Probiotics in asthma management: fiction or truth?

Figures & data

Figure 1. Potential mechanisms of action of probiotics.

Table 1. Randomized controlled studies investigating a role of probiotics in children with asthma.

Authors	Enrolled children (age)	Probiotics	Study design	Duration of treatment	Parameters	Outcomes	Ref.
Rose MA et al.	131 (6–24 m)	Lactobacillus rhamnosus GG	DBPC	6 months	Symptoms and medications Sensitizations	Slight increase of symptom-free days Reduced number of sensitization (p = 0.027)	[10]
Chen Y-S et al.	105 (6–12 y)	Lactobacillus gasseri	RDBPC	2 months	Asthma symptoms Lung function Cytokines	Reduction asthma symptoms (p < 0.05) Increased FEV1 FEV1/FVC (p < 0.05 and 0.001) Reduction of TNF-α, IFN-γ, IL-12, IL-13 (p < 0.05)	[11]
Miraglia del Giudice M et al.	50 (6–14 y)	Lactobacillus reuteri	DBPC	2 months	Lung function Asthma control FeNO	Reduced FeNO levels (p = 0.005)	[12]
Miraglia del Giudice M et al.	40 (6–12 y)	Bifidobacterium longum Bifidobacterium infantis Bifidobacterium breve	BBPC	1 month	Symptom score Quality of life	Reduction of symptoms (p < 0.005) Improved QoL (p < 0.001)	[13]
Ahanchian H et al.	72 (6–12 y)	L casei, L rhamnosus, S thermophilus, B breve, L acidophilus, B infantis, L bulgaricus	RDBPC	2 months	Viral respiratory infections School absence Rescue medications Outpatient visits Hospital admission	Reduced infections (p = 0.007) and salbutamol use (p = 0.017)	[14]
Hassanzad M et al.	100 (6–12 y)	L casei, L rhamnosus, S thermophilus, B breve, L acidophilus, B infantis, L bulgaricus	RDBPC	6 months	Asthma attacks Hospitalizations Outpatient visits	Reduced outpatient visits (p = 0.001)	[15]
Sangkanjanavanich S et al.	64 (adults)	Bifidobacterium infantis 35,624	RDBPC	4 weeks	Asthma control Lung function Rescue medications T regs	Improved control Unchanged Reduced Increased	[16]
Drago L et al.	500 (3–14 y)	Ligilactobacillus salivarius Bifidobacterium breve	RDBPC	4 months	Asthma exacerbations (number and severity) Medication scores	Reduction of exacerbations (OR 3.17)	[17]

Abbreviations: m = month; y = year; DBPC = double-blind placebo-controlled; RDBPC = randomized BDPC; FeNO = fractional exhaled nitric oxide; ACT = asthma control test; QoL = quality of life.

Rose MA, Stieglitz F, Koksal A, et al. Efficacy of probiotic Lactobacillus GG on allergic sensitization and asthma in infants at risk. Clin Exp Allergy. 2010;40(9):1398–1405.

 PubMed Web of Science ®Google Scholar

Chen Y-S, Jan R-L, Lin Y-L, et al. Randomized placebo-controlled trial of Lactobacillus on asthmatic children with allergic rhinitis. Ped Pulmonol. 2010;45(11):1111–1120.

 PubMed Web of Science ®Google Scholar

Miraglia Del Giudice M, Maiello N, Decimo F, et al. Airways allergic inflammation and L. reuterii treatment in asthmatic children. J Biol Regul Homeost Agents. 2012;26(1 Suppl):S35–S40.

 PubMedGoogle Scholar

Miraglia Del Giudice M, Indolfi C, Capasso M, et al. Bifidobacterium mixture (B longum BB536, B infantis M-63, B breve M-16V) treatment in children with seasonal allergic rhinitis and intermittent asthma. It J Ped. 2017;43:25

 PubMed Web of Science ®Google Scholar

Ahanchian H, Jafari SA, Ansari E, et al. A multi-strain synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial. Electr Physicians. 2016;8(9):2833–2839.

 PubMedGoogle Scholar

Hassanzad M, Mostashari KM, Ghaffaripour H, et al. Synbiotics and treatment of asthma: a double-blinded, randomized, placebo-controlled clinical trial. GMJ. 2019;8:e1350.

 Google Scholar

Sangkanjanavanich S, Pradubpongsa P, Mitthamsiri W, et al. Bifidobacterium infantis 35624 efficacy in patients with uncontrolled asthma: a randomized placebo-controlled trial. Ann Allergy Asthma Immunol. 2022;129(6):790–792.

 PubMed Web of Science ®Google Scholar

Drago L, Cioffi L, Giuliano M, et al. The PRObiotics in Pediatric Asthma Management (PROPAM) study in the primary care setting: a randomized, controlled, double-blind trial with Ligilactobacillus Salivarius LS01 (DSM 22775) and Bifidobacterium Breve B632 (DSM 24706). J Immunol Res. 2022;2022:3837418.

 PubMed Web of Science ®Google Scholar