Probiotics and refractory chronic spontaneous urticaria.
Background. In chronic spontaneous urticaria (CSU) first-line therapy with an antihistamine-based regimen may not achieve satisfactory control in patients. Thus, a continuing need exists for effective and safe treatments for refractory CSU. Aim. To evaluate the clinical efficacy and safety of an intake of a combination of 2 probiotics (Lactobacillus salivarius LS01 and Bifidobacterium breve BR03) in patients with CSU who remain symptomatic despite concomitant H1-antihistamine therapy. Methods. This report analyzes the effects of therapy with two probiotic strains on the clinical progress of 52 unselected patients with difficulty to treat CSU underwent to medical examination in two Italian specialist urticaria Clinics between September 2013 and September 2014. A mixture of Lactobacillus LS01 and Bifidobacterium BR03 were administered in each patient twice daily for 8 weeks. To evaluate patients' improvement with probiotics, urticaria activity score over 7 days (UAS7) was used at baseline and at week 8 in addition to a 5-question urticaria quality of life questionnaire. Results. Fifty-two patients with CSU were included in this study (10 male and 42 female, age range 19-72 years). Mean disease duration was 1.5 years. Fourteen patients discontinued treatment, so evaluable population consisted of 38 patients. Nine of the 38 patients experienced mild clinical improvement during probiotic treatment (23.7%); one patient reported significant clinical improvement (2.6%) and one patient had complete remission of urticaria (2.6%). Twenty-seven patients did not have improvement in symptoms (71.1%). No side effects during the course of therapy were reported. Conclusions. A combination of Lactobacillus salivarius LS01 and Bifidobacterium breve BR03 administered twice daily for 8 weeks might reduce the symptoms scores and improve quality of life scores in a part of patients with CSU who remained symptomatic despite treatment with H1 antihistamine mostly in subjects with allergic rhinitis.
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy. Phone: +39 080 5592 821 Fax: +39 080 5593 576 E-mail: ambulatorio.allergologia@uniba.it.
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Nettis
Section of Allergology and Clinical Immunology, Unit of Internal Medicine, "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy.
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Di Leo
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Pastore
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Distaso
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Zaza
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Vacca
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Macchia
Department of Allergy and Clinical Immunology, University of Bari Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Vacca
D000328:Adult; D000368:Aged; D000069984:Bifidobacterium breve / Q000502:physiology*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D007558:Italy; D000069996:Ligilactobacillus salivarius / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000009:adverse effects; D011788:Quality of Life; D012074:Remission Induction; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014581:Urticaria / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D055815:Young Adult
D039563:Histamine H1 Antagonists, Non-Sedating
Bifidobacterium breve; Chronic spontaneous urticaria; H1-antihistamine therapy; Lactobacillus salivarius