Comparison of two oral probiotic preparations in a randomized crossover trial highlights a potentially beneficial effect of Lactobacillus paracasei NCC2461 in patients with allergic rhinitis

Abstract

BackgroundThere is promising but conflicting evidence to recommend the addition of probiotics to foods for prevention and treatment of allergy. Based on previous studies with fermented milk containing Lactobacillus paracasei NCC2461, we aimed to compare the effect of a powder form of the latter probiotic with the effect of a blend of Lactobacillus acidophilus ATCC SD5221 and Bifidobacterium lactis ATCC SD5219 in patients with allergic rhinitis.MethodsA double-blind, randomized, cross-over study, involving 31 adults with allergic rhinitis to grass pollen, was performed outside the grass pollen season (registration number: NCT01233154). Subjects received each product for 4-weeks in two phases separated by a wash-out period of 6 to 8 weeks. A nasal provocation test was performed before and after each 4-week product intake period, and outcome parameters (objective and subjective clinical symptoms; immune parameters) were measured during and/or 24 hours after the test.ResultsOut of the 31 subject enrolled, 28 completed the study. While no effect was observed on nasal congestion (primary outcome), treatment with NCC2461 significantly decreased nasal pruritus (determined by VAS), and leukocytes in nasal fluid samples, enhanced IL-5, IL-13 and IL-10 production by peripheral blood mononuclear cells in an allergen specific manner and tended to decrease IL-5 secretion in nasal fluid, in contrast to treatment with the blend of L. acidophilus and B. lactis.ConclusionsDespite short-term consumption, NCC2461 was able to reduce subjective nasal pruritus while not affecting nasal congestion in adults suffering from grass pollen allergic rhinitis. The associated decrease in nasal fluid leukocytes and IL-5 secretion, and the enhanced IL-10 secretion in an allergen specific manner may partly explain the decrease in nasal pruritus. However, somewhat unexpected systemic immune changes were also noted. These data support the study of NCC2461 consumption in a seasonal clinical trial to further demonstrate its potentially beneficial effect.

Oral administration of Lactobacillus paracasei NCC 2461 for the modulation of grass pollen allergic rhinitis: a randomized, placebo‐controlled study during the pollen season

“…Prior to this study, the effect of NCC 2461 in modulating grass pollen allergic rhinitis was evaluated in two exploratory studies, outside the pollen season in nasal provocation test settings [ 12 , 13 ]. Results of these trials suggested a role of NCC 2461 in immune regulation, as cytokine expression by peripheral blood mononuclear cells cultures [ 12 ] or in nasal secretions [ 13 ] was significantly different when compared to a placebo [ 12 ] or a different probiotic blend [ 13 ]. In addition, both studies showed that NCC 2461 administration might affect distinct subjective symptoms of allergic rhinitis, namely congestion [ 12 ] and pruritus [ 13 ].…”

“…Results of these trials suggested a role of NCC 2461 in immune regulation, as cytokine expression by peripheral blood mononuclear cells cultures [ 12 ] or in nasal secretions [ 13 ] was significantly different when compared to a placebo [ 12 ] or a different probiotic blend [ 13 ]. In addition, both studies showed that NCC 2461 administration might affect distinct subjective symptoms of allergic rhinitis, namely congestion [ 12 ] and pruritus [ 13 ]. In contrast, the results from the study presented in this manuscript indicate no effect of NCC 2461 in modulating TNSS, TOSS, nor any of the symptoms considered individually.…”

rBet v 1 immunotherapy of sensitized mice with Streptococcus thermophilus as vehicle and adjuvant

“…29 Notably, a recent study evidenced a clear Th2-Th1 shift and Treg induction in allergic patients treated with lactobacilli without improvement in allergic symptoms. 30 One possible explanation for the lack of clinical remission might be that lactobacilli evoke immune cellular responses that are allergen-independent and, therefore, not allergen-specific. This may hamper the clinical efficacy of the treatment.…”

Therapeutic Modification of the GI Microbiome

“…53 A crossover RCT compared the effects of two oral probiotic preparations (a powdered form of L. paracasei NCC2461 versus a blend of L. acidophilus ATCC SD5221 and Bifidobacterium lactis ATCC SD 5219) in 28 adults with allergic rhinitis to grass pollen. 54 Subjects received each product for 4 weeks-separated by a washout period of 6-8 weeksfollowed by a nasal provocation test. In contrast to consumption of the L. acidophilus and B. lactis blend, treatment with L. paracasei significantly reduced nasal pruritus but not nasal congestion, associated with a decrease in nasal fluid leukocytes and secretions of several interleukins.…”