Subcutaneous Immunotherapy and Synbiotic combination Shift T-Helper 1 and Cytotoxic T Cells in Allergic Rhinitis

Authors

1 MD, Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 PhD, Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 MD, Clinical Research Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

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.

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