [corrected].
Collapse
Affiliation(s)
- Luis Fontana
- Department of Biochemistry & Molecular Biology II, School of Pharmacy and Institute of Nutrition & Food Technology José Mataix, Biomedical Research Centre, University of Granada, Granada, Spain
| | | | | | | | | |
Collapse
|
47
|
Isolauri E, Rautava S, Salminen S. Probiotics in the development and treatment of allergic disease. Gastroenterol Clin North Am 2012; 41:747-62. [PMID: 23101685 DOI: 10.1016/j.gtc.2012.08.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gut microbiota composition can discriminate between allergic and healthy children, and the distinction may precede clinical manifestations of disease. The mother provides the first inoculum of bacteria, which influences the risk of becoming allergic later in life. Bifidobacterium species are major determinants of disease risk. Specific probiotics may modulate early microbial colonization, which represents the first intervention target in allergic disease, together with their ability to reverse the increased intestinal permeability characteristic of children with atopic eczema and food allergy. Probiotics also enhance gut-specific IgA responses, which are frequently defective in children with food allergy. In addition, probiotics have the potential to alleviate allergic inflammation locally and systemically.
Collapse
Affiliation(s)
- Erika Isolauri
- Department of Paediatrics, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
| | | | | |
Collapse
|
48
|
O'Connor A, Lovei GL, Eales J, Frampton G, Glanville J, Pullin A, Sargeant J. Implementation of systematic reviews in EFSA scientific outputs workflow. ACTA ACUST UNITED AC 2012. [DOI: 10.2903/sp.efsa.2012.en-367] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | | | | | - G.K. Frampton
- Southampton Health Technology Assessments Centre, University of Southampton U.K
| | | | | | | |
Collapse
|
49
|
Passalacqua G, Ciprandi G. Emerging drugs for perennial allergic rhinitis. Expert Opin Emerg Drugs 2012. [PMID: 23186314 DOI: 10.1517/14728214.2012.746312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Allergic rhinitis (AR) is a high-prevalence disease, sustained by an IgE-triggered reaction with histamine release, followed by an inflammatory response which involves cells, mediators, cytokines and adhesion molecules. According to its duration, AR can be either intermittent or persistent. In the persistent form, the inflammatory component usually predominates. AREAS COVERED The current therapeutic strategy is based on antihistamines, antileukotrienes and on corticosteroids (which broadly act on inflammation). Allergen-specific immunotherapy is a biological response modifier that affects the immune response to allergens in a broad sense. The available pharmacotherapy is overall effective in controlling symptoms and inflammation, but safety concerns may be present (especially for prolonged treatments), and a proportion of patients remain uncontrolled. The available therapeutic innovations, as derived from the most recent literature are reviewed herein. EXPERT OPINION In the last years there have been very few innovative approaches to optimize the management of AR. These include new histamine receptor antagonists, combination therapy and strategies to selectively block relevant signaling pathways of the allergic reaction. Some more promising advances have been shown for allergen immunotherapy, where a number of new strategies are currently under development.
Collapse
Affiliation(s)
- Giovanni Passalacqua
- Allergy & Respiratory Diseases, IRCCS S. Martino-IST-University of Genoa, Padiglione Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy.
| | | |
Collapse
|
50
|
Abstract
The microbiota contributes to the induction of both effector and regulatory responses in the gastrointestinal (GI) tract. However, the mechanisms controlling these distinct properties remain poorly understood. We previously showed that commensal DNA promotes intestinal immunity. Here, we find that the capacity of bacterial DNA to stimulate immune responses is species specific and correlated with the frequency of motifs known to exert immunosuppressive function. In particular, we show that the DNA of Lactobacillus species, including various probiotics, is enriched in suppressive motifs able to inhibit lamina propria dendritic cell activation. In addition, immunosuppressive oligonucleotides sustain T(reg) cell conversion during inflammation and limit pathogen-induced immunopathology and colitis. Altogether, our findings identify DNA-suppressive motifs as a molecular ligand expressed by commensals and support the idea that a balance between stimulatory and regulatory DNA motifs contributes to the induction of controlled immune responses in the GI tract and gut immune homeostasis. Further, our findings suggest that the endogenous regulatory capacity of DNA motifs enriched in some commensal bacteria could be exploited for therapeutic purposes.
Collapse
|