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Abstract
Continuous increase of bacterial resistance to antibiotics causes many problems such as the advent of resistance to pathogenic bacteria, difficulty of microbial disease treatments, environmental pollution and others. It is inevitable to find potential substitutes for antibiotics in order to solve the above mentioned problems. Recently many literatures have shown that probiotics could be applied to the treatment or amelioration of respiratory diseases in addition to intensively studied gut related diseases. Target diseases for collecting data and analysis of the efficacies were chosen because viral respiratory infections are the most common diseases in humans. They were mainly viral diseases like common colds, pneumonia in addition to allergies and asthma. Papers on clinical efficacies, safety risks and mechanisms of microbial action of respiratory diseases were secured through known information sites and analyzed for their exact evaluations. The present analysis of research results on probiotics efficacies for respiratory diseases showed discrepancies in efficacies. On the whole, half to one third of papers reviewed only showed certain level of efficacies against respiratory viral diseases. It is very difficult to compare the results directly because the studies varied highly in study design, outcome measures, probiotics, dose, and matrices used. However, the results obtained so far show the potential applications of probiotics to the prevention or amelioration of the diseases. Conclusively, further well organized studies using randomized, double-blind, placebo-controlled clinical trials are needed to elucidate the realities of probiotics on respiratory related diseases and to obtain more definite efficacy results.
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Figure 1.
Airway composition of microbiota in health and chronic disease. (A) Normal constituents of microbiota, (B) Comparative increase of pathogenic microbial numbers.
Figure 2.
Types of probiotic activity on epithelial layer. (A) Direct attack, production of antimicrobial factors by probiotics, (B) Inhibition of virulence factors produced by pathogens, (C) Competition for barrier layer between probiotics and pathogens.
Table 1.
Summaries of double blind randomized, controlled clinical trials for patients of intensive care units after administration of various probiotics on mechanical ventilation pneumonia and mortality
| Reference number | Number of patients Assessed. Probiotics vs. Control | Incidence VAPa, Probiotics vs. Control | Mortality Probiotics vs. Control | Indicator disease |
|---|---|---|---|---|
| 45 | 130 vs. 129 | 9% vs. 13% | 21.5% vs. 26.3% | Pneumonia |
| 43 | 102 vs. 106 | 23% vs. 22% | NAb | Pneumonia |
| 44 | 23 vs. 21 | 4% vs. 14% | 22% vs. 19% | Pneumonia |
| 47 | 26 vs. 87 | 15% vs. 39% | 8% vs. 6% | Pneumonia |
| 46 | 35 vs. 30 | 54% vs. 80% | 14% vs. 30% | Pneumonia |
| 42 | 68 vs. 70 | 19% vs. 40% | 21% vs. 17% | Pneumonia |
| 48 | 87 vs. 80 | 18.7% vs. 26.4% | 25.3% vs. 33.7% | Pneumonia |
Table 2.
Antimicrobial substances produced by probiotic bacteria (56)
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