TitleBacterial Lysates as Add-On Therapy Prevent Recurrent Paediatric Wheezing and Asthma
By Chris Berrie
LJUBLJANA, Slovenia -- May 14, 2019 -- Bacterial lysates can be considered as add-on therapy to prevent recurrent wheezing episodes and asthma exacerbations in children, according to results of a systematic review and meta-analysis at the 37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID2019).
For children suffering from obstructive lung disease, wheezing and asthma exacerbations represent an important cause of morbidity. It previously has been reported that lyophilised bacterial extracts, or bacterial lysates, can act as non-specific immunomodulators, and might prevent respiratory-tract infections.
“We aimed to assess the clinical and immunological effects of add-on bacterial lysate therapy on exacerbation frequency in children with obstructive lung disease,” stated Gerdien A. Tramper-Stranders, MD, PhD, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands, speaking here on May 9.
Dr. Tramper-Stranders screened 98 articles in the medical literature, selecting the only 4 that provided paediatric data: 2 on asthma in school children, and 2 on wheezing in infants. They included 3 of these studies in their meta-analysis. The data extracted included a total of 152 children in the control groups, plus 133 in the bacterial-lysates groups.
The meta-analysis showed significant benefit over the study periods for the bacterial lysates against infant wheezing episodes and childhood asthma exacerbations (mean difference, -1.15 events; P
“Importantly, adverse events were equal, and the safety profile across these studies was good,” said Dr. Tramper-Stranders.
The researchers also noted a further recent meta-analysis of Chinese studies, not included in the present study due to the language of publication. The Chinese data demonstrated a significant decrease in wheezing days promoted by bacterial lysates.
Although human paediatric immunological data were scarce, 2 of the 4 studies did show significant increases in serum interleukin (IL)-10 and interferon-gamma, and decreases in IL-4 and IL-7, and increases in serum natural killer T-cells, which are indicative of activation of immune responses.
“Mechanistic and larger clinical studies are needed to elucidate which wheezing phenotype or asthma phenotype will benefit most,” Dr. Tramper-Stranders concluded.
Study limitations include the heterogeneous nature of the 4 studies chosen, and their overall low quality. The 4 studies were also different in terms of the type of bacterial lysate intervention and the participant ages.
[Presentation title: Bacterial Lysates as Add-On Therapy in Obstructive Lung Diseases: a Systematic Review and Meta-Analysis. Session EPD14]