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Probiotics for people with seasonal allergies.

Dennis-Wall JC, Culpepper T, Nieves Jnr C, Rowe CC, Burns AM et al. 2017. Probiotics (Lactobacillusgasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life with seasonal allergies: a double-blind, placebo-controlled, randomized trial. Am J Clin Nutr, 105: 758-67

Allergic rhinitis can cause significant impact on quality of life, and has been associated with lack of sleep, reduced productivity, emotional distress, and embarrassment. Additionally, medications for allergic rhinitis may cause side effects that may also impact quality of life. Whilst a recent meta-analysis reported that probiotics have potential to improve quality of life in people experiencing allergies, additional research is required to confirm this. Accordingly, the aim of this study was to assess whether supplementation with a probiotic combination in people who self-identify with seasonal allergies would have improved rhinoconjunctivitis quality of life scores compared to placebo.

The study population of 173 participants were recruited from Florida and were eligible for inclusion if aged between 18-60 years and self-identified as having seasonal allergies. Participants were required to maintain their regular levels of physical activity and diet for the duration of the study, and discontinue consumption of fermented foods, probiotics, and immune-enhancing supplements. Exclusion criteria included use of allergy medications (including nasal sprays) [greater than or equal to] 5 d/wk during allergy season, having received allergy shorts, pregnancy or attempting to conceive, regular use of systemic corticosteroids, androgens, or large doses of antiinflammatory drugs, recent history of chemotherapy or other immune-suppressing treatment, and a number of medical conditions. Participants were assigned to receive either a probiotic or placebo twice daily during spring allergy season for 8 weeks. The probiotic capsules contained 1.2 billion CFU of Lactobacillus gasseri KS-13, 0.15 billion CFU of Bifidobacterium bifidum G9-1, and 0.15 billion CFU of B. longum MM-2 for a total of 1.5 billion CFU/capsule before expiration. Participants were instructed to complete daily and weekly questionnaires for the entire 8 weeks of the study, with the primary outcome, rhinoconjunctivitis-specific quality of life, measured by using validated scores obtained through the questionnaire. Fasting blood samples were taking from a subgroup of the population at baseline and week 6 (predicted peak of pollen) to determine serum immunoglobulin (Ig) E concentrations and regulatory T cell percentages.

The probiotic group reported an improvement in the scores from baseline to pollen peak compared with placebo, demonstrating significant improvement in rhinoconjunctivitis specific quality of life during allergy season in otherwise healthy individuals with self-reported seasonal allergies. No difference in mean serum total IgE levels were observed between placebo and probiotic groups at baseline or week 6, nor were any differences between groups of regulatory T cells levels observed.

Whilst the study demonstrated at improvement in quality of life scores, due to the combination of the probiotic supplement, it cannot be ascertained if the effect was due to one or a combination of the three strains included. The mechanism for action remains unclear. Future research should aim to identify the mechanisms of action of specific probiotics on immune function to better understand and utilise probiotic supplements.
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Title Annotation:Reviews of medical journal articles
Author:Tester, Jodie
Publication:Australian Journal of Herbal Medicine
Article Type:Report
Date:Jun 1, 2017
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