Studies in animals have suggested that lactic acid bacteria alleviate allergic diseases, however, little information is available on their clinical effect on allergy in humans. Thus, we examined the efficacy of orally administered Lactobacillus acidophilus strain L-92 (L-92) on perennial allergic rhinitis. In a randomized, double-blind, placebo-controlled clinical trial, 49 patients with perennial allergic rhinitis were randomized to receive either 100 mL of heat-treated fermented milk containing L-92 (n = 25) or acidified milk without lactic acid bacteria (placebo; n = 24) for 8 wk. The severity of symptoms was evaluated based on the changes in the scores of clinical symptoms. Oral administration of milk fermented with L-92 resulted in a statistically significant improvement of nasal symptom-medication scores. Ocular symptom-medication scores of patients in the L-92 intervention group tended to improve compared with those in the placebo group. In addition, clear decreases of the scores of swelling and color of the nasal mucosa were observed in the L-92 intervention group at 6 and 8 wk after the start of ingestion of fermented milk. There were no significant differences in serum antihouse dust mite immunoglobulin E levels nor in T helper type 1/T helper type 2 ratio between the 2 groups. These results suggest that oral administration of L-92 can alleviate the symptoms of perennial allergic rhinitis, however, statistically significant changes were not shown in blood parameters.
Forty healthy individuals with a low defecation frequency were selected, and the effects of intake of a fermented milk beverage that contains Lactobacillus casei strain Shirota (LcS) at 4 × 10 9 bacteria/bottle for 2 weeks (1 bottle/day) on the defecation frequency and intestinal microflora were evaluated by the placebo-controlled double-blind cross-over scheme. Defecation frequency both in times per week and days per week significantly increased in the LcS beverage period compared with the frequency before the beginning of intake. The differences were more notable in those with a stronger tendency to constipation (frequency of defecation before intake ≤ 4.0 times/week, n=21), and the frequency of defecation in the LcS beverage period was significantly higher than in the placebo period. The stool smell and feeling of completion of voiding improved significantly in the LcS beverage period compared with the placebo period, and in those with a stronger tendency to constipation, the stools were significantly softened compared with the state before intake. The number of bifidobacteria and their percentage in the total number of fecal bacteria in the LcS beverage period increased significantly compared with the levels before intake and were significantly higher than the values in the placebo period. No marked change due to the intake of the LcS beverage was observed in the other components of the microflora, the organic acid contents, stool pH, water content, or contents of putrefactive metabolites. These results suggest that intake of the probiotic fermented milk beverage conditions the intestines by improving the state of bowel movements and stool quality and increasing the fecal population level of bifidobacteria.
Background
Patients with vascular Ehlers-Danlos syndrome (EDS) occasionally suffer from arterial dissection. Eagle syndrome, which is caused by an elongated styloid process and also causes arterial dissection, is difficult to diagnose and could sometimes be overlooked. Little is known of the coexistence of these two diseases, and treatment strategy is not established. Here, we present a case of bilateral internal carotid artery (ICA) dissection due to Eagle syndrome in a patient with vascular EDS.
Case presentation
A 30-year-old man was admitted to our hospital because of sudden onset of mild sensory disturbance in his left limbs. He had a history of Ehlers-Danlos syndrome (EDS) and also had left cervical internal carotid artery (ICA) dissection 3 years before. Diffusion-weighted imaging showed acute cerebral infarcts in the right hemisphere. Cervical computed tomography angiography (CTA) revealed the right ICA narrowing at the cervical portion in addition to the previous left cervical ICA dissection. Cervical magnetic resonance imaging (MRI) revealed double-lumen and intramural hematoma at the narrowing portion of the right cervical ICA, which indicates arterial dissection. CT also revealed bilateral elongated styloid processes which are close to each side of cervical ICA. We diagnosed him as bilateral ICA dissection due to bilateral Eagle syndrome. Considering vascular complications due to vascular EDS, we performed closer follow-up with transoral carotid ultrasonography (TOCU). In 4 months, his right ICA dissection gradually improved without stroke recurrence or deterioration of dissection.
Conclusions
Since patients with vascular EDS easily develop arterial dissection, Eagle syndrome may be overlooked. Clinicians should consider Eagle syndrome in the case of vascular EDS with extracranial ICA dissection and close follow-up should be prioritized in cases of Eagle syndrome with vascular EDS.
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