Combination of specific allergen and probiotics induces specific regulatory B cells and enhances specific immunotherapy effect on allergic rhinitis

// Ling-Zhi Xu 1,* , Li-Tao Yang 1,2,* , Shu-Qi Qiu 1,2,* , Gui Yang 1,2 , Xiang-Qian Luo 3 , Bei-Ping Miao 4 , Xiao-Rui Geng 1,2 , Zhi-Qiang Liu 1,2 , Jun Liu 5 , Zhong Wen 6 , Shuai Wang 1,2 , Huan-Ping Zhang 7 , Jing Li 8 , Zhi-Gang Liu 1 , Hua-Bin Li 3 and Ping-Chang Yang 1 1 ENT Institute of The Research Center of Allergy & Immunology, Shenzhen University School of Medicine, Shenzhen, China 2 Longgang ENT Hospital, Shenzhen, China 3 Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China 4 Department of Otolaryngology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China 5 Shenzhen Maternity & Child Health Hospital, Shenzhen, China 6 Department of Otolaryngology of Zhujiang Hospital, Southern Medical University, Guangzhou, China 7 Brain Body Institute, McMaster University, Hamilton, ON, Canada 8 Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China * These authors have equally contributed to this work Correspondence to: Ping-Chang Yang, email: // Hua-Bin Li, email: // Keywords : allergic rhinitis; specific immunotherapy; probiotics; regulatory B cells; immunoglobulin E; Immunology and Microbiology Section; Immune response; Immunity Received : June 13, 2016 Accepted : July 19, 2016 Published : July 29, 2016 Abstract The therapeutic efficacy of allergen specific immunotherapy (SIT) on allergic diseases is to be improved. Probiotics can regulate immune response. This study aims to promote the effect of SIT on allergic rhinitis (AR) by co-administration with Clostridium butyricum (Cb). In this study, patients with AR sensitized to mite allergens were enrolled to this study, and treated with SIT or/and Cb. The therapeutic efficacy was evaluated by the total nasal symptom scores (NSS), medication scores, serum specific IgE levels and T helper (Th)2 cytokine levels. The improvement of immune regulation in the AR patients was assessed by immunologic approaches. The results showed that treating AR patients with SIT alone markedly reduced NSS and medication scores; but did not alter the serum specific IgE, Th2 cytokines and skin prick test (SPT) index. The clinical symptoms on AR in SIT group relapsed one month after stopping SIT. Co-administration of Cb significantly enhanced the efficacy of SIT on AR as shown by suppression of NSS, medication scores, serum specific IgE, Th2 cytokines and SPT index; the regulatory B cell frequency was also markedly increased. Such an effect on AR was maintained throughout the observation period even after stopping the treatment. Butyrate blocked the activation of histone deacetylase-1, the downstream activities of epsilon chain promoter activation, and the IgE production in the antigen specific B cells. On the other hand, butyrate induced the IL-10 expression in B cells with a premise of the B cell receptor activation by specific antigens. In conclusion, administration with Cb can markedly enhance the efficacy of SIT on AR.