title: Enhancement of the Circulating Antibody Secreting Cell Response in Human Diarrhea by a Human Lactobacillus Strain No effect of oral treatment with an intestinal bacterial strain, Lactobacillus rhamnosus (ATCC 53103), on birch‐pollen allergy: a placebo‐controlled double‐blind study Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial Effect of Milk Fermented with Lactobacillus acidophilus Strain L-92 on Symptoms of Japanese Cedar Pollen Allergy: A Randomized Placebo-Controlled Trial Dietary therapy with Lactobacillus GG, bovine colostrum or bovine immune colostrum in patients with juvenile chronic arthritis: Evaluation of effect on gut defence mechanisms The efficacy and safety of heat-killed Lactobacillus paracasei for treatment of perennial allergic rhinitis induced by house-dust mite. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effect of probiotics on allergic rhinitis in Df, Dp or dust-sensitive children: A randomized double blind controlled trial Improvements in Seasonal Allergic Disease with Lactobacillus plantarum No. 14 Clinical effects of Lactobacillus acidophilus strain L-92 on perennial allergic rhinitis: a double-blind, placebo-controlled study. Randomized placebo-controlled trial of lactobacillus on asthmatic children with allergic rhinitis. Effect of probiotic Bifidobacterium longum BB536 [corrected] in relieving clinical symptoms and modulating plasma cytokine levels of Japanese cedar pollinosis during the pollen season. A randomized double-blind, placebo-controlled trial. Specific probiotics alleviate allergic rhinitis during the birch pollen season. Immune-modulatory effect of probiotic Bifidobacterium lactis NCC2818 in individuals suffering from seasonal allergic rhinitis to grass pollen: an exploratory, randomized, placebo-controlled clinical trial Efficacy of Oral Administration of a Heat-Killed Lactobacillus gasseri OLL2809 on Patients of Japanese Cedar Pollinosis with High Japanese-Cedar Pollen-Specific IgE Bacillus clausii effects in children with allergic rhinitis Treatment of perennial allergic rhinitis with lactic acid bacteria. Airway inflammation in probiotic-treated children at 5 years. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort.
abstract: ABSTRACT : Human Lactobacillus sp strain GG ( Lactobacillus GG ) administered during acute rotavirus diarrhea has been shown to promote clinical recovery . To eluci date the immune mechanisms behind such a favorable outcome , the ELISPOT ( solid phase enzyme-linked immunospot ) assay of Ig- and specific antibody-secreting cells among circulating lymphocytes was used , giving indirect evidence of the immunologic events in the gut . After rehydration , 39 children with acute rotavirus diarrhea , mean age 16 ( SD 6 ) mo , r and omly received either a Lactobacillus GG fermented milk product ( study group ) or a pasteurized yogurt ( placebo group ) . The duration of diarrhea was significantly shorter in the study group than in the placebo group [ mean 1.1 ( SD 0.6 ) versus 2.5 ( SD 1.4 ) d , p = 0.001 ] . Lactobacillus GG therapy was associated with a significantly enhanced nonspecific humoral response during the acute phase of the infection , reflected in the IgG , IgA , and IgM Ig-secreting cell numbers . At convalescence , 90 % of the study group versus 46 % of the placebo group had developed an IgA specific antibody-secreting cell response to rotavirus ( p = 0.006 ) . The results indicate that Lactobacillus GG promotes recovery from rotavirus diarrhea via augmentation of the local immune defense . Furthermore , specific IgA response to rotavirus is endorsed , which is possibly relevant in protection against reinfections Background : Oral probiotic bacteriotherapy with Lactobacillus rhamnosus has given promising results in small children with food allergy . We studied the effects of similar therapy in teenagers and young adults , who were allergic to birch pollen and apple food and had intermittent symptoms of atopic allergy and /or mild asthma Perinatal administration of the probiotic Lactobacillus rhamnosus strain GG ( ATCC 53103 ) , reduces incidence of atopic eczema in at-risk children during the first 2 years of life ( infancy ) . We have therefore assessed persistence of the potential to prevent atopic eczema at 4 years . Atopic disease was diagnosed on the basis of a question naire and a clinical examination . 14 of 53 children receiving lactobacillus had developed atopic eczema , compared with 25 of 54 receiving placebo  ( relative risk 0.57 , 95 % CI 0.33 - 0.97 ) . Skin prick test reactivity was the same in both groups : ten of 50 children previously given lactobacillus compared with nine of 50 given placebo tested positive . Our results suggest that the preventive effect of lactobacillus GG on atopic eczema extends beyond infancy A placebo-controlled , single-blind study was conducted to evaluate the effects of Lactobacillus acidophilus strain L-92 ( L-92 ) on the symptoms of Japanese cedar-pollen allergy .  This study was carried out during the 2002 and 2003 seasons of Japanese cedar pollination . Twenty-three in-house volunteers were asked to drink 100 ml of heat-treated milk fermented with L-92 containing 5 × 1010 of the bacteria , twice a day , for 6 consecutive weeks . A similar study was carried out during the 2003 season for 10 weeks , but the daily dose of bacteria was 2 × 1010 . A significant improvement of the ocular symptom-medication score ( SMS ) was observed in 2002 and of the score of distress of life in 2003 . These data show that a daily oral intake of not less than 2 × 1010 heat-treated L-92 cells  improved the symptoms of Japanese cedar pollinosis  , thereby contributing to reduce the dose of concomitant medications . However , no blood parameter was significantly affected in these trials The effect of dietary therapy with a human Lactobacillus strain GG ( ATCC 53103 ) , bovine colostrum , or bovine immune colostrum with specific antibodies against anaerobic intestinal bacteria on gut defence mechanisms were studied in juvenile chronic arthritis . Thirty patients with juvenile chronic arthritis were r and omly allocated to receive a freeze-dried powder of Lactobacillus GG , or bovine colostrum , or bovine immune colostrum , for a two-week period . Immunologic and non-immunologic gut defence mechanisms were indirectly investigated in blood and faecal sample s. In patients receiving Lactobacillus GG , the median ( interquartile range ) frequency of immunoglobulin-secreting cells , determined by enzyme-linked immunospot assay , increased in the IgA class from 1840 ( 690–2530 ) to 3480 ( 1030–13 170)/106 cells ; p=0.02 . Likewise the median ( interquartile range ) frequency of specific antibody-secreting cells against dietary antigens increased during the Lactobacillus GG therapy in the IgM class from 3.8 ( 1.4–5.0 ) to 11.2 (5.0–30.0)/106 cells ; p=0.02 . In addition , Lactobacillus GG therapy decreased the median ( interquartile range ) activity of faecal urease , which has been associated with mucosal tissue damage , from 40.3 ( 21.7–54.3 ) to 28.6 ( 24.5–49.4 ) nmol . min−1 ( mg protein)−1 ; p=0.10 , while , in patients receiving bovine colostrum , faecal urease activity increased ( from 42.2 to 80.6 ; p=0.04 ) . All findings were transient . We suggest that gut defence mechanisms are disturbed in juvenile chronic arthritis and we further suggest that orally administered Lactobacillus GG has a potential to reinforce the mucosal barrier mechanisms in juvenile chronic arthritis Live Lactobacillus paracasi 33 ( LP33 ) may effectively improve the quality of life for patients with perennial allergic rhinitis . It has been demonstrated that heat-killed lactic acid bacteria ( LAB ) suppress specific immunoglobulin E synthesis and stimulate interleukin-12 production in animals . The aim of this study was , therefore , to evaluate the efficacy of heat-killed LP33 in the treatment of allergic rhinitis induced by house-dust-mite in human subjects . A total of 90 patients were enrolled in a r and omized , double blind , placebo-controlled trial and assigned to three treatment groups . Patients in groups A and B received two capsules per day of live or heat-killed LAB ( 5 x 10(9 ) colony-forming units/capsule ) , respectively , over a period of 30 days while those in Group C received placebo capsules . A modified question naire on pediatric rhinoconjunctivitis-related quality of life was administered to all subjects or their parents during each clinical visit . The overall quality of life score decreased for groups A and B , as compared with the placebo group , in terms of both frequency ( 9.47 + /- 2.89 , 6.30 + /- 2.19 , vs. -3.47 + /- 1.53 , respectively ; p < 0.0001 ) and level of bother ( 5.91 + /- 3.21 , 6.04 + /- 2.44 , vs. -2.80 + /- 1.64 , respectively ; p = 0.004 ) after the 30-day treatment . The efficacy of the heat-killed LP33 was not inferior to the live variant . No obvious side effects were reported for either active treatment group during the study period . Our results suggest that heat-killed LP33 can effectively improve the overall quality of life for patients with allergic rhinitis , and that it may be efficacious as an alternative treatment Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objective To study , we examined the effect of Lactobacillus salivarius on the clinical symptoms and medication use among children with established allergic rhinitis ( AR ) . Design Double blind , r and omized , controlled trial . Setting Hualien Tzu-Chi General Hospital . Methods Atopic children with current allergic rhinitis received 4 × 109 colony forming units/g of Lactobacillus salivarius ( n=99 ) or placebo ( n=100 ) daily as a powder mixed with food or water for 12 weeks . The SCORing Allergic rhinitis index ( specific symptoms scores [ SSS ] and symptom medication scores [ SMS ] ) , which measures the extent and severity of AR , was assessed in each subject at each of the visits — 2 weeks prior to treatment initiation ( visit 0 ) , at the beginning of the treatment ( visit 1 ) , then at 4 ( visit 2 ) , 8 ( visit 3 ) and 12 weeks ( visit 4 ) after starting treatment . The WBC , RBC , platelet and , eosinophil counts as well as the IgE antibody levels of the individuals were evaluated before and after 3 months of treatment . Results The major outcome , indicating the efficacy of Lactobacillus salivarius treatment , was the reduction in rhinitis symptoms and drug scores . No significant statistical differences were found between baseline or 12 weeks in the probiotic and placebo groups for any immunological or blood cell variables . Conclusions Our study demonstrates that Lactobacillus salivarius treatment reduces rhinitis symptoms and drug usage in children with allergic rhinitis We conducted two r and omized , placebo-controlled , double-blind studies of Lactobacillus plantarum No. 14 ( LP14 ) in female students with seasonal allergic diseases . We also examined the mitogenic activity and cytokine inducibility of LP14 using Peyer ’s patch cells and mesenteric lymph node cells of swine . For subjects who took 8.7 × 108 of LP14  , a significant improvement in ocular symptom-medication score was observed . In the placebo group , the T helper type 1 (Th1)/T helper type 2 ( Th2 ) ratio tended to decrease after a 6-week intake period , while in the LP14 group , the percentage of Th1 cells significantly increased . Post-intake eosinophil counts significantly increased in comparison to those at intake cessation in the placebo group , but it appeared to be suppressed in the LP14 group . There were no changes in fecal microflora .  LP14  strongly induced the gene expression of Th1-type cytokines . This study indicates the clinical effects of LP14 on seasonal allergic diseases 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 r and omized , double-blind , placebo-controlled clinical trial , 49 patients with perennial allergic rhinitis were r and omized 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 result ed 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 Previous studies have suggested that probiotic administration may have therapeutic and /or preventive effects on atopic dermatitis in infants ; however , its role in allergic airway diseases remains controversial . To determine whether daily supplementation with specific Lactobacillus gasseri A5 for 8 weeks can improve the clinical symptoms and immunoregulatory changes in school children suffering from asthma and allergic rhinitis ( AR ) . We conducted a r and omized , double-blind , placebo-controlled study on school children ( age , 6 - 12 years ) with asthma and AR . The eligible study subjects received either L. gasseri A5 ( n = 49 ) or a placebo ( n = 56 ) daily for 2 months . Pulmonary function tests were performed , and the clinical severity of asthma and AR was evaluated by the attending physicians in the study period . Diary cards with records of the day- and nighttime peak expiratory flow rates ( PEFR ) , symptoms of asthma , and AR scores of the patients were used for measuring the outcome of the treatment . Immunological parameters such as the total IgE and cytokine production by the peripheral blood mononuclear cells ( P BMC s ) were determined before and after the probiotic treatments . Our results showed the pulmonary function and PEFR increased significantly , and the clinical symptom scores for asthma and AR decreased in the probiotic-treated patients as compared to the controls . Further , there was a significant reduction in the TNF-α , IFN-γ , IL-12 , and IL-13 production by the P BMC s following the probiotic treatment . In conclusion , probiotic supplementation may have clinical benefits for school children suffering from allergic airway diseases such as asthma and AR Probiotic microorganisms have been shown to be effective in the treatment of allergic inflammation and food allergy , but their efficacy remains controversial . This study tested the effect of a yogurt supplemented with a probiotic strain Bifidobacterium longum BB536 in the treatment of Japanese cedar pollinosis ( JCPsis ) . Forty subjects with a clinical history of JCPsis were given yoghurt either containing BB536 ( BB536 yoghurt ) or without BB536 ( placebo yoghurt ) at 2 X 100 g per day for 14 weeks , in a r and omized , double-blind , placebo-controlled trial . Subjective symptoms and self-care measures were recorded daily and blood sample s were taken before and during the intervention ( at weeks 4 , 9 , and 14 ) to measure the blood parameter levels related to JCPsis . Yoghurt supplemented with BB536 significantly alleviated eye symptoms compared with placebo yoghurt ( odds ratio 0.31 ; 95 % confidence interval 0.10 - 0.97 ; p = 0.044 ) . Although no statistically significant differences were detected , nasal symptoms such as itching , rhinorrhea , and blockage , as well as throat symptoms tended to be relieved with the BB536 yoghurt . BB536 tended to suppress the decreasing blood levels of interferon-gamma ( IFN-y ) and the increasing blood eosinophil rates ; a significantly higher IFN-gamma level was observed for the difference from baseline at week 4 . A decreased trend in the difference from baseline levels of JCP-specific IgE levels was also observed at week 4 in the BB536 group compared with the placebo group . In conclusion , these results suggest that intake of BB536-supplemented yoghurt may relieve JCPsis symptoms , probably through a modulating effect on Th balance AIM To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these . METHODS Forty seven children with confirmed birch pollen allergy were r and omized to receive either a probiotic combination of Lactobacillus acidophilus ( L. acidophilus ) NCFM ( ATCC 700396 ) and Bifidobacterium lactis ( B. lactis ) Bl-04 ( ATCC SD5219 ) or placebo in a double-blind manner for 4 mo , starting prior to onset of the birch pollen season . Symptoms were recorded in a diary . Blood sample s were taken for analysis of cytokines and eosinophils . Fecal sample s were analysed for microbiota components , calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils . RESULTS The pollen season induced a reduction in Bifidobacterium , Clostridium and Bacteroides which could not be prevented by the probiotic intervention . During the intervention , significantly higher numbers of B. lactis 11.2 x 10(7 ) + /- 4.2 x 10(7 ) vs 0.1 x 10(7 ) + /- 0.1 x 10(7 ) bacteria/g feces ( P < 0.0001 ) and L. acidophilus NCFM 3.5 x 10(6 ) + /- 1.3 x 10(6 ) vs 0.2 x 10(6 ) + /- 0.1 x 10(6 ) bacteria/g feces ( P < 0.0001 ) were observed in the probiotic group compared to the placebo group . During May , there was a tendency for fewer subjects , ( 76.2 % vs 95.2 % , P = 0.078 ) to report runny nose , while during June , fewer subjects , 11.1 % vs 33.3 % , reported nasal blocking in the probiotics group ( P = 0.101 ) . Concomitantly , fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group , 57.1 % vs 95 % ( P = 0.013 ) . Eye symptoms tended to be slightly more frequent in the probiotic group , 12.5 d [ interquartile range ( IQR ) 6 - 18 ] vs 7.5 d ( IQR 0 - 11.5 ) ( P = 0.066 ) during May. Fecal IgA was increased in the placebo group during the pollen season ; this increase was prevented by the probiotics ( P = 0.028 ) . CONCLUSION Birch pollen allergy was shown to be associated with changes in fecal microbiota composition . The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa , and indicated a trend for reduced nasal symptoms Background / Objectives : Probiotics are defined as ‘ living micro-organisms that when administered in adequate amounts confer a health benefit to the host ’ . Different probiotic strains have been investigated for beneficial effects on allergic disorders . The purpose of the current study was to evaluate the effect of orally administering the probiotic Nestlé culture collection (NCC)2818 Bifidobacterium lactis strain on immune parameters and nasal symptom scores in subjects suffering from seasonal allergic rhinitis (SAR).Subjects/ Methods : The study was a double-blinded , parallel , r and omized placebo-controlled trial conducted during the peak of the pollen season . Adult subjects with clinical history of SAR and positive skin prick test to grass pollen were recruited . The subjects received B. lactis NCC2818 or placebo for 8 weeks and completed symptom question naires every week . Whole blood was collected at baseline ( V1 ) , 4 weeks ( V2 ) and 8 weeks ( V3 ) to measure immune parameters . Results : Concentrations of Th-2 cytokines , secreted by stimulated blood lymphocytes , were significantly lower in the probiotic group compared with the placebo group at V3 ( interleukin (IL)-5 , P=0.016 ; IL-13 , P=0.005 ) . Total nasal symptom scores were significantly lower in the second month of the study ( weeks 5–8 ) in the probiotic group compared with the placebo group ( P=0.03 ) . Also , percentages of activated CD63 expressing basophils were significantly lower in the probiotic group at V2 ( P=0.02 ) . Conclusions : Oral administration of the probiotic NCC2818 mitigates immune parameters and allergic symptoms during seasonal exposure . These promising results warrant that B. lactis NCC2818 be investigated further in large-scale trials for management of respiratory allergy A r and omized , double-blind , placebo-controlled clinical trial was conducted to determine whether oral administration of heat-killed Lactobacillus gasseri OLL2809 would affect the immune response and reduce the symptoms of Japanese cedar pollinosis ( JCP ) in subjects with JCP . Following a 1-week pre-observation period , the subjects were r and omly divided into two groups and were orally administered a placebo or tablets containing 100 mg of L. gasseri OLL2809 per d for 8 weeks during the pollen season in 2007 . The results showed no obvious differences between the groups . Supplementary subgroup analysis revealed that the OLL2809 subgroups with CAP-RAST scores of 4 or 5 exhibited improvement in nasal symptoms scores and serum allergy-related items , including Japanese cedar pollen-specific IgE levels .  L. gasseri OLL2809 was found to be effective in reducing symptoms in subjects with a high predisposition to allergies by modulating systemic immune systems Allergic rhinitis is characterized by T-helper (Th)2 polarization as elevated levels of Th2-derived cytokines , including interleukin (IL)-4 , IL-5 and IL-13 , have been evidence d at nasal level in allergic rhinitics ( 1 ) . Th2 cytokines play a pathogenic role as they induce IgE synthesis and eosinophil infiltration . Th2 polarization in allergic subjects may occur as consequence of reduced pressure of microbial agents in the gut : the so-called Hygiene Hypothesis ( 2 ) . Probiotics may stimulate immune system at all mucosal surfaces and exert a primary prevention of atopic diseases and reduce allergic symptoms and inflammatory parameters ( 3 ) . We previously found out that Bacillus clausii was capable of modulating cytokine pattern at nasal level in allergic children with recurrent respiratory infections ( 4 ) . Particularly , B. clausii restored physiological Th1 polarization and induced T-regulatory cell response , as documented by increased levels of IL-10 and tumor growth factor (TGF)b after treatment ( 4 ) . Therefore , we conducted a pilot study to investigate the potential effects exerted by B. clausii on nasal symptoms , eosinophils , and symptomatic use of antihistamines in children with allergic rhinitis . Twenty allergic children , 13 males and seven females , with an average age of 13.4 years ( range 12–15 ) were consecutively evaluated . A detailed clinical history and a complete physical examination , including allergy evaluation , were carried out for each patient . The diagnosis of allergic rhinitis due to pollen sensitization was made according to vali date d criteria ( 5 ) . The study was blinded both to the investigator who performed the nasal eosinophil assessment and the investigator who carried out statistical analysis . Symptomatic use of levocetirizine ( 5 mg tablets ) was prescribed for all children . Ten of them were r and omly treated with oral B. clausii ( EnterogerAL LERGY 2 0 0 5 : 6 0 : 7 0 2 – 7 1 0 • COPYRIGHT a 2005 BLACKWELL MUNKSGAARD • ALL R IGHTS RESERVED • CONTRIBUT IONS TO THIS SECT ION WILL NOT UNDERGO PEER REV IEW , BUT WILL BE REV IEWED BY THE ASSOCIATE ED ITORS Probiotics are perceived to exert beneficial effects in the prevention and treatment of allergic diseases via modifying the gut ecosystem . The aim of this study was to assess whether ingestion of fermented milk containing Lactobacillus paracasei-33 ( LP-33 ) , a strain newly isolated from the human intestinal tract , can improve the quality of life of patients with perennial allergic rhinitis . In a r and omized , double-blind , placebo-controlled trial , we gave patients fermented milk with ( n = 60 ) or without ( n = 20 ) the addition of LP-33  ( 2 x 10(9 ) colony-forming units per bottle ) for 30 days . A modified question naire concerning pediatric rhinoconjunctivitis quality of life was administered to all subjects or their parents at each clinical visit . Scores for the overall quality of life significantly decreased in the LP-33 group as compared with the placebo group , in both frequency ( -16.02 + /- 2.14 vs. -7.27 + /- 3.55 , respectively ; p = 0.037 ) and level of bother ( -16.35 + /- 2.33 vs. -6.20 + /- 3.13 , respectively ; p = 0.022 ) after the 30-day treatment . Subjects reported no severe adverse effects such as fever , abdominal pain , or diarrhea . The results suggest that ingestion of LP-33-fortified fermented milk for 30 days can effectively and safely improve the quality of life of patients with allergic rhinitis , and may serve as an alternative treatment for allergic rhinitis Early treatment of new-born high-risk children with certain probiotic strains has reduced the risk of atopic eczema . Whether probiotics reduce risk for airway inflammation in long term is not known . We aim ed at study ing the effect of probiotic treatment during the six first months of life on airway inflammation at age 5 yr . In a r and omized double-blind allergy prevention trial between 2000 and 2007 in Helsinki , Finl and , we gave a probiotic combination , plus pre-biotics , or placebo , to 1018 children during 6 months from birth . At age 5 , we measured exhaled nitric oxide ( FE(NO ) ) in a r and omized sub- population of 160 children . Allergic diseases and IgE-sensitization  were assessed in all infants .  FE(NO ) did not differ between probiotic and placebo groups , median ( interquartile range , IQR ) 5.45 ( 4.3 - 7.3 ) vs. 5.70 ( 3.9 - 6.8 ) ppb , p = 0.22 . FE(NO ) was elevated among those suffering from asthma during the first 5 yr than in healthy non-sensitized children ( p = 0.009 ) . FE(NO ) correlated positively with serum total and allergen-specific IgE concentrations . Early intervention with probiotics and pre-biotics does not affect airway inflammation later in childhood BACKGROUND Less microbial exposure in early childhood is associated with more allergic disease later . Allergic children have a different fecal microflora , with less lactobacilli and bifidobacteria . Beneficial effects regarding the development of allergy have been suggested to come through probiotic supplementation . OBJECTIVE We sought to study the effect of probiotic and prebiotic supplementation in preventing allergies . METHODS In a double-blinded , placebo-controlled study we r and omized 1223 mothers with infants at high risk for allergy to receive a probiotic mixture ( 2 lactobacilli , bifidobacteria , and propionibacteria ) or placebo during the last month of pregnancy and their infants to receive it from birth until age 6 months . Infants also received a prebiotic galacto-oligosaccharide or placebo . At 5 years , we evaluated the cumulative incidence of allergic diseases ( eczema , food allergy , allergic rhinitis , and asthma ) and IgE sensitization . RESULTS Of the 1018 intent-to-treat infants , 891 ( 88 % ) attended the 5-year visit .  Frequencies of allergic and IgE-associated allergic disease and sensitization in the probiotic and placebo groups were similar : 52.6 % versus 54.9 % and 29.5 % versus 26.6 % , respectively , and 41.3 % in both . No significant difference appeared in frequencies of eczema ( 39.3 % vs 43.3 % ) , atopic eczema ( 24.0 % vs 25.1 % ) , allergic rhinitis ( 20.7 % vs 19.1 % ) , or asthma ( 13.0 % vs 14.1 % ) between groups . However , less IgE-associated allergic disease occurred in cesarean-delivered children receiving probiotics ( 24.3 % vs 40.5 % ; odds ratio , 0.47 ; 95 % CI , 0.23 % to 0.96 % ; P = .035 ) . CONCLUSIONS No allergy-preventive effect that extended to age 5 years was achieved with perinatal supplementation of probiotic bacteria to high-risk mothers and children . It conferred protection only to cesarean-delivered children
target: Conclusions The current evidence is not sufficiently strong to verify a preventive role of probiotics in AR , but probiotics may improve the overall quality of life and nasal symptom scores .
background: Background Allergic rhinitis ( AR ) is a disease of respiratory allergy , and probiotics can provide a potential strategy for its management .
  The purpose of this study was to carry out a systematic review to investigate the role of probiotics in the prevention and treatment of AR .