Citrus juice fermented with Lactobacillus plantarum YIT 0132 alleviates symptoms of perennial allergic rhinitis in a double-blind, placebo-controlled trial

Efficacy and safety of gastrointestinal microbiome supplementation for allergic rhinitis: A systematic review and meta-analysis with trial sequential analysis

BACKGROUND

Allergic rhinitis (AR) is a non-infective chronic inflammatory disease of nasal mucosa.

PURPOSE

To evaluate the efficacy and safety of gastrointestinal microbiome supplementation (GMS) for patients with allergic rhinitis (AR), concerning improvement on symptoms and signs, laboratory outcomes, quality of life, and medication scores.

METHODS

Five English databases were searched up to Dec 12th, 2022. Probiotics, prebiotics, and synbiotics were main therapies or adjuvants in experimental groups. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method by using RevMan 5.4 Software, with meta-influence analyses, subgroup-analyses, meta-regression, and publication bias performed for exploration of heterogeneity by Stata V.14. Trial sequential analyses were performed by TSA 0.9, and quality of the results was accessed through the GRADE-pro GDT.

RESULTS

Finally, extracted from 53 articles, 65 RCTs involving 3,634 participants with sound worldwide representativeness were included. Primary results showed better improvement in GMS groups on TNSS (WMD=1.05, P for WMD=0.004, 95%CI:0.34 to 1.76), overall nasal condition (WMD=1.25, P for WMD<0.001, 95%CI:0.90 to 1.61), overall quality of life (WMD=6.16, P for WMD<0.001, 95%CI:4.92 to 7.40) and medication score (WMD=0.42, P for WMD=0.42, 95%CI:-0.06 to 0.90).However, GMS groups were inferior than the controls concerning reduction on serum total IgE (WMD=-1.81) and ratios of serum Th1/Th2 (WMD=-1.06). Meta-regressions suggested significant (p<0.05) variations of the effects in some comparisons. In addition, results of sub-group analyses firstly revealed potential influence between final results and the variables above. Instantly after intervention, the GRADE levels of evidence were sound, including "High ⨁⨁⨁⨁" in 10, "Moderate ⨁⨁⨁◯" in 33, and "Low ⨁⨁◯◯" in nine comparisons. However, overall certainties decreased obviously during follow-ups.

CONCLUSION

Overall, our pooled results firstly revealed that GMS yielded acceptable benefits for patients with AR compared with controls with sound certainties, after balancing the benefits and harms.

Combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy in cow's milk allergy: a randomised controlled trial

Safer and more effective cow milk (CM)-oral immunotherapy that does not induce allergic reactions has not yet been standardised. We sought to explore the efficacy and feasibility of a combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy for treating IgE-mediated cow milk allergy (CMA). We conducted a 24-week, double-blind, randomised (1:1), two-arm, parallel-group, placebo-controlled, phase 2 trial of LP0132 intervention for treating IgE-mediated CMA in children aged 1-18 years (n=60) from January 29, 2018 to July 12, 2019 in Tokyo, Japan. Participants were randomly assigned to the LP0132 group receiving citrus juice fermented with LP0132 or to the control group receiving citrus juice without. Both groups received low-dose slow oral immunotherapy with CM. The primary outcome was improved tolerance to CM, proven by the CM challenge test at 24 weeks. Secondary outcomes were changes in serum biomarkers of serum-specific β-lactoglobulin-IgE (sIgE) and β-lactoglobulin-IgG4 (sIgG4). Exploratory outcomes included changes in serum cytokine levels and gut microbiota composition. A total of 61 participants were included. Finally, 31 children were assigned to the LP0132 group and 30 to the control group, respectively. After the intervention, 41.4 and 37.9% of the participants in the LP0132 and control groups, respectively, showed improved tolerance to CM. In serum biomarkers after the intervention, the sIgG4 level was significantly higher, and interleukin (IL)-5 and IL-9 were significantly lower, in the LP0132 group than in the control group. In the gut microbiome, the α-diversity and Lachnospiraceae increased significantly in the LP0132 group, and Lachnospiraceae after the intervention was significantly higher in the LP0132 group than in the control group. In conclusion, low-dose oral immunotherapy with modulating gut microbiota might be a safer and more effective approach for treating cow's milk allergy.

Fermented Food in Asthma and Respiratory Allergies—Chance or Failure?

In the last few decades, a dramatic increase in the global prevalence of allergic diseases and asthma was observed. It was hypothesized that diet may be an important immunomodulatory factor influencing susceptibility to allergic diseases. Fermented food, a natural source of living microorganisms and bioactive compounds, has been demonstrated to possess health-promoting potentials and seems to be a promising strategy to reduce the risk of various immune-related diseases, such as allergic diseases and asthma. The exact mechanisms by which allergic diseases and asthma can be alleviated or prevented by fermented food are not well understood; however, its potential to exert an effect through modulating the immune response and influencing the gut microbiota has been recently studied. In this review, we provide the current knowledge on the role of diet, including fermented foods, in preventing or treating allergic diseases and asthma.

Use of allopathic and complementary medicine for preventing SARS-CoV-2 infection in Mexican adults: A national survey

Background

The aim of this study was to assess the frequency of allopathic and complementary medicine use for preventing the infection with SARS-CoV-2 in Mexico. A descriptive and cross-sectional study was conducted using an online questionnaire among general adult population (n = 16,724) of the 32 Mexican states from March to November 2020.

Methods

The factors associated with the use, self-medication practice, and adverse reactions due the consumption of allopathic and complementary medicine to prevent infection with SARS-CoV-2 virus were assessed using a structured questionnaire. The suspected adverse reactions associated with the use of drugs or complementary medicine were reported.

Results

The prevalence (42.9%) of allopathic and/or complementary medicine use for preventing SARS-CoV-2 infection was mainly associated with unemployment [OR:2.026 (1.722–2.283)]. Acetaminophen (n = 2272) and vitamin C (n = 3252) were the main allopathic and complementary medicine products used to prevent SARS-CoV-2 infection, respectively. The prevalence of self-medication and adverse reactions was 35.3% and 4.8%, respectively. Self-medication [OR:1.930 (1.633–2.282)] and adverse reactions [OR:2.603 (2.015–3.363)] were mainly associated with individuals of low socioeconomic status. Hydroxychloroquine (21.2%) and chloroquine (15.2%) showed the highest prevalence of adverse reactions, which were mainly related to gastrointestinal disorders.

Conclusion

The use of medications and complementary medicine to prevent SARS-CoV-2 infection is prevalent (almost one-half of the respondents) among Mexican population, and it is mainly associated with unemployment. Self-medication and the adverse reactions derived from self-medication are also prevalent and seem to be influenced by low socioeconomic status.

Health-Promoting Role of Lactiplantibacillus plantarum Isolated from Fermented Foods

Fermentation processes have been used for centuries for food production and preservation. Besides the contribution of fermentation to food quality, recently, scientific interest in the beneficial nature of fermented foods as a reservoir of probiotic candidates is increasing. Fermented food microbes are gaining attention for their health-promoting potential and for being genetically related to human probiotic bacteria. Among them, Lactiplantibacillus (Lpb.) plantarum strains, with a long history in the food industry as starter cultures in the production of a wide variety of fermented foods, are being investigated for their beneficial properties which are similar to those of probiotic strains, and they are also applied in clinical interventions. Food-associated Lpb. plantarum showed a good adaptation and adhesion ability in the gastro-intestinal tract and the potential to affect host health through various beneficial activities, e.g., antimicrobial, antioxidative, antigenotoxic, anti-inflammatory and immunomodulatory, in several in vitro and in vivo studies. This review provides an overview of fermented-associated Lpb. plantarum health benefits with evidence from clinical studies. Probiotic criteria that fermented-associated microbes need to fulfil are also reported.

Effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on Japanese cedar pollinosis during probiotic consumption: an open study

Certain strains of lactic acid bacteria (LAB) have beneficial effects on Japanese cedar pollinosis (JCPsis), which is a major concern in Japan. Heat-killed Lactobacillus plantarum YIT 0132 (LP0132), selected for its ability to induce interleukin (IL)-10, has been shown to suppress JCPsis symptoms. Lactobacillus casei Shirota (LcS), a popular probiotic, potentially induces a high level of IL-12 and is reported to delay the onset of JCPsis symptoms. However, it is unclear whether a combination of different types of LAB exerts additional effects without interfering with the benefits of each individual LAB. Thus, we conducted a pilot study to investigate the effects of LP0132-fermented citrus juice on JCPsis during simultaneous consumption of LcS-fermented milk. Fifty-nine subjects with JCPsis were allocated to two groups after a 2-week preconsumption period: one group consumed LP0132-fermented citrus juice and LcS-fermented milk (LcS+LP0132 group) for 12 weeks, while the other consumed LcS-fermented milk alone (LcS group). JCPsis symptoms, JCPsis-associated quality of life (QOL) impairment, and bowel movements were assessed by questionnaires. Compared with the LcS group, the LcS+LP0132 group showed significant alleviation of total symptoms and total ocular symptoms during the consumption period, as well as relief of impaired QOL. Bowel movements were significantly improved during the consumption period compared with the baseline in a combined analysis of all subjects in the two groups. In conclusion, LP0132-fermented citrus juice appears to have positive effects on some JCPsis symptoms and QOL in a population consuming immunomodulating probiotics such as LcS-fermented milk.

Postbiotics and paraprobiotics: A review of current evidence and emerging trends

In recent years, new probiotic-related concepts such as postbiotics and paraprobiotics have been coined to indicate that non-viable microorganisms or bacterial-free extracts may provide benefits to the host by offering additional bioactivities to probiotics, including but not limited to anti-inflammatory, immunomodulatory, anti-proliferative and antioxidant activities. Despite in vitro and in vivo studies that support the promising use of postbiotics and paraprobiotics as health promoters, the mechanism of action and the signaling pathway involved have not yet been fully elucidated. Therefore, the aim of this chapter is to provide an overview of novel probiotic-related concepts and the scientific evidence that supports their bioactivities as well as the possible mechanisms underlying their health-promoting effects. Additionally, current trends in food, feed, and pharmaceutical applications are discussed.

Non-Dairy Fermented Beverages as Potential Carriers to Ensure Probiotics, Prebiotics, and Bioactive Compounds Arrival to the Gut and Their Health Benefits

In alignment with Hippocrates' aphorisms "Let food be your medicine and medicine be your food" and "All diseases begin in the gut", recent studies have suggested that healthy diets should include fermented foods to temporally enhance live microorganisms in our gut. As a result, consumers are now demanding this type of food and fermented food has gained popularity. However, certain sectors of population, such as those allergic to milk proteins, lactose intolerant and strict vegetarians, cannot consume dairy products. Therefore, a need has arisen in order to offer consumers an alternative to fermented dairy products by exploring new non-dairy matrices as probiotics carriers. Accordingly, this review aims to explore the benefits of different fermented non-dairy beverages (legume, cereal, pseudocereal, fruit and vegetable), as potential carriers of bioactive compounds (generated during the fermentation process), prebiotics and different probiotic bacteria, providing protection to ensure that their viability is in the range of 106-107 CFU/mL at the consumption time, in order that they reach the intestine in high amounts and improve human health through modulation of the gut microbiome.

Nobiletin Attenuates DSS-Induced Intestinal Barrier Damage through the HNF4α-Claudin-7 Signaling Pathway

The intestinal epithelium barrier functions to protect human bodies from damages such as harmful microorganisms, antigens, and toxins. In this study, we evaluated the protective effect and molecular mechanism of a dominant polymethoxyflavone nobiletin (NOB) from tangerine peels on intestinal epithelial integrity. The results from transepithelial electrical resistance (TEER) suggested that NOB pretreatment counteracts epithelial injury induced by inflammatory cytokines (TEER value in 48 h: vehicle, 135.6 ± 3.9 Ω/cm²; TNF-α + IL-1β, 90.7 ± 0.5 Ω/cm²; 10 μM NOB + TNF-α + IL-1β, 126.1 ± 0.8 Ω/cm²; 100 μM NOB + TNF-α + IL-1β, 125.3 ± 0.5 Ω/cm². P < 0.001). Clinical and pathological test results suggested that administration of NOB effectively alleviates intestinal barrier injury induced by dextran sulfate sodium (DSS) as evidenced by the length of colon villi on day 7 (control, 253.7 ± 4.8 μm, DSS 131.6 ± 4.6 μm, NOB + DSS, 234.5 ± 5.1 μm. P < 0.001). Interestingly, when screening tight junction molecules for intestinal barrier integrity, we observed that independent treatment with NOB sharply increased claudin-7 levels (ratio of claudin-7 over GAPDH: control, 1.0 ± 0.06; DSS, 0.02 ± 0.001; NOB + DSS, 0.3 ± 0.07. P < 0.001), which was previously suppressed upon DSS stimulation. Furthermore, hepatocyte nuclear factor 4α (HNF-4α) transcriptional regulation of claudin-7 contributed to intestinal barrier homeostasis. Therefore, our study suggests potential intestinal protective strategies based on polymethoxyflavones of aged tangerine peels.