Immune Modulation Through Long-Term Lacticaseibacillus rhamnosus Therapy in Home Mechanically Ventilated Patients

Area of Science:

• Immunology
• Microbiology
• Respiratory Medicine

Background:

• Probiotics modulate the immune system, but their effects on home mechanically ventilated (HMV) patients are unknown.
• HMV patients are susceptible to infections, necessitating strategies to bolster their immune defenses.

Purpose of the Study:

• To investigate the impact of Lacticaseibacillus rhamnosus GG (LGG) oral supplementation on nasal microbiota and immune parameters in HMV patients.
• To assess the safety and potential immunomodulatory effects of LGG in this patient group.

Main Methods:

• Thirty-one HMV patients received LGG (8 × 10^9 CFU/day) for 6 months after a 3-month probiotic washout.
• Nasal swabs and blood samples were collected at baseline, 3, and 6 months.
• Assessed nasal microflora, Th1/Th2 balance, and levels of IL-2, IL-4, IL-5, IL-10, TNF-α, and IFN-γ.

Main Results:

• Significant increases in IL-2 (at 3 and 6 months) and transient increases in IFN-γ (at 3 months) and IL-4 (at 6 months) were observed.
• The IFN-γ/IL-10 ratio increased at 3 months, suggesting a shift towards pro-inflammatory responses.
• No significant changes in nasal bacterial flora or other measured cytokines were detected; no antibiotic therapy was required during the study.

Conclusions:

• LGG supplementation appears safe and well-tolerated in HMV patients.
• Elevated IL-2 and IFN-γ suggest enhanced anti-infective immunity, while increased IL-4 may modulate inflammation.
• LGG may be a valuable adjunctive therapy to reduce infection risk and improve outcomes in HMV patients.