In natural medicine, probiotics are primarily used to treat gastrointestinal disorders, but recent studies have noted that they also help patients with allergy-related asthma. What these studies haven’t addressed, however, is which strain of probiotic works best to combat this inflammatory disease. Researchers from Milan therefore tested 2 common probiotics—Lactobacillus salivarius LS01 and Bifidobacterium breve BR03—alone and in combination to ascertain the most effective probiotic format for treating asthma.
To this end, the research team collected blood samples from patients with a clinical diagnosis of allergic asthma (median age=30 y; range 20-35 y). All participants underwent radioallergosorbent test and prick test to ascertain their specific allergens (most common were dust mite, ragweed, grass, dust, and pollen). After isolating the peripheral blood mononuclear cells (PBMCs, markers of immune function) in the samples, the research team subjected the samples to the pathogenic bacterial strains Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Streptococcus pyogenes, and Pseudomonas aeruginosa. The samples were then treated with strains of L salivarius LS01 and B breve BR03 (Bifiderm, Bayer, Milan, Italy) containing about 1×109 colony forming units of each strain. The strains were used both alone and in combination.
Only the LS01 and BR03 co-culture was able to inhibit the growth of all the tested pathogens, and in By adjusting the pH, the researchers found that the antimicrobial effect of LS01 and BR03 supernatant against E. coli and S. aureus may be due to a direct inhibition activity on pathogens’ growth and on the production of bacteriocins. Thus the combination probiotics demonstrated the ability to rebalance the altered intestinal microbiota in patients affected by atopic dermatitis.
Additionally, after treatment with the probiotics, the researchers measured the cytokines in the PBMCs to assess the effect on the production of interleukin (IL)-10, IL-4, Il-5, IL-13, IL-17, and transforming growth factor (TGF)-β. They found that L salivarius LS01 and B breve BR03 working together led to greater production of the antiinflammatory cytokine IL-10, which indicates a concomitant inhibition of the proinflammatory cytokines Il-4 and IL-5. The combination of probiotics also inhibited the production of proinflammatory IL-13, IL-17, and TGF-β. Given that high levels of TGF-β are especially indicative of persistent inflammation, its inhibition with this probiotic treatment is potentially relevant for asthma sufferers. Additionally, the ability of LS01 and BR03 to down-regulate the secretion of TGF-β, IL-13, and IL-17 in asthmatic subjects may lead to the rebalancing of Th1/Th2 ratio and to the improvement of allergic symptoms.
As the incidence of allergy-related asthma increases worldwide, these preliminary results should encourage larger trials of the combination probiotics, such as L salivarius LS01 and B breve BR03 as an affordable, accessible treatment for this prevalent condition.
Drago l, DeVecchi E, Gabrieli A, DeGrandi R, Toscano M. Immunomodulatory effects of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03, alone and in combination, on peripheral blood mononuclear cells of allergic asthmatics. Allergy Asthma Immunol Res. 2015;7(4):409-413.

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