Can this "hyped-up" probiotic really treat allergic rhinitis? Listen to what the doctor says →

gossip

"There are probiotics specifically for the treatment of allergic rhinitis. Just taking a little bit every day can cure it !"

There is a claim online that good news has come for people with allergic rhinitis. Scientific research has shown that there is a probiotic that can cure our chronic rhinitis, with a 200% cure rate. Allergic rhinitis can be cured in 3 days! Many patients suffering from allergic rhinitis believed it and purchased this type of probiotic.

Rumor Analysis

This statement is debatable.

There is currently no clear research showing that probiotics, prebiotics or synbiotics can effectively treat or cure allergic rhinitis, and whether they are effective requires further research.

When the seasons change, many patients with allergic rhinitis start sneezing and itching their nostrils. These annoying symptoms keep people awake at night and make them miserable. Many patients hope to find a good cure. When they search online, they find all kinds of strategies and "folk remedies". "Eating certain probiotics can cure allergic rhinitis" is a popular "remedy" online.

I opened an online shopping platform and entered relevant keywords, and found that a bunch of probiotic products claiming to treat allergic rhinitis popped up on the page. So, are there really probiotics that are specifically effective in treating rhinitis?

Image source: Internet screenshot

What are probiotics, prebiotics,

Biostime, postbiotics?

To understand the above questions, let's first clarify what probiotics, prebiotics, synbiotics, and postbiotics are. According to the definitions of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the World Gastroenterology Organization (WGO):

1

Probiotics

Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.

2

Prebiotics

Common ingredients that are selectively utilized by host microorganisms and confer health benefits include oligosaccharides inulin, fructooligosaccharides (FOS), galacto-oligosaccharides (GOSs), lactulose and human milk oligosaccharides (HMOs).

3

Biostime

A combination of prebiotics and probiotics.

4

Postbiotics

Inactivated microorganisms and/or their component preparations have health benefits for the host.

As the largest microbial exposure to date, intestinal flora is also related to regulating immunity and inhibiting allergies. For this reason, over the past few decades, people have designed a series of intervention studies to try to treat allergic diseases by regulating intestinal flora, including the study of the effects of probiotics, prebiotics and synbiotics in the treatment or prevention of allergic rhinitis.

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Probiotic treatment

Theoretical basis of allergic rhinitis

Allergic rhinitis is also called allergic rhinitis. Its main symptoms include sneezing, runny nose, postpharyngeal dripping, and nasal congestion, often accompanied by itching of the eyes, nose and palate. Other common symptoms are cough, irritability and fatigue.

If the patient is continuously exposed to a certain allergen, persistent nasal mucosal inflammation will occur, the sensitivity of the nasal mucosa will increase over time , the nasal allergy threshold will slowly decrease, and it will begin to become more and more sensitive. This makes it easy to have persistent or even more severe rhinitis symptoms when exposed to low concentrations of allergens.

Results from in vitro studies and animal models have shown that probiotics can directly change the composition of intestinal microorganisms, or indirectly by affecting microbial products, host products or food components or regulating the host immune system. Symbiotic intestinal bacteria can reduce local inflammation and may stabilize the integrity of the intestinal barrier, thereby potentially reducing systemic allergen load.

Probiotic treatment

Practice results for allergic rhinitis

However, in the large number of existing clinical studies on probiotics, the conclusions vary greatly. Two high-quality meta-analyses reported that certain probiotic strains can alleviate the symptoms of allergic rhinitis and improve the quality of life; however, there are also studies on similar strains that have reached opposite conclusions.

Although there are positive research conclusions, the quality of the studies varies, and the research designs and outcome indicators vary. Affected by the study population, strain, dosage, usage time and course of treatment, it is difficult for clinicians to give appropriate treatment recommendations to the corresponding population based on these conclusions.

There is still limited evidence that probiotics, prebiotics and synbiotics can improve the symptoms and quality of life of patients with allergic rhinitis, and further research is needed to draw clear conclusions.

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Allergic rhinitis

What are the main treatments?

Current research has evaluated the therapeutic prospects of probiotics, prebiotics and synbiotics in allergic diseases, but they are not yet suitable for clinical treatment. There are no probiotic-related recommendations in the latest international guidelines and Chinese guidelines in 2023.

Allergic rhinitis persists in most people, recurs repeatedly, and requires continuous treatment. The preferred treatment method recommended by the guidelines is to avoid contact with allergens + drug treatment, and add allergen immunotherapy for refractory or severe cases, and surgical treatment is used as appropriate in rare cases.

1

Avoid allergens

This is a measure that seems simple but is actually very troublesome to implement. Usually, it needs to be guided by a professional allergist and a comprehensive environmental control plan should be formulated according to the specific situation. Once the rhinitis patient has identified the allergen, he or she should avoid or reduce contact with the relevant allergen as much as possible.

2

Drug treatment

First-line drugs include nasal glucocorticoids (nasal hormones), second-generation oral antihistamines, and nasal antihistamines. The recommendations for mast cell membrane stabilizers and leukotriene receptor antagonists in China are slightly different from those in foreign countries. China lists anti-leukotriene drugs as first-line treatment, while foreign countries do the opposite.

Image source: Reference [4]

Patients can learn and master the indications for medication, and take medication as needed or continuously according to the onset of rhinitis. The safety of these drugs is very high when used rationally. You can discuss adverse drug reactions with your doctor. It is not recommended not to use medication due to concerns about adverse reactions. After all, the cognitive and life effects of repeated rhinitis attacks will be more serious.

In addition, nasal saline irrigation is a safe, convenient and inexpensive auxiliary treatment that has the effects of diluting mucus, improving mucociliary clearance, reducing mucosal edema and reducing allergens in the nasal cavity and sinuses. It does not increase the risk of otitis media, and other discomfort reactions are mild.

3

Immunotherapy

Immunotherapy, also known as desensitization therapy, is also a first-line treatment method and is recommended for clinical use. In China, it is suitable for patients with rhinitis caused by allergies to house dust mites, dust mites, and Artemisia annua pollen.

It can be administered by subcutaneous injection, sublingual tablet or drops, and by giving gradually increasing doses of allergen extracts, the body's immune tolerance is induced, so that when the patient is exposed to the corresponding allergen again, the symptoms are significantly reduced, or even no clinical symptoms occur. The course of treatment is usually 3 years.

in conclusion

Although some studies have shown that certain probiotic strains can alleviate the symptoms of allergic rhinitis, there are also studies on similar strains that have reached the opposite conclusion. Currently, there is limited evidence that probiotics can improve the symptoms of patients with allergic rhinitis, and further research is needed to draw a clear conclusion.

Allergic rhinitis is a chronic disease characterized by recurrent attacks, and there are limited safe and effective treatments. When conventional treatments for rhinitis are ineffective, it is recommended that patients seek evaluation from professional allergists and otolaryngologists.

Looking in the mirror of rumors

In previous articles published by Science Rumor Refutation, we mentioned that every day, scientific journals around the world publish a large number of new developments and discoveries in life science and medical research, some of which involve health, medical care, drug development or clinical progress. These research results are often the source of news reports in the health field. Especially in the era of self-media, many people who care about their own and their family's health often look for information that is beneficial to maintaining health or treating diseases from the published news. However, for ordinary people who do not have professional knowledge, it is very difficult to understand the research content described in a scientific paper and make correct judgments on the results.

It is completely understandable that patients and their families seek the latest research progress in treatment when they are suffering from illness. However, for practical reasons, we do not encourage people without professional knowledge to seek treatment from so-called new research results, or to change or abandon existing treatment plans.

Scientific research is a gradual process, and there are rarely earth-shattering discoveries and inventions. When faced with new medical research, you may wish to consult professionals first, or "let the bullet fly for a while", and do not blindly place your hopes on personal experience, new or old methods that have not been safely and scientifically verified, etc.

References

[1] WGO. Probiotics and prebiotics. Mandarin | World Gastroenterology Organization

[2] DynaMed. Probiotics. EBSCO Information Services. Accessed March 20, 2024. https://www.dynamed.com/drug-review/probiotics

[3] Susan Prescott, Christina West. Prebiotics and probiotics for treatment of allergic disease. UpToDate Clinical Advisor. https://www.uptodate.com/contents/prebiotics-and-probiotics-for-treatment-of-allergic-disease. Accessed on Dec 30, 2023.

[4] Rhinology Group of the Editorial Committee of the Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Rhinology Group of the Chinese Society of Otorhinolaryngology Head and Neck Surgery. Chinese Guidelines for the Diagnosis and Treatment of Allergic Rhinitis (2022 Revised Edition)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2022, 57(2):106-129.

[5] DynaMed. Allergic Rhinitis. EBSCO Information Services. Accessed March 20, 2024. https://www.dynamed.com/condition/allergic-rhinitis

Planning and production

Author: Fan Yunzhu, Chief Physician of Jiahui Medical

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital

Planning丨Zhong Yanping

Editor: Zhong Yanping

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