MD, Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
PhD, Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
MD, Clinical Research Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Background: Synbiotics have been used in the prevention and treatment of various immunological diseases. There is paucity of data regarding the use of a combination of synbiotics and immunotherapy in the treatment of allergic rhinitis.
Objective: Investigating the synergistic clinical and immunologic effects of synbiotics and subcutaneous allergen immunotherapy (SCIT) combination in patients with allergic rhinitis.
Methods: Nineteen individuals with allergic rhinitis aged between 5 and 55 years were enrolled in this single blind, placebo-controlled trial. Patients were randomly divided into two groups: A) Immunotherapy plus one synbiotic capsule per day and B) Immunotherapy plus placebo for two months. The Sino-nasal outcome test (SNOT-22) and mini rhinoconjunctivitis quality of life questionnaire (RQLQ) scores were filled by patients while intracellular expression of interlukin-4 (IL-4), interferon-gamma (IFN-gamma) and Forkhead Box P3 (FOXP3) and variations in the T helper 1 (Th1), T helper 2 (Th2) and T regulatory cells and cytotoxic T lymphocytes (CTL) frequency were examined by flow cytometry assay at baseline, after 2 and 6 months of intervention.
Results: No significant difference in the frequency of symptoms between the two groups was observed after 2 and 6 months of intervention (P= 0.10 and p=0.47, respectively). A significant increase in the percentage of Th1 cells was recorded in group A compared to group B (P= 0.02). CTL enhancement percentage was significantly increased in group A compared to B after 2 months (P=0.013).
Conclusion: Subcutaneous Immunotherapy (SCIT) concomitant with synbiotics administration temporarily increased the percentage of Th1 cells.