PMID- 22513081
OWN - NLM
STAT- MEDLINE
DCOM- 20121031
LR  - 20131121
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 76
IP  - 7
DP  - 2012 Jul
TI  - A trial of adding Lactobacillus johnsonii EM1 to levocetirizine for treatment of 
      perennial allergic rhinitis in children aged 7-12 years.
PG  - 994-1001
LID - 10.1016/j.ijporl.2012.03.018 [doi]
AB  - BACKGROUND: Supplementary consumption of probiotics may temporarily alter the 
      intestinal microflora of infants and children, thereby preventing and treating 
      allergic disorders. OBJECTIVE: To compare the clinical efficacy of levocetirizine 
      with that of levocetirizine plus Lactobacillus johnsonii EM1 (Lj EM1) for 
      treating perennial allergic rhinitis (PAR) in children. METHODS: Sixty-three 
      children aged 7-12 years fulfilled the entry criteria for the study and had 
      moderate to severe PAR of at least 1 year's duration. The treatment followed a 
      randomized, open-label crossover design: all subjects were randomized to 2 
      crossover treatment regimens of levocetirizine with Lj EM1 (group 1) or 
      levocetirizine alone (group 2) for 12 weeks; subsequently, treatments were 
      reversed for a further 12 weeks. The effects of the 2 regimens were compared 
      using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and 
      the total symptom score (TSS) from diary cards. The parameters evaluated were 
      nasal peak expiratory flow rate (nPEFR), FVC, FEV1, serum immunoglobulin E (IgE), 
      mite-specific IgE, eosinophilic cationic protein (ECP), resistin, blood 
      eosinophils, eosinophil percentage in nasal smears, IL-4, IL-10, interferon-gamma 
      (IFN-gamma), and transforming growth factor-beta (TGF-beta). RESULTS: After the first 12 
      weeks of treatment, TSS in both groups had improved progressively compared with 
      that in the run-in period. Both groups had improved TSS at weeks 4, 8, and 12 
      (P<0.05), and group 1 was more efficacious than group 2 at week 4 (P=0.014), week 
      8 (P=0.011), and week 12 (P<0.009). During the second 12-week period, group 2 
      showed continual and progressive improvement, while group 1 did not. The PRQLQ 
      scores were significantly decreased in both groups (P<0.05), but there was no 
      statistically significant difference between the 2 groups (P=0.446). The 
      eosinophil percentage in nasal smears decreased in both groups compared with that 
      in the run-in period, and significant differences were detected in groups 2 and 
      1at 16 and 24 weeks of treatment, respectively (P<0.05). Both groups showed 
      significant improvement in nPEFR at weeks 4, 8, 12, 16, and 24 (P<0.01), and the 
      treatment for group 1 appeared to be more efficacious than that for group 2 at 
      weeks 12, 16, and 20 (P<0.05). FVC and FEV1 were improved in both groups at weeks 
      8 through 24 (P<0.05), but there was no significant difference between the 2 
      groups. In cytokine measurements, IFN-gamma and IL-10 increased significantly and 
      IL-4 decreased significantly in both groups, while elevation of TGF-beta was seen 
      only in group 1 at 12 weeks (P<0.001). However, the difference in TGF-beta 
      disappeared after 24 weeks treatment. There was no difference in serum resistin 
      levels. No serious adverse events were recorded in either treatment group. 
      CONCLUSION: The 24-week, 2-phase, crossover treatment program showed that 
      levocetirizine plus Lj EM1 was more effective for PAR than levocetirizine and 
      that this difference persisted for at least 3 months after discontinuation of Lj 
      EM1.
CI  - Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved.
FAU - Lue, Ko-Haung
AU  - Lue KH
AD  - Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung 
      Shan Medical University Hospital, Taichung, Taiwan. cshy095@csh.org.tw
FAU - Sun, Hai-Lun
AU  - Sun HL
FAU - Lu, Ko-Hsiu
AU  - Lu KH
FAU - Ku, Min-Sho
AU  - Ku MS
FAU - Sheu, Ji-Nan
AU  - Sheu JN
FAU - Chan, Ching-Hui
AU  - Chan CH
FAU - Wang, Yun-Hu
AU  - Wang YH
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20120417
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
RN  - 0 (Histamine H1 Antagonists, Non-Sedating)
RN  - 6U5EA9RT2O (levocetirizine)
RN  - YO7261ME24 (Cetirizine)
SB  - IM
MH  - Cetirizine/*therapeutic use
MH  - Child
MH  - Cross-Over Studies
MH  - Histamine H1 Antagonists, Non-Sedating/*therapeutic use
MH  - Humans
MH  - *Lactobacillus
MH  - *Probiotics
MH  - Rhinitis, Allergic, Perennial/*therapy
EDAT- 2012/04/20 06:00
MHDA- 2012/11/01 06:00
CRDT- 2012/04/20 06:00
PHST- 2011/12/28 00:00 [received]
PHST- 2012/03/17 00:00 [revised]
PHST- 2012/03/20 00:00 [accepted]
PHST- 2012/04/20 06:00 [entrez]
PHST- 2012/04/20 06:00 [pubmed]
PHST- 2012/11/01 06:00 [medline]
AID - S0165-5876(12)00197-8 [pii]
AID - 10.1016/j.ijporl.2012.03.018 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2012 Jul;76(7):994-1001. doi: 
      10.1016/j.ijporl.2012.03.018. Epub 2012 Apr 17.