Effectiveness of probiotic interventions for allergic rhinitis

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Created On: 09/05/2025

This network meta-analysis aimed to assess the effectiveness of various probiotic regimens in managing allergic rhinitis (AR), providing a foundation for evidence-based treatment selection.

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Key take away

Probiotic mixtures or cocktails provide the most comprehensive relief for hay fever or seasonal allergies (allergic rhinitis), with Saccharomyces reducing itching, sneezing, congestion along with runny nose, and Lactobacillus lowering inflammation.

Background

This network meta-analysis aimed to assess the effectiveness of various probiotic regimens in managing allergic rhinitis (AR), providing a foundation for evidence-based treatment selection.

Method

A comprehensive search was conducted across 9 databases from their beginning until April 30, 2024. The Stata 17.0 and Review Manager 5.4 were used to conduct the analysis. The Rhinoconjunctivitis quality of life questionnaire (RQLQ) scores, total and specific immunoglobulin E (IgE) levels, total nasal symptom score (TNSS), blood eosinophil levels, treatment efficacy, and adverse events were regarded as the key outcome measures.

Result

A total of 31 randomized controlled trials (RCTs) comprising 2,544 AR patients were analyzed. The findings indicated:

TNSS reduction: Saccharomyces was the most effective, followed by probiotic mixtures, Bifidobacterium, Enterococcus faecalis, Lactobacillus, Bacillus, and standard therapy.
RQLQ improvement: Probiotic mixtures ranked highest, followed by Lactobacillus, Enterococcus faecalis, and standard treatment.
Total IgE reduction: Probiotic mixtures outperformed other options, followed by Bifidobacterium, Lactobacillus, Tetragenococcus halophilus, and standard therapy.
Specific IgE reduction: Probiotic mixtures were most effective, followed by standard treatment, Bifidobacterium, Lactobacillus, and Leuconostoc.
Blood eosinophil count reduction: Lactobacillus was the most effective, followed by standard therapy and probiotic mixtures.
Overall efficacy rate: Saccharomyces led, followed by probiotic mixtures and standard therapy.

No substantial adverse events were reported, confirming the safety of probiotics in AR therapy.

Conclusion

Multi-strain probiotics demonstrated the most extensive efficacy, improving RQLQ and IgE levels, while Saccharomyces reduced TNSS and Lactobacillus lowered blood eosinophils.