Oral and nasal probiotic administration for the prevention and alleviation of allergic diseases, asthma, and COPD.

Interaction between the healthy microbiome and the immune system leads to body homeostasis, as dysbiosis in microbiome content and loss of diversity may result in disease development. Due to the ability of probiotics to help and modify the microbiome reconstitution, probiotics are now widely used for the prevention and treatment of different gastrointestinal, inflammatory, and more recently, respiratory diseases. In this regard, chronic respiratory diseases including chronic obstructive pulmonary disease (COPD), asthma, and allergic rhinitis are among the most common and complicated respiratory diseases with no specific treatment till now. Accordingly, many studies have evaluated the therapeutic efficacy of probiotic administration (mostly via the oral route and much lesser nasal route) chronic respiratory diseases. We tried to summarize and evaluate these studies to give a perspective of probiotic therapy via both oral and nasal routes for respiratory infections (in general) and chronic respiratory diseases (specifically). We finally concluded that probiotics might be useful for allergic diseases. For asthmatic patients, it can modulate the serum cytokines and IgE and decrease eosinophilia, but no significant reduction in clinical symptoms. For COPD, only limited studies were found with uncertain clinical efficacy. For intranasal administration, although some studies propose more efficiency than the oral route, more clinical evaluations are warranted.