Related Experiment Video

Updated: Jun 27, 2026

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
05:31

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels

Published on: August 7, 2017

Bacterial-Derived Immunomodulators as a Preventive Strategy for Viral Respiratory Tract Infections and Associated

Manuel E Soto-Martinez1,2, Wojciech Feleszko3, Alexander Moeller4

  • 1Servicio de Neumología, Departamento de Pediatría, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social, San José 1654-1000, Costa Rica.

Children (Basel, Switzerland)
|June 26, 2026
PubMed

Insights

Bacterial immunomodulators like OM-85 show promise for preventing recurrent respiratory infections (RTIs) in children. While mechanisms are shared, clinical evidence varies, with more research needed for some agents to clarify their role in early-life respiratory health.

Area of Science:

  • Pediatric immunology
  • Infectious disease prevention
  • Respiratory health

Background:

  • Recurrent respiratory tract infections (RTIs) significantly impact children under five, increasing asthma risk.
  • Current treatments focus on acute symptoms, lacking effective preventive strategies.
  • Bacterial-derived immunomodulators offer potential but require further characterization in pediatric populations.

Purpose of the Study:

  • To review preclinical mechanisms and clinical findings of four bacterial immunomodulators for pediatric respiratory health.
  • To contextualize existing evidence and identify research gaps in their use for preventing RTIs.
  • To explore their role in mitigating asthma risk following infections like RSV and RV.

Main Methods:

  • A narrative review of literature indexed in PubMed up to September 2025.
  • Included mechanistic studies, pediatric clinical trials (0-18 years), and meta-analyses.
  • Focused on OM-85, polyvalent mechanical bacterial lysates (PMBL), MV130, and Lactobacillus rhamnosus CRL1505.

Main Results:

  • All agents demonstrated convergent immunomodulatory mechanisms, including epithelial barrier enhancement and immune activation.
  • OM-85 has the most extensive preclinical and clinical data (18 RCTs, 7 meta-analyses).
  • PMBL, MV130, and CRL1505 show distinct mechanisms (e.g., IL-23/IL-22 axis, trained immunity, gut-lung axis), with varying levels of clinical evidence.

Conclusions:

  • These bacterial immunomodulators share a consistent mechanistic basis and favorable safety profiles.
  • Clinical evidence for their efficacy in preventing pediatric RTIs is developing but varies among agents.
  • Further research is anticipated to define their role in early-life respiratory health and prevention.
Abstract

Keywords:
early-life preventionimmunomodulatorspediatric asthmarespiratory tract infectionstrained immunitywheezing

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