Allergy symptoms

Allergies are a rapidly growing problem that predominantly manifest in people with a Western lifestyle. Hay fever, for instance, affects 10-30% of the world’s population1. Hay fever is an allergic reaction to pollen, for instance from trees (e.g. birch) or grasses. Many hay fever sufferers are allergic to the pollen of one or more specific plant species. Hay fever symptoms include frequent sneezing, a runny or blocked nose, itchy red eyes and irritation of the throat, mouth, nose and ears. Headache or earache are also possible. These symptoms are frequently seen in other types of allergy as well. All this means that allergies have a major impact on quality of life, reduce productivity and increase healthcare costs2.

The role of the microbiota in allergies

An allergy is an overreaction of the immune system. The development of the immune system starts immediately after birth and is intimately linked with the development of the microbiota3. According to the hygiene hypothesis, the strong increase in the prevalence of allergies in the Western world is the result of reduced exposure to microbes in the first years of life.

To prevent rejection of the foetus during pregnancy, the body of a pregnant woman will lower its Th1 response, which results in an altered Th1/Th2 balance. This imbalance is passed on to the newborn. Contact with pathogens and developing infections stimulate the baby’s immune defences and ensure the development of an appropriate Th1/Th2 balance. However, when Th2 cells continue to dominate the immune system for too long, the body becomes sensitive to foreign proteins, such as pollen, house dust mites and dietary proteins. The immune system will then respond by producing specific antibodies (sIgEs), which will immediately launch into action whenever the allergen is detected. This process ultimately results in allergy symptoms. Regulatory T-cells have a significant impact on the Th1/Th2 balance4 in that stimulation of these Tregs can lessen the allergy symptoms5.

Bacteria can modulate the immune system and influence Treg production. In that light, an obvious question would be whether probiotics can alleviate existing allergy symptoms.

Probiotics in allergy management

It is clear that the administration of probiotics to a mother in the final phase of her pregnancy and to the child in its first year will lower the likelihood of a baby developing eczema (see: Eczema prevention)7. A great deal of research has also been devoted to the role of probiotics in the management of existing eczema891011, and hay fever1213 but with less consistent results. This is related to the high degree of heterogeneity in study design, parameters measured, dosages and the strains used. We know that the beneficial effects of probiotics are strain-specific. That makes it difficult to determine the efficacy of probiotics in general for people with allergies.

There is an important difference between prevention of eczema and the management of an existing allergy. In both cases, there is an imbalance in Th1 and Th2, but in an existing allergy that imbalance has progressed further. For that reason, stimulating Th1 cells is not enough to restore the balance. Regulatory T-cells have a far greater impact on the Th1/Th2 balance. That makes it interesting to do research to find out which bacterial strains specifically stimulate these cells. One in-vitro study demonstrated that quite a number of strains can stimulate naive T-cells to develop into Treg cells14 and can increase the subsequent production of Treg cytokine IL-1015.

Strain selection in the Ecologic® AllergyCare formula

Winclove developed the Ecologic® AllergyCare formula with the bacterial strains:

  • Bifidobacterium bifidum W23,
  • Lactobacillus acidophilus W55,
  • Lactobacillus casei W56,
  • Lactococcus lactis W58
  • Lactobacillus salivarius W57.

In addition to bacterial strains, this formula also contains vitamin B2 and biotin.

In vitro, these strains have been shown to be adequately capable, both individually and in combination, of inhibiting Th2-related cytokine profiles and of boosting IL-10 (Treg cell cytokine) levels (non-published data).

Ecologic® AllergyCare formula in eczema and hay fever symptoms

The effect of the specific combination of bacterial strains – Bifidobacterium bifidum W23, Lactobacillus acidophilus W55, Lactobacillus casei W56, Lactococcus lactis W58 and Lactobacillus salivarius W57 – with vitamin B2 and biotin on existing eczema symptoms was researched in a double-blind, randomized, placebo-controlled study by Yeşilova (2012) in 40 children aged 1-13 with eczema. The SCORAD index showed that after 8 weeks the eczema symptoms had reduced significantly in children in the probiotics group. The conclusion that total IgE had decreased significantly in the probiotics group supports these clinical findings16.

In a  recent study with the Ecologic® AllergyCare formulation, adult participants with hay fever – reviewed the quality of life (based on the RQLQ questionnaire), hay fever symptoms as well as  drug use. Results are expected soon17.

The research formulation Ecologic® AllergyCare is not sold as a consumer product. However our worldwide business partners offer the formulation Ecologic® AllergyCare as their own branded product. Thus the specific bacterial composition can be found in different products around the world.

References

  • 1. Pawankar R, Holgate ST, Canonica GW, Lockey RF, Blaiss MS (editor). WAO White Book on Allergy 2013 Update. World Allergy Organization 2013.
  • 2. Zuberbier T, Lotvall J, Simoens S, Subramanian SV, Church MK. Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review. Allergy. 2014;69(10):1275-9
  • 3. Gensollen T, Iyer SS, Kasper DL, Blumberg RS. How colonization by microbiota in early life shapes the immune system. Science. 2016 Apr 29;352(6285):539-44.
  • 4. Bridgman SL, Kozyrskyj AL, Scott JA, Becker AB, Azad MB. Gut microbiota and allergic disease in children. Ann Allergy Asthma Immunol. 2016 Feb;116(2):99-105.
  • 5. Palomares O, Yaman G, Azkur AK, Akkoc T, Akdis M, Akdis CA. Role of Treg in immune regulation of allergic diseases. Eur J Immunol. 2010 May;40(5):1232-40.
  • 7. Niers LE, Martín R, Rijkers G, Sengers F, Timmerman H, van Uden N, Smidt H, Kimpen J, Hoekstra M.. The effects of selected probiotic strains on the development of eczema (the PandA study). et al. Allergy, 64, pp. 1349-58 (2009).
  • 8. Prescott SL, Björkstén B.Probiotics for the prevention or treatment of allergic diseases. J Allergy Clin Immunol. 2007 Aug;120(2):255-62.
  • 9. Kim SO, Ah YM, Yu YM, Choi KH, Shin WG, Lee JY. Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol. 2014 Aug;113(2):217-26.
  • 10. Johannsen, H. and Prescott, S.L., 2009. Practical prebiotics, probiotics and synbiotics for allergists: how useful are they? Clinical and Experimental Allergy 39: 1801-1814.
  • 11. Boyle RJ, Bath-Hextall FJ, Leonardi-Bee J, Murrell DF, Tang ML. Probiotics for the treatment of eczema: a systematic review. Clin Exp Allergy. 2009 Aug;39(8):1117-27.
  • 12. Peng Y, Li A, Yu L, Qin G. The role of probiotics in prevention and treatment for patients with allergic rhinitis: A systematicreview. Am J Rhinol Allergy. 2015 Jul-Aug;29(4):292-8.
  • 13. Zajac AE, Adams AS, Turner JH. A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis. Int Forum Allergy Rhinol. 2015 Jun;5(6):524-32.
  • 14. Roock S de, Van Elk M, Van Dijk ME, Timmerman HM, Rijkers GT, Prakken BJ, Hoekstra MO, de Kleer IM. Lactic acid bacteria differ in their ability to induce functional regulatory T cells in humans. Clin Exp Allergy. 2010 Jan;40(1):103-10.
  • 15. Niers LE, Timmerman HM, Rijkers GT, van Bleek GM, van Uden NO, Knol EF, Kapsenberg ML, Kimpen JL, Hoekstra MO. Identification of strong interleukin-10 inducing lactic acid bacteria which down-regulate T helper type 2 cytokines. Clin Exp Allergy, 35, pp. 1481-9 (2005).
  • 16. Yavuz Yeşilova, M.D., Ömer Çalka, M.D., et al. Effect of Probiotics on the Treatment of Children with Atopic Dermatitis. Ann Dermatol. 2012 May; 24(2): 189–193.
  • 17. Watts AM, West NP Smith PK, Cripps AW, Cox AJ. Probiotics and Allergic Rhinitis: A Simon Two-Stage Design to Determine Effectiveness. J Altern Complement Med. 2016 Dec;22(12):1007-1012. Epub 2016 Oct 12.