Limosilactobacillus reuteri DSM‐17938 for preventing cough in adults with mild allergic asthma: A double‐blind randomized placebo‐controlled cross‐over study. Issue 9 (8th July 2021)

• Record Type: Journal Article
• Authors: Satia, Imran; Cusack, Ruth; Stevens, Catie; Schlatman, Abbey; Wattie, Jennifer; Mian, Firoz; Killian, Kieran J.; O'Byrne, Paul M.; Bienenstock, John; Forsythe, Paul; Gauvreau, Gail M.
• Is Part Of: Clinical & experimental allergy. Volume 51:Issue 9(2021)
• Page Start: 1133
• Page End: 1143
• Publication Date: 2021-07-08
• Subjects: asthma -- capsaicin -- cough -- lactobacillus -- probiotic -- transient receptor potential vanilloid type 1; Allergy -- Periodicals; Immunology -- Periodicals; 616.97
• DOI: 10.1111/cea.13976
• Languages: English
• ISSNs: 0954-7894

Abstract

Abstract: Background: Cough is a common troublesome symptom in asthma which is neuronally mediated. Limosilactobacillus reuteri DSM‐17938 ( L . reuteri DSM‐17938) is a probiotic shown to be effective in pre‐clinical models at suppressing neuronal responses to capsaicin, a transient receptor potential vanilloid agonist (TRPV1). Objective: Investigate the effects of DSM‐17938 versus matched placebo on capsaicin‐evoked coughs in mild allergic asthmatics. Methods: We performed a 4‐visit, randomized, double‐blind, placebo‐controlled, two‐way cross‐over study comparing full dose cough responses with inhaled capsaicin in mild allergic asthmatics after 1 month of treatment with DSM‐17938 compared with matched placebo. Randomization and allocation to trial group were carried out by a central computer system. Histamine skin prick testing, airway hyper‐responsiveness and inflammatory cells in induced sputum were measured at every visit. Blood was collected to extract PBMCs and stimulated with CD3/CD28 to ascertain the effects of DSM‐17938 /placebo on T‐cell cytokine responses. Results: Seventeen subjects were recruited and 15 completed the study (8 females, mean age 27.3 years). There was no difference in the change in maximum capsaicin‐evoked coughs (Emax) after treatment with L . reuteri DSM‐17938 compared with placebo [mean difference 2.07 coughs (95% CI −2.77 to 6.91, p = .38) or relative changes in geometric mean ratios for the dose evoking at least half the Emax (ED50) [1.05 (95% CI 0.31–3.58, p = .94)], concentration evoking 2 coughs (C2) [0.63 (0.26–1.53), p = .28] and 5 coughs (C5) [0.79 (0.25–2.50), p = .67]. There was no effect on histamine skin prick wheal size, intensity of itch sensation, methacholine PC20, airway inflammation or T‐cell responses after stimulation with CD3/CD28. There were no serious adverse events. One subject developed a mild upper respiratory tract infection and another mild transient nausea whilst on DSM‐17938. Conclusion: In this small study in adults with mild allergic asthma, we found no evidence that L . reuteri DSM‐17938 has any systemic effects on airway nerves, smooth muscle, sputum inflammatory cells, skin responses or T‐cell responses after oral consumption. Trial Registration: Clinicaltrials.gov Identifier: NCT03603522.