Isabel Ojeda and Filippo Fassio*
Allergic Rhinitis (AR) is a “type 2“ inflammatory disease, caused by an immunoglobulin E (IgE)-mediated reaction to inhaled allergens and characterized by nasal symptoms. Pharmacologic treatment of AR mainly consists of oral/intranasal anti-histamines, intranasal glucocorticosteroids and Allergen-Specific Immunotherapy (AIT). When used correctly, these therapies are effective in most - but not in all - patients and can improve symptoms and Quality of Life (QOL); however, many patients show poor adherence to treatment, do not follow prescriptions, and coincidently experience side effects that lead to treatment cessation.
Here, we briefly review and discuss recent findings from a proof-of-concept study about a synbiotic food supplement (Lactobacillus acidophilus NCFM, Bifidobacterium lactis BL-04 and Fructo-Oligosaccharides), which was evaluated in birch pollen allergic patients with AR, in a highly standardized setting of an Allergen Exposure Chamber (AEC). The study has demonstrated significant symptom improvement after the intake of the synbiotic food supplement. Both, the median TNSS was reduced by 50% (adjusted p-value=0.025) and the median TSS by 80% (adjusted p-value=0.0097), as well as the personal well-being of the patients was increased by 50%. In addition, the synbiotic food supplement revealed an excellent safety and tolerability profile.
The present study is an excellent example that demonstrates efficacy for a specific synbiotic product and a superior tolerability and safety profile in the treatment of AR. It can be considered as an adjunct therapy for patients who do not improve with conventional medication for rhinitis, do not tolerate it or do not fit criteria for AIT. Evidence available to date guides us to consider probiotics/synbiotics as complementary treatment strategies in AR.
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