0
Correspondence |

Probiotics in United Airways DiseaseProbiotics in Allergic Rhinobronchitis FREE TO VIEW

Rashmi Ranjan Das, MD
Author and Funding Information

From the Department of Pediatrics, All India Institute of Medical Sciences.

Correspondence to: Rashmi Ranjan Das, MD, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi-110029, India; e-mail: rrdas05@gmail.com


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(4):1099-1100. doi:10.1378/chest.11-0983
Text Size: A A A
Published online

To the Editor:

I read with great interest the article by Forsythe1 in a recent issue of CHEST (April 2011). The author reports that probiotics are not shown to be beneficial in the treatment of asthma. This holds true for the preventive effect, but not the therapeutic effect, of probiotics. I agree with the author that clinical trials have not shown beneficial effects of probiotics in patients with asthma. But, at the same time, children having concomitant asthma and allergic rhinitis (AR) have benefited from probiotics treatment, as shown in some trials.

In one trial,2 researchers found that the time free from episodes of asthma/rhinitis was longer and the cumulative number of asthma and rhinitis episodes was lower in the probiotics group. In another trial,3 researchers found improvement in the pulmonary function, a significant increase in peak expiratory flow rate, and decreases in the clinical symptom scores for asthma and AR in the patients treated with probiotics compared with the control group. The beneficial effects of probiotics treatment in patients with both asthma and AR (but not asthma alone) can be explained by the fact that probiotics treatment has consistently been shown in clinical trials to be beneficial in patients with AR. In a systematic review by our group,4 we also found that probiotics intake improved the quality-of-life score (standardized mean difference, −1.17; 95% CI, −1.47 to −0.86; P < .00001) and decreased the number of episodes per year in patients with AR. This has important clinical as well as therapeutic implications if we consider the concept of united airways disease or allergic rhinobronchitis.5 Increasing evidence shows a close link between the upper and lower airways and suggests rhinitis may have an important impact on asthma. The result of any common inflammatory process can explain some of the complex interactions among rhinitis, sinusitis, bronchial hyperresponsiveness/asthma, and viral infections. Moreover, evidence that treatment of rhinitis benefits patients with asthma has recently provided further support for the hypothesis.

To conclude, though current evidence does not show probiotics to be beneficial in asthma, it would be premature to say at this stage that probiotics are not beneficial in the treatment of asthma. I hope that future trials will try to answer the many unresolved questions (eg, beneficial effect of any particular strain of bacteria, subgroup of population showing the benefit, actual molecular mechanism, effectiveness of larger dose of probiotics if smaller dose is not effective, etc.) before any firm conclusions are made.

Forsythe P. Probiotics and lung diseases. Chest. 2011;1394:901-908 [CrossRef] [PubMed]
 
Giovannini M, Agostoni C, Riva E, et al; Felicita Study Group Felicita Study Group A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containingLactobacillus caseiin pre-school children with allergic asthma and/or rhinitis. Pediatr Res. 2007;622:215-220 [CrossRef] [PubMed]
 
Chen YS, Jan RL, Lin YL, Chen HH, Wang JY. Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. Pediatr Pulmonol. 2010;4511:1111-1120 [CrossRef] [PubMed]
 
Das RR, Singh M, Shafiq N. Probiotics in treatment of allergic rhinitis. World Allergy Organiz J. 2010;39:239-244 [CrossRef]
 
Passalacqua G, Ciprandi G, Canonica GW. The nose-lung interaction in allergic rhinitis and asthma: united airways disease. Curr Opin Allergy Clin Immunol. 2001;11:7-13 [PubMed]
 

Figures

Tables

References

Forsythe P. Probiotics and lung diseases. Chest. 2011;1394:901-908 [CrossRef] [PubMed]
 
Giovannini M, Agostoni C, Riva E, et al; Felicita Study Group Felicita Study Group A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containingLactobacillus caseiin pre-school children with allergic asthma and/or rhinitis. Pediatr Res. 2007;622:215-220 [CrossRef] [PubMed]
 
Chen YS, Jan RL, Lin YL, Chen HH, Wang JY. Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. Pediatr Pulmonol. 2010;4511:1111-1120 [CrossRef] [PubMed]
 
Das RR, Singh M, Shafiq N. Probiotics in treatment of allergic rhinitis. World Allergy Organiz J. 2010;39:239-244 [CrossRef]
 
Passalacqua G, Ciprandi G, Canonica GW. The nose-lung interaction in allergic rhinitis and asthma: united airways disease. Curr Opin Allergy Clin Immunol. 2001;11:7-13 [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543