Discussion
PMBL, allergic, grass pollen-induced AR, allergic disease
ALLERGIC CONJUNCTIVITIS, CHRONIC INFLAMMATORY DISEASE
As mentioned earlier, the present study was designed to evaluate the efficacy of PMBL therapy in children with SAR, and primarily to further understand the immune mechanisms of bacterial immunostimulants responsible for reducing the severity of allergic disease symptoms. To the best of our knowledge, this is the first study to evaluate the effect of PMBL therapy on changes of γδT, iNKT and Tc cell subsets in the serum levels in children with AR.The study presented here is a continuation of a series of studies on the efficacy of BLs in the treatment of grass pollen-induced AR in children, but it focuses primarily on the immunological mechanisms of these preparations. The results of the first project were published in 2019. It was a pilot, randomized, open-label study that included 38 children with SAR. The addition of sublingual BL to standard AR treatment (oral antihistamine, intranasal corticosteroid) has been shown to reduce the severity of nasal symptoms as assessed by a standard scoring scale and to improve nasal patency expressed as an increase in PNIF values. Nevertheless, the drug has not been confirmed to alleviate symptoms of allergic conjunctivitis (Recent data indicate that Tc cells play a role in the chronic inflammatory diseases, including allergic ones (It has been shown that some molecules can modulate the activation of the above-mentioned cells. Johansson et al. investigated if lactobacilli-derived factors could beneficially change immune responsiveness of γδT and NK cells γδT can be divided similarly to the conventional T helper cells into populations based on their cytokine profile and transcription factors. At least the major subsets (Th1-, Th2-, Th10-, Th17- and Treg-like) can be distinguished (Our study has some limitations. First, a longer follow up, more numerous population and more detailed studies are needed to elucidate the mechanism of action of PMBL in patients with AR. Second, since we have only studied systemic effects, it is possible that different or stronger immune effects can be found locally in the respiratory tract.