Eng Probiotic Therapy on Children With Allergic Rhinitis

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JOURNAL READINGProbiotic therapy on children with allergicrhinitis

Franky Luluhima, IPG Karyana, Sumadiono(Paeditrica Indonesiana Volume 53, September 2013)

Annurianisa Luhur Pekerti2010730013


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Abstract

BackgroundInflammation of the mucosal epithelium by eosinophils in nasalsecretions of patients with allergic rhinitis may cause persistent nasalblockage.

A common therapy for allergic rhinitis is oral or intranasalcorticosteroids.

Probiotic treatment in allergic rhinitis patients works by manipulatingthe bacterial ecosystem of the digestive tract, stimulating the balanceof Th1 and Th2 immune responses.

Methode A randomized, double-blind, controlled trial was performed onchildren aged 2 to 18 years who visited Sanglah Hospital, Denpasar,between March to July 2012 due to allergic rhinitis.55 eligible subjects were involved in the study.Subjects were randomly allocated to receive either standard therapy(antihistamines) and probiotics or standard therapy and placebo for30 days.


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ResultThe median (range) nasal eosinophil percentagereduction before the study compared to after 30 days oftreatment was higher in the probiotic group than in theplacebo groupMedian (range) duration of allergic rhinitis episode in theprobiotic group was shorter compared to the placebogroupThe median (range) total nasal symptom score was alsolower in the probiotic group compared to the placebogroup

Conclusion

Probiotic supplementation reduces the percentage of

nasal eosinophils, duration of allergic rhinitis episode,and total nasal symptoms.


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Introduction

Allergic rhinitis is an inflammation in the nosecharacterized by nasal symptoms with anterior orposterior rhinorrhea, sneezing, nasal obstruction, or

itching and 10-26% of all ear-nose-throat (ENT)patients in a few large hospitals in Indonesia.

Probiotics are living, microbial supplements thatimprove the intestinal microfloral balance in humans,and have a unique role on allergic diseaseprevention and treatment.


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Methode

A randomized, double-blind, controlled trial wasundertaken on children 2 to 18 years of age withallergic rhinitis symptoms who visited SanglahHospital, Denpasar, between March 1 to July 15,

2012.The inclusion criteria were patients with allergicrhinitis, aged 2 to 18 years, whose parents agreed toparticipate in this study.

The exclusion criteria those with a history ofcigarette smoke exposure in the 6 months prior tothe study or those who were using corticosteroids.


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55 eligible subjects were randomized into two groups(probiotic or placebo).The probiotics used in this study containedLactobacillus acidophilus, Bacillus clausii,Lactobacillus paracasei, Lactobacillus casei, andLactobacillus rhamnosus species at 1011CFU/sachet and administered once daily for 30days.Nasal swab eosinophils before and after treatment

(probiotics or placebo) was taken after history-takingand physical examinationStandard therapy for allergic rhinitis in this study isantihistamine (cetirizine) at a dose of 0.25 mg/kg

body weight once daily.


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Result


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DiscussionThe aim of this study was to assess probioticeffectiveness on nasal eosinophil levels in children withallergic rhinitis.Previous studies reported inconsistent results withprobiotics usage, either as therapy or prevention, in

children with allergic rhinitis.In this study, we found a statistically significant reductionof the percentage of nasal eosinophils in children withallergic rhinitis who were given probiotics plus standardtherapy compared to those given placebo plus standardtherapy (P


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A meta-analysis of probiotic supplementationconsisting of different probiotic species for 4 weeksas allergic rhinitis and asthma therapy, revealed that9 out of 12 studies reported that probioticsupplementation provided beneficial effects inchildren with allergic rhinitis and significantimprovements in symptoms compared to placeboWe also found that episodes of illness weresignificantly shortened in the probiotic and standard

therapy group compared to the placebo andstandard therapy group.These results were consistent with a review thatprobiotics supplementation that may effectively andsafely prevent and/or cure children with allergicrhinitis


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Limitation

A limitation of this study was that the probiotic usedis a combination of species, hence, we could notdetermine which species best decreased nasaleosinophils in children with allergic rhinitis.

Further studies that control for other confoundingfactors, such as food or milk that containedprobiotics, are needed


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Conclusion

Probiotic supplementation is beneficial fordecreasing nasal eosinophils percentages in childrenwith allergic rhinitis.Further study is needed to strengthen probiotic

effects in children with allergic rhinitis.


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Thank You

Documents

Eng Probiotic Therapy on Children With Allergic Rhinitis