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5 April 2018
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5 April 2018
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5 April 2018
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Abstract

It is expected that probiotics may act synergistically to improve the clinical efficacy of sublingual immunotherapy (SLIT). The aim of this study was to investigate the role of probiotics in enhancing efficacy of sublingual immunotherapy in childhood allergic asthma. This was a randomized single blind clinical trial conducted on 6-17 year-old asthmatic children sensitive to house dust mite allergens. Subjects were allocated to Group A receiving SLIT, Group B receiving probiotics and SLIT, Group C receiving probiotics only. Clinical parameters (FEV1 reversibility, medication score, and symptom score) and immunological parameters (total IgE, eosinophil count, IFN-γ, IL-2, IL-4, IL5, IL10, and TGF-b were evaluated in week 0 until 14. Statistical analysis revealed that the difference of clinical parameters (FEV1 reversibility, medication score, and symptom score) between groups were not significant. The difference of the immunological parameters of total IgE, IFN-γ, IL-2, IL-4, IL5, IL10, and TGF-íŸ were also not significant. Eosinophil count decreased in subjects who received combination SLIT with probiotics. In conclusion, probiotics enhanced the efficacy of sublingual immunotherapy in childhood allergic asthma by decreasing the eosinophil count.

Keywords

Asthma allergy sublingual immunotherapy probiotics efficacy

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  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

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How to Cite
Endaryanto, A., & Irmawati, M. (2018). Enhanced Efficacy of Sublingual Immunotherapy in Childhood Allergic Asthma by Probiotics. Folia Medica Indonesiana, 54(1), 64–74. https://doi.org/10.20473/fmi.v54i1.8055
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References

  1. Allam J-P, Novak N (2011). Local immunological me-chanisms of sublingual immunotherapy. Curr Opin Allergy Clin Immunol 11, 571-578
  2. Ariano R, Spadolini I, Panzani RC (2001). Efficacy of sublingual specific immunotherapy in Cupressaceae allergy using an extract of Cupressus arizonica: a double blind study. Allergol Immunopathol (Madr) 29, 238-44
  3. Bahcecilier NN, Isik U, Barlan IB, Basaran N (2001). Efficacy of sublingual immunotherapy in children with asthma and rhinitis: a double-blind, placebo-controlled study. Pediatr Pulmonol 32, 49-55
  4. Bousquet J, Lockey R, Malling HJ (1998). Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol 102, 558 62
  5. Bousquet J, Scheinmann P, Guinnepain MT, et al (1999). Sublingual swallow immunotherapy (SLIT) in patients with asthma due to house dust mites: a double blind placebo controlled study. Allergy 54, 249-60
  6. Caffarelli C, Sensi LG, Marcucci F, Cavagni C (2000). Preseasonal local allergoid immunotherapy to grass pollen in children: a double-blind, placebo-controlled, randomized trial. Allergy 55, 1142-7
  7. Canonica GW, Passalacqua G (2003). Noninjection routes for immunotherapy. J Allergy Clin Immunol 111, 437-448
  8. Clavel R, Bousquet J, Andre C (1998). Clinical efficacy of sublingual-swallow immunotherapy: a double-blind, placebo-controlled trial of a standardized five-grass-pollen extract in rhinitis. Allergy 53, 493-8
  9. Creticos PS, Adkinson NF Jr, Kagey-Sobotka A, et al (1985). Nasal challenge with ragweed pollen in hay fever patients. J Clin Invest 76, 2247-53
  10. Dahl R, Kapp A, Colombo G, et al (2006). Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinocon-juncti-vitis. J Allergy Clin Immunol 118, 434-440
  11. Durham SR (2011). Sustained effects of grass pollen AIT. Allergy 66, 50-52
  12. Durham SR, Emminger W, Kapp A, et al (2012). SQ-standardized sublingual grass immunotherapy: confir-mation of disease modification 2 years after 3 years of treatment in a randomized trial. J Allergy Clin Immunol 129, 717-725
  13. Elazab N, Mendy A, Gasana J, Vieira ER, Quizon A, Forno E (2013). Probiotics administration in early life, atopy, and asthma: a meta-analysis of clinical trials. Pediatrics 132, e666-76
  14. Fanta C, Bohle B, Hirt W, et al (1999). Systemic immunological changes induced by administration of grass pollen allergens via the oral mucosa during sublingual immunotherapy. Int Arch Allergy Appl Immunol 120, 218-24
  15. Feliziani V, Lattuada G, Parmiani S, Dall'Aglio PP (1995). Safety and efficacy of sublingual rush immu-notherapy with grass allergen extracts. A double blind study. Allergol Immunopathol (Madr) 23, 224- 30
  16. Fukushima Y, Kawata Y, Mizumachi K, Kurisaki J, Mitsuoka T (1999). Effect of bifidobacteria feeding on fecal flora and production of immunoglobulins in lactating mouse. Int J Food Microbiol 46, 193-197
  17. Fuller R (1991). Probiotics in human medicine. Gut 32, 439-4429
  18. Geuking MB, Cahenzli J, Lawson MA, Ng DC, Slack E, Hapfelmeier S, et al (2011). Intestinal bacterial coloni-zation induces mutualistic regulatory T cell responses. Immunity 27, 794-806
  19. Gorissen DM, Rutten NB, Oostermeijer CM, Niers LE, Hoekstra MO, Rijkers GT, et al (2014). Preventive effects of selected Probiotics strains on the development of asthma and allergic rhinitis in childhood. The Panda study. Clin Exp Allergy 4, 1431-3.
  20. Guez S, Vatrinet C, Fadel R, André C (2000). House dust mite sublingual swallow immunotherapy in perennial rhinitis: a double blind placebo controlled study. Allergy 55, 369-75
  21. Hirsch T, Sahn M, Leupold W (1997). Double blind placebo controlled study of sublingual immunotherapy with house dust mite extracts in children. Pediatr Allergy Immunol 8, 21-7
  22. Horak F, Stubner UE, Berger U, Marks B, Toth J, Jager S (l998). Immunotherapy with sublingual birch pollen extract: a short term double blind study. J Investig Allergol Clin Immunol 8, 165-71
  23. Hordijk GJ, Antwelink JB, Luwema RA (1998). Sublingual immunotherapy with a standardized grass pollen extract: a double blind placebo controlled study. Allergol Immunopathol 26, 234-40
  24. Isolauri E, Arvola T, Sütas Y, Moilanen E, Salminen S (2000). Probiotics in the management of atopic eczema. Clin Exp Allergy 30, 1604-1610.
  25. Isolauri E (2001). Probiotics in human disease. Am J Nutr 73, 1142S 46S
  26. Kirjavainen PV, Apostolou E, Salminen SJ, Isolauri E (1999). New aspects of probiotics a novel approach in the management of food allergy. Allergy 54, 909-915
  27. La Rosa M, Ranno C, André C, et al (1999). Double blind placebo controlled evaluation of sublingual swallow immunotherapy with standardized parietaria judaica extract in children with allergic rhinocon-junctivitis. J Allergy Clin Immunol 104, 425-32
  28. Lichtenstein LM, Ishizaka K, Norman PS, et al (1973). IgE antibody measurements in ragweed hay fever. Relationship to clinical severity and the results of immunotherapy. J Clin Invest 52, 472-82
  29. Lima MT, Wilson D, Pitkin L, et al (2002). Grass pollen sublingual immunotherapy for seasonal rhinocon-junctivitis: a randomized controlled trial. Clin Exp Allergy 32, 507-14
  30. Lombardi C, Gargioni S, Venturi S, Zoccali P, Canonica GW, Passalacqua G (2001). Controlled study of preseasonal immunotherapy with grass pollen extract in tablets: effect on bronchial hyperreactivity. J Investig Allergol Clin Immunol 11, 41-5
  31. Matricardi PM, Bjorksten B, Bonini S, Bousquet J, Djukanovic R, Dreborg S, Gereda J, Malling H-J, Popov T, Raz E, renz H (2003). Microbial products in allergy prevention and therapy. Allergy 58, 461-71
  32. Matsuzaki, chin J (2000). Modulating immune response with Probiotics bacteria. Immunol and Cell Biol 78, 67-73
  33. Moingeon P, Batard T, Fadel R, Frati F, Sieber J, Van Overtvelt L (2006). Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy 61, 151-165
  34. Moingeon P, Mascarell L (2012). Induction of tolerance via the sublingual route: mechanisms and applications. Clin Dev Immunol 623474
  35. Niers LE, Hoekstra MO, Timmerman HM, van Uden NO, de Graaf PM, Smits HH (2007). Selection of Probiotics bacteria for prevention of allergic diseases: immunomodulation of neonatal dendritic cells. Clin Exp Immunol 149, 344-52
  36. Niers LE, Timmerman HM, Rijkers GT, van Bleek GM, van Uden NO, Knol EF, et al (2005). Identification of strong interleukin-10 inducing lactic acid bacteria which down-regulate T helper type 2 cytokines. Clin Exp Allergy 35, 1481-9
  37. Paganelli R, Ciuffreda S, Verna N, Cavallucci E, Paolini F, Ramondo S et al (2002). Probiotics and food-allergic diseases. Allergy 57, 97-99
  38. Pajno GB, Morabito L, Barberio G, Parmiani S (2000). Clinical and immunological effects of longterm sub-lingual immunotherapy in asthmatic children sensi-tized to mite: a double blind study. Allergy 55, 842-9
  39. Passalacqua G, Albano M, Fregonese L, et al (1998). Randomised controlled trial of local allergoid immunotherapy on allergic inflammation in mite-induced rhinoconjunctivitis. Lancet 351, 629-32
  40. Passalacqua G, Albano M, Riccio AM, et al (1999). Clinical and immunological effects of a rush sublingual immunotherapy to parietaria species: a double blind placebo controlled trial. J Allergy Clin Immunol 104, 964-8
  41. Pfaar O, Cazan D, Klimek L, Larenas-Linnemann D, Calderon M (2012). Adjuvants for immunotherapy. Curr Opin Allergy Clin Immunol 12, 648-657
  42. Pradalier A, Basset D, Claudel A, et al (1999). Sublingual swallow immunotherapy (SLIT) with a standardized five grass pollen extract (drops and sublingual tablets) versus placebo in seasonal rhinitis. Allergy 54, 819-28
  43. Price DB, Rigazio A, Campbell JD, Bleecker ER, Corrigan CJ, Thomas M, Wenzel SE, Wilson AM, Small MB, Gopalan G, Ashton VL, Burden A, Hillyer EV, Kerkhof M, Pavord ID (2015).Blood eosinophil count and prospective annual asthma disease burden: a UK cohort study. Lancet Respir Med 3, 849-58
  44. Purello D'Ambrosio F, Gangemi S, Isola S, et al (1999). Sublingual immunotherapy: a double blind placebo controlled trial with Parietaria judaica extract stan-dardized in mass units in patients with rhinocon-junctivitis, asthma or both. Allergy 54, 968-73
  45. Quirino T, Iemoli E, Siciliani E, Parmiani S, Milazzo F (1996). Sublingual versus injective immunotherapy in grass pollen allergic patients: a double blind (double dummy) study. Clin Exp Allergy 26, 1253-61
  46. Radulovic S, Jacobson MR, Durham SR, Nouri-Aria KT (2008). Grass pollen immunotherapy induces Foxp3-expressing CD4+ CD25+ cells in the nasal mucosa. J Allergy Clin Immunol 121, 1467-1472
  47. Sabbah A, Hassoun S, Le Sellin J, Andre C, Sicard H (1994). A double-blind, placebo-controlled trial by the sublingual route of immunotherapy with a standard-ized grass pollen extract. Allergy 49, 309-13
  48. Scadding GW, Shamji MH, Jacobson MR, et al (2010). Sublingual grass pollen immunotherapy is associated with increases in sublingual Foxp3-expressing cells and elevated allergen-specific immunoglobulin G4, immunoglobulin A and serum inhibitory activity for immunoglobulin E-facilitated allergen binding to B. Clin Exp Allergy 40, 598-606
  49. Secrist H, Dekruyff RH, Umetsu DT (1995). Interleukin 4 production by CD4+T cells from allergic individuals is modulated by antigen concentrations and antigen presenting cell type. J Exp Med 181, 1081-9
  50. Silvestri M, Spallarossa D, Battistini E, et al (2002). Changes in inflammatory and clinical parameters and in bronchial hyperreactivity asthmatic children sensitized to house dust mites following sublingual immunotherapy. J Invest Allergol Clin Immunol 12, 52-9
  51. Sudo N, Sawamura S, Tanaka K, Aiba Y, Kubo C, Koga Y (1997). The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. J Immunol 5, 1739-45
  52. Tari MG, Mancino M, Monti G (1990). Efficacy of sublingual immunotherapy in patients with rhinitis and asthma due to house dust mite. A double-blind study. Allergol Immunopathol (Madr) 18, 277-84
  53. Troise C, Voltolini S, Canessa A, Pecora S, Negrini AC (1995). Sublingual immunotherapy in Parietaria poll-en-induced rhinitis: a double-blind study. J Investig Allergol Clin Immunol 5, 25-30
  54. Upton MN, Mcconnachie A, Mcsharry C, Hart CL, Smith GD, Gillis CR (2000). Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ 321, 88-92
  55. Varney VA, Hamid QA, Gaga M (1993). Influence of grass pollen immunotherapy on cellular infiltration and cytokine mRNA expression during late phase cutaneous response. J Clin Invest 92, 644-50
  56. Voltolini S, Modena P, Minale P, et al (2001). Sublingual immunotherapy in tree pollen allergy: double blind, placebo controlled study with a biologically standardized extract of tree pollen (alder, birch and hazel) administered by a rush schedule. Allergol Immunopathol 29, 103-10
  57. Vourdas D, Syrigou E, Potamianou P, et al (1998). Double blind placebo controlled evaluation of sublingual immunotherapy with a standardized olive tree pollen extract in pediatric patients with allergic rhinoconjunctivitis and mild asthma due to olive tree pollen sensitization. Allergy 53, 662-71
  58. Wu CT, Chen PJ, Lee YT, Ko JL, Lue KH (2016). Effects of immunomodulatory supplementation with Lactobacillus rhamnosus on airway inflammation in a mouse asthma model. J Microbiol Immunol Infect 49, 625-35