Alerjik rinit ve irritabl bağırsak sendromu hastalarında probiyotik takviyesinin hastane yatış sıklığı ve inflamatuar belirteçler üzerine etkisi

Yıl 2024, Cilt: 15 Sayı: 3, 442 - 448, 30.09.2024

Berzan Haznedar , Günay Kozan , Berat Ebik

https://doi.org/10.18663/tjcl.1550711

Öz

Amaç: Bu çalışma, tekrarlayan alerjik rinit (AR) ve irritabl bağırsak sendromu (IBS) olan hastalarda kısa süreli (3-6 ay) probiyotik kullanımının etkisini, özellikle inflamasyon indekslerindeki değişikliklere odaklanarak incelemeyi amaçlamıştır.
Gereç ve Yöntemler: Bu retrospektif çalışmaya 2020-2021 yılları arasında IBS ve AR tanısı almış ve 3-6 ay süreyle probiyotik takviyesi kullanan hastalar dahil edildi. Demografik özellikler, sistemik inflamasyon indeksi (SII), nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) gibi klinik veriler ile probiyotik kullanımı öncesi ve sonrası hemogram sonuçları ve AR ile ilişkili başvuru sayıları toplandı. Probiyotik müdahalesi, probiyotik içermeyen standart IBS tedavisi alan kontrol grubu ile karşılaştırıldı.
Bulgular: Değerlendirilen 135 hasta arasında, probiyotik tedavisi alan grupta kontrol grubuna kıyasla AR ile ilişkili hastane başvuru sıklığında anlamlı bir azalma gözlendi (p<0.001). Her iki grupta da IBS ile ilişkili hastane başvuru sıklığında azalma görülürken, probiyotik grubunda daha yüksek bir etki büyüklüğü tespit edildi (Cohen's d: 1.72 vs 0.55). Probiyotik takviyesi, tedavi grubunda sistemik inflamasyon indekslerinde (SII, NLR, PLR, CRP) azalmaya yol açtı (p<0.05), ancak kontrol grubunda anlamlı bir değişiklik gözlenmedi (p>0.05).
Sonuçlar: IBS ve AR hastalarında en az 3 ay boyunca probiyotik kullanımı, inflamasyon indekslerinde iyileşme ve hastalıkla ilişkili hastane başvuru sıklığında azalma sağladı. Bu, probiyotiklerin alerjik yanıtları ve inflamasyonu modüle etmede potansiyel bir rol oynayabileceğini ve özellikle gastrointestinal bozuklukları olan bireylerde AR yönetimi için umut verici bir yardımcı tedavi olabileceğini göstermektedir.

Anahtar Kelimeler

probiyotikler, alerjik rinit, İrritabl barsak sendromu, inflamasyon indeksleri, hastalığa bağlı hastaneye yatış

Effect of probiotic supplementation on hospital admission frequency and inflammatory markers in allergic rhinitis and irritable bowel syndrome patients

Öz

Aim: This study aimed to investigate the effect of short-term (3-6 months) probiotic use on patients with recurrent allergic rhinitis (AR) and irritable bowel syndrome (IBS), focusing on changes in inflammation indices and hospital admission frequency.
Material and Methods: This retrospective study included patients diagnosed with IBS and AR between 2020 and 2021, who used probiotic supplements for 3 to 6 months. Clinical data, including demographic characteristics, systemic inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), hemograms before and after probiotic use, and AR-related admission numbers, were collected. The probiotic intervention was compared to a control group receiving standard IBS treatment without probiotics.
Results: Of the 135 patients evaluated, a significant reduction in AR-related hospital admission frequency was observed in the probiotic-treated group compared to the control group (p<0.001). Both groups exhibited decreased IBS-related hospital admission frequency, with a higher effect size in the probiotic group (Cohen’s d: 1.72 vs 0.55). Probiotic supplementation led to reductions in systemic inflammation indicators (SII, NLR, PLR, CRP) in the treatment group (p<0.05), whereas no significant changes were noted in the control group (p>0.05).
Conclusion: Probiotic use for at least 3 months in patients with IBS and AR demonstrated improvements in inflammation indices and a reduction in disease-related hospital admission frequency. This suggests a potential role for probiotics in modulating allergic responses and inflammation, providing a promising adjunctive therapy for managing AR, particularly in individuals with co-existing gastrointestinal conditions.

Anahtar Kelimeler

probiotics, allergic rhinitis, irritabl bowel syndrome, inflammation indices, disease-releated hospital admission

Etik Beyan

The study was approved by the Gazi Yasargil Training and Research Hospital Clinical Research Ethics Committee (17.11.2023 - No: 567).

Kaynakça

• Melli LC, do Carmo-Rodrigues MS, Araujo-Filho HB, Sole D, and de Morais MB. Intestinal microbiota and allergic diseases: A systematic review. Allergol Immunopathol (Madr). 2016;44(2):177-88. DOI: 10.1016/j.aller.2015.01.013.
• Hevia A, Milani C, Lopez P, et al. Allergic Patients with Long-Term Asthma Display Low Levels of Bifidobacterium adolescentis. PLoS One. 2016;11(2):e0147809. DOI: 10.1371/journal.pone.0147809.
• Simonyte Sjodin K, Vidman L, Ryden P, and West CE. Emerging evidence of the role of gut microbiota in the development of allergic diseases. Curr Opin Allergy Clin Immunol. 2016;16(4):390-5. DOI: 10.1097/ACI.0000000000000277.
• Zimmermann P, Messina N, Mohn WW, Finlay BB, and Curtis N. Association between the intestinal microbiota and allergic sensitization, eczema, and asthma: A systematic review. J Allergy Clin Immunol. 2019;143(2):467-85. DOI: 10.1016/j.jaci.2018.09.025.
• West CE. Gut microbiota and allergic disease: new findings. Curr Opin Clin Nutr Metab Care. 2014;17(3):261-6. DOI: 10.1097/MCO.0000000000000044.
• Ismail IH, Oppedisano F, Joseph SJ, et al. Reduced gut microbial diversity in early life is associated with later development of eczema but not atopy in high-risk infants. Pediatr Allergy Immunol. 2012;23(7):674-81. DOI: 10.1111/j.1399-3038.2012.01328.x.
• Tang RB, Chang JK, and Chen HL. Can probiotics be used to treat allergic diseases? J Chin Med Assoc. 2015;78(3):154-7. DOI: 10.1016/j.jcma.2014.08.015.
• Enaud R, Prevel R, Ciarlo E, et al. The Gut-Lung Axis in Health and Respiratory Diseases: A Place for Inter-Organ and Inter-Kingdom Crosstalks. Front Cell Infect Microbiol. 2020;10:9. DOI: 10.3389/fcimb.2020.00009.
• Powell N, Huntley B, Beech T, Knight W, Knight H, and Corrigan CJ. Increased prevalence of gastrointestinal symptoms in patients with allergic disease. Postgrad Med J. 2007;83(977):182-6. DOI: 10.1136/pgmj.2006.049585.
• Shen TC, Lin CL, Wei CC, et al. Bidirectional Association between Asthma and Irritable Bowel Syndrome: Two Population-Based Retrospective Cohort Studies. PLoS One. 2016;11(4):e0153911. DOI: 10.1371/journal.pone.0153911.
• Tobin MC, Moparty B, Farhadi A, DeMeo MT, Bansal PJ, and Keshavarzian A. Atopic irritable bowel syndrome: a novel subgroup of irritable bowel syndrome with allergic manifestations. Ann Allergy Asthma Immunol. 2008;100(1):49-53. DOI: 10.1016/S1081-1206(10)60404-8.
• Mansueto P, D'Alcamo A, Seidita A, and Carroccio A. Food allergy in irritable bowel syndrome: The case of non-celiac wheat sensitivity. World J Gastroenterol. 2015;21(23):7089-109. DOI: 10.3748/wjg.v21.i23.7089.
• Loo EXL, Wang Y, and Siah KTH. Association between Irritable Bowel Syndrome and Allergic Diseases: To Make a Case for Aeroallergen. Int Arch Allergy Immunol. 2020;181(1):31-42. DOI: 10.1159/000503629.
• Lillestol K, Helgeland L, Arslan Lied G, et al. Indications of 'atopic bowel' in patients with self-reported food hypersensitivity. Aliment Pharmacol Ther. 2010;31(10):1112-22. DOI: 10.1111/j.1365-2036.2010.04261.x.
• Iftikhar H, Awan MO, Awan MS, Mustafa K, Das JK, and Ahmed SK. Role of Probiotics in Patients with Allergic Rhinitis: A Systematic Review of Systematic Reviews. Int Arch Otorhinolaryngol. 2022;26(4):e744-e52. DOI: 10.1055/s-0042-1749370.
• Watts AM, West NP, Zhang P, Smith PK, Cripps AW, and Cox AJ. The Gut Microbiome of Adults with Allergic Rhinitis Is Characterised by Reduced Diversity and an Altered Abundance of Key Microbial Taxa Compared to Controls. Int Arch Allergy Immunol. 2021;182(2):94-105. DOI: 10.1159/000510536.
• Zhou MS, Zhang B, Gao ZL, et al. Altered diversity and composition of gut microbiota in patients with allergic rhinitis. Microb Pathog. 2021;161(Pt A):105272. DOI: 10.1016/j.micpath.2021.105272.
• Schmulson MJ and Drossman DA. What Is New in Rome IV. J Neurogastroenterol Motil. 2017;23(2):151-63. DOI: 10.5056/jnm16214.
• Maldonado Galdeano C, Cazorla SI, Lemme Dumit JM, Velez E, and Perdigon G. Beneficial Effects of Probiotic Consumption on the Immune System. Ann Nutr Metab. 2019;74(2):115-24. DOI: 10.1159/000496426.
• Hajavi J, Esmaeili SA, Varasteh AR, et al. The immunomodulatory role of probiotics in allergy therapy. J Cell Physiol. 2019;234(3):2386-98. DOI: 10.1002/jcp.27263.
• Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, and Salminen S. Probiotics: effects on immunity. Am J Clin Nutr. 2001;73(2 Suppl):444S-50S. DOI: 10.1093/ajcn/73.2.444s.
• Fiocchi A, Burks W, Bahna SL, et al. Clinical Use of Probiotics in Pediatric Allergy (CUPPA): A World Allergy Organization Position Paper. World Allergy Organ J. 2012;5(11):148-67. DOI: 10.1097/WOX.0b013e3182784ee0.
• Pawankar R, Mori S, Ozu C, and Kimura S. Overview on the pathomechanisms of allergic rhinitis. Asia Pac Allergy. 2011;1(3):157-67. DOI: 10.5415/apallergy.2011.1.3.157.
• Cansever M and Sari N. The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in children. North Clin Istanb. 2022;9(6):602-09. DOI: 10.14744/nci.2022.96236.
• Goker AE, Ekincioglu E, Alagoz MH, et al. The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in adults. Eur Arch Otorhinolaryngol. 2019;276(12):3383-88. DOI: 10.1007/s00405-019-05640-0.
• Zajac AE, Adams AS, and Turner JH. A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis. Int Forum Allergy Rhinol. 2015;5(6):524-32. DOI: 10.1002/alr.21492.
• Ford AC and Talley NJ. Irritable bowel syndrome. BMJ. 2012;345:e5836. DOI: 10.1136/bmj.e5836.
• Yoon JS, Sohn W, Lee OY, et al. Effect of multispecies probiotics on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Gastroenterol Hepatol. 2014;29(1):52-9. DOI: 10.1111/jgh.12322.
• Didari T, Mozaffari S, Nikfar S, and Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21(10):3072-84. DOI: 10.3748/wjg.v21.i10.3072.
• Zhang Y, Li L, Guo C, et al. Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterol. 2016;16(1):62. DOI: 10.1186/s12876-016-0470-z.
• Konstantis G, Efstathiou S, Pourzitaki C, Kitsikidou E, Germanidis G, and Chourdakis M. Efficacy and safety of probiotics in the treatment of irritable bowel syndrome: A systematic review and meta-analysis of randomised clinical trials using ROME IV criteria. Clin Nutr. 2023;42(5):800-09. DOI: 10.1016/j.clnu.2023.03.019.