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Effectiveness and safety of probiotic therapy for pediatric allergic rhinitis management: A systematic review and
Xia Wang1, Xiangsheng Tan2, Jiwei Zhou3
1Department of Pediatrics, The Second Affiliated Hospital of Army Medical University, Army Medical University Xinqiao Hospital, Chongqing, 400037, China.
Insights
Probiotics show promise in managing pediatric allergic rhinitis (AR) by improving nasal symptoms and quality of life. This therapy modulates immune balance and reduces medication needs without significant adverse effects.
Area of Science:
- Immunology
- Microbiology
- Pediatrics
Background:
- Allergic rhinitis (AR) is a common condition in children, impacting their quality of life.
- Current management strategies for pediatric AR often involve medications with potential side effects.
- Probiotics offer a potential alternative or complementary approach to AR management.
Purpose of the Study:
- To evaluate the effectiveness of probiotics in managing pediatric allergic rhinitis.
- To assess the safety profile of probiotic use in children with AR.
- To analyze the impact of probiotics on symptom scores, quality of life, and immune markers.
Main Methods:
- A meta-analysis was conducted, including 26 randomized controlled trials.
- Searches were performed across 6 databases to identify relevant studies.
- The Cochrane risk-of-bias tool was used for quality assessment.
Main Results:
- Probiotics significantly improved nasal symptom remission rates and reduced Total Nasal Symptoms Scores (TNSS).
- Quality of life, as measured by the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), showed significant improvement.
- Probiotic use modulated immune markers, decreasing pro-inflammatory cytokines (IL-4, IL-6, IL-17) and increasing anti-inflammatory cytokines (IFN-γ, IL-10).
- A reduction in the duration of cetirizine use was observed, with no significant adverse reactions reported.
Conclusions:
- Probiotic therapy offers a safe and partially effective approach to improving outcomes in pediatric allergic rhinitis.
- Probiotics contribute to managing AR by modulating immune balance and reducing reliance on anti-allergic medications.
- Further research may elucidate optimal probiotic strains and dosages for pediatric AR.
Objective:
This meta-analysis aimed to evaluate the effectiveness and safety of probiotics for allergic rhinitis (AR) management in children.
Methods:
In total, 6 databases were searched, and 26 randomized controlled trials that compared the effects of probiotics with those not using probiotics in pediatric AR were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. Data for relevant endpoints were extracted and analyzed.
Results:
Our meta-analysis of the effectiveness of probiotics for pediatric AR showed that probiotics improved the remission rate of nasal symptoms (risk ratio (RR) 1.21, 95% confidence interval (CI) 1.04 to 1.40; P = 0.01), reduced the Total Nasal Symptoms Scores (TNSS) (weighted mean difference (WMD) -2.58, 95% CI -2.77 to -2.39; P < 0.00001) and the total scores of Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) (for frequency of symptoms: WMD -9.51, 95% CI -10.34 to -8.69; P < 0.00001; and for level of bother: WMD -9.27, 95% CI -10.13 to -8.41; P < 0.00001). Furthermore, they reduced the serum levels of interleukin-4 (IL-4) (WMD -13.86 ng/L, 95% CI -15.92 to -11.81; P < 0.00001), IL-6 (WMD -13.70 pg/mL, 95% CI -16.34 to -11.07; P < 0.00001), and IL-17(WMD -5.41 pg/mL, 95% CI -7.29 to -3.52; P < 0.00001), and significantly elevated the serum levels of interferon-γ (WMD 9.08 ng/L, 95% CI 8.10 to 10.06; P < 0.00001) and IL-10 (WMD 7.82 pg/mL, 95% CI 5.01 to 10.63; P < 0.00001). Probiotics also reduced the duration of cetirizine use in pediatric AR (WMD -2.88 days, 95% CI -4.50 to -1.26; P < 0.0005). No obvious adverse reactions were found to be related to probiotic treatment.
Conclusions:
This meta-analysis indicated that probiotic therapy can partially improve pediatric AR outcomes, assisted by modulating immune balance and reducing anti-allergic medication use, without obvious adverse reactions.
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