组合益生菌改善季节过敏性鼻结膜炎患者的生活质量

Probiotics (Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial

Dennis-Wall et al. American Journal of Clinical Nutrition（2017）

DOI: 10.3945/ajcn.116.140012. 

ABSTRACT

Background: Rhinoconjunctivitis-specific quality of life is often reduced during seasonal allergies. The Mini Rhinoconjunctivitis Quality of Life Questionnaire (MRQLQ) is a validated tool used to measure quality of life in people experiencing allergies (0 = not troubled to 6 = extremely troubled). Probiotics may improve quality of life during allergy season by increasing the percentage of regulatory T cells (Tregs) and inducing tolerance.

Objective: The objective of this study was to determine whether consuming Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and B. longum MM-2 compared with placebo would result in beneficial effects on MRQLQ scores throughout allergy season in individuals who typically experience seasonal allergies. Secondary outcomes included changes in immune markers as part of a poten- tial mechanism for changes in MRQLQ scores.

Design: In this double-blind, placebo-controlled, parallel, randomized clinical trial, 173 participants (mean 6 SEM: age 27 6 1 y) who self-identified as having seasonal allergies received either a probiotic (2 capsules/d, 1.5 billion colony-forming units/capsule) or placebo during spring allergy season for 8 wk. MRQLQ scores were collected weekly throughout the study. Fasting blood samples were taken from a subgroup (placebo, n = 37; probiotic, n = 35) at baseline and week 6 (predicted peak of pollen) to determine serum immunoglobulin (Ig) E concentrations and Treg percentages. 

Results: The probiotic group reported an improvement in the MRQLQ global score from baseline to pollen peak (20.68 6 0.13) when compared with the placebo group (20.19 6 0.14; P = 0.0092). Both serum total IgE and the percentage of Tregs increased from baseline to week 6, but changes were not different between groups.

Conclusions: This combination probiotic improved rhinoconjunctivitis specific quality of life during allergy season for healthy individuals with self-reported seasonal allergies; however, the associated mechanism is still unclear. 

关键词：健康成人；益生菌；季节性过敏；生活质量；格氏乳杆菌；两歧双歧杆菌；长双歧杆菌

研究对象：患有季节性过敏症状的成年人（18-60岁）

入组标准：

• 具有季节性过敏

• 愿意并且能够签署知情同意

• 愿意并且能够维持正常水平的体力活动和饮食

• 愿意停止食用发酵食品、益生菌(如含活菌的酸奶、活性培养物或补充剂)或增强免疫力的补充剂(如紫锥菊或鱼油)

排除标准：

• 使用过了敏药物,包括鼻喷剂

• 接受过过敏注射

• 在登记的时候已怀孕或试图怀孕

• 采取任何系统性皮质类固醇，雄激素(睾酮等)，或大剂量的抗炎药物

• 正在接受治疗或患有下列任何一种经医生诊断的疾病：艾滋病、免疫调节疾病(自身免疫性疾病、肝炎、癌症等)、肾脏疾病、胰腺炎、肺疾病、肝胆疾病

• 有静脉导管

• 在过去一年内接受过化疗或其他免疫治疗的，如憩室炎、溃疡性结肠炎、克罗恩病、乳糜泻、短肠病、回肠造口术或结肠造口术，但不包括胃食管反流病

实验方法：在春季过敏季节(2015年3月至2015年5月)，随机分配受试者服用益生菌胶囊或安慰剂胶囊各8周。在整个8周的研究中，参与者被要求完成每日和每周的问卷调查，包括鼻结膜炎生活质量问卷(MRQLQ)进行评分（通过在7分制范围内平均14个项目的值来计算：0 = 没有困扰 到 6 = 极度困扰），以及胃肠道症状评分量表(GSRS)。另外收集粪便样品，在排便后4小时内将样本放置冰上，六小时后置于-70℃冰箱。

检测方法：16S rRNA测序，流式细胞术

研究结果：

1. 与安慰剂组(20.19 6 0.14)相比，益生菌组的MRQLQ全球评分从基线到花粉峰值(20.68 6 0.13)均有改善；P = 0.0092)；

2. 血清总IgE和调节性T细胞百分比从基线到第6周均有升高，但各组间无明显差异；

3. 便秘症状评分较低，但是和安慰剂组相比益生菌组在第3、4、6、和7周显著降低；

4. 与安慰剂组相比，益生菌组OTUs患病率的变化更多，这表明益生菌介导了肠道微生物谱的变化。

结论：该组合益生菌改善了健康个体在过敏季节鼻结膜炎特异性生活质量。然而，相关机制仍不清楚。

FIGURE 4 Changes in prevalence (determined by z scores) of specific fecal OTUs were detected more often in the probiotic group than in the placebo group. Bold text indicates the group that had changes in OTU prevalence from week 0 to week 6; the other group is included for comparison of the same OTUs. (A) OTUs that increased in the placebo group. (B) OTUs that increased in the probiotic group. (C) OTUs that decreased in the placebo group. (D) OTUs that decreased in the probiotic group. Placebo at week 0, n = 34; at week 6, n = 32. Probiotic at week 0, n = 33; at week 6, n = 34. OTU, operational taxonomic unit. 

图4. 益生菌组比安慰剂组更容易检测到特定粪便OTUs患病率的变化(由z分数决定)。粗体显示的是第0周至第6周OTU患病率发生变化的组；另一组用于比较相同的OTU。(A)安慰剂组OTUs增加。(B)益生菌组的OTUs增加。(C)安慰剂组OTUs下降。(D)益生菌组OTUs减少。安慰剂在第0周，n = 34;第6周，n = 32。第0周益生菌，n = 33;第6周，n = 34。OTU，操作分类单位。

知几未来研究院正在搭建一个“疾病-肠道菌群”知识库。

你可以在公众号对话框回复“IBD”或“肠易激综合征”，查看与疾病相关的菌群；

也可以回复“双歧杆菌”或“Hp”，查看与细菌相关的疾病。

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