Gut reactions to Asthma treatment with Probiotics

Gary Culliton speaks to Dr James Martin of the Alimentary Pharmabiotic Clinic, UCC, on his research into the immunology of asthma.Gut reactions to Asthma treatment with Probiotics

It is increasingly the view in Europe — more even than in North America — that probiotics and the intestinal bacteria may be crucial in the treatment of allergy and asthma. “I’m interested in the immunology of asthma and the basis for allergic bronchial constriction,” said Dr James Martin, who was appointed last September to the Alimentary Pharmabiotic Centre (APC) at University College Cork, on a Science Foundation Ireland Walton Fellowship.

The inflammatory response that is caused by allergens and mediated by T-lymphocytes is part of our adaptive immune system. When we are exposed to foreign antigens, our immune system learns from the exposure and we have lymphocytes that will subsequently recognise an invasion by these foreign materials.

“We breathe in more than 10,000 litres of air every day, so we carry in all sorts of materials including proteins. Conditioning in the first year of life teaches us to ignore these,” Dr Martin said.

“The problem arises when innocuous proteins are reacted to vigorously and a pattern of allergic inflammation develops. There is emerging sentiment that the intestinal flora may have an important role in the education of our immune systems.”

The Walton Fellowship awards allow people from abroad to come back and work for a year with a group in a university here. Dr Martin, a graduate of UCC, has worked in McGill University in Montreal for the last 31 years. Using rats, Dr Martin has done experimental asthma model work with lipid mediators and leukotrienes.

Currently, he is investigating the role of intestinal bacteria in allergic diseases such as asthma, as well as the possible therapeutic potential of probiotics, in conjunction with APC researchers.

Commensal organisms

Probiotics are benign commensal organisms which seem to live in harmony with host humans and are important for our health. The good bacteria are introduced into the stomach and they make their way to the intestine. There has been a small amount of investigation work using mouse models of asthma that have made it into the literature.

There is some literature which suggests that in mice, an allergic response to an experimental sensitisation can be substantially attenuated. “At APC, we will look at the immune response to see whether immunity has been altered, as there are potentially other ways that this might operate,” he said.

The tests to be done will typically involve animals being sensitised through their stomachs to the chicken/egg albumen protein. When it is then introduced through their airways, they will have the features of an asthma response to it. Then the animals are fed with the probiotics – hundreds of millions of organisms – through their food or directly into the stomach. The probiotics make their way into the intestines.

“We believe that the immune system, which is in the intestinal wall, communicates with the immune systems elsewhere – the bronchial tubes for example,” Dr Martin said.

One question we are interested in, is whether if you intervene early in life – in children – this might prevent the condition developing. If you could intervene in the first year of life, you might be able to prevent the disease ever happening in the first place. It’s possible you could never put the disease into remission or truly get a cure in adults.

However, a treatment may be possible that would be more analogous to a drug treatment – you would have to constantly treat the person and if you stop treating them, they might revert to the way they were before,” Dr Martin said.

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