Vitamin D3 associated to lactobacillus reuteri improves effects of allergen immunotherapy in asthmatic children

BACKGROUND: The possibility of additional strategies to enhance the effectiveness of specific immunotherapy (SIT) is highly attractive. The aim of our study was to assess the influence vitamin D(3) associated or not to Lactobacillus Reuteri in asthmatic children on the SIT efficacy. METHODS: It was a randomized, double-blind, placebo-controlled trial conducted in 112 asthmatic children allergic to house dust mites. Intervention was based on receiving a dose/weight of vitamin D (3) associated to Lactobacillus Reuteri (VD3R+) or no Lactobacillus Reuteri (VDR3R-) or placebo during SIT. We compared in these 3 arms: eosinophil cationic protein (ECP), fractionated exhaled nitric oxide (FeNO), asthma symptoms and medication scores. RESULTS: After 12 months of SIT, in the group treated with VD3R+ a control of asthma9s symptoms was observed of 24% better than VD3R- group. However, a 50% reduction was observed in the control group. Serum ECP levels decreased significantly in the SIT group with VD3R+ (P = .01 and P = .018) compared to baseline, whereas VD3R- group vs control group values remained similar. We found a statistically significant difference in two group between median pre- and post treatment FeNO levels but better in VD3R+ treated group [22.5 ppb (16.0-29.0 ppb) vs 15.6 ppb (11.8-26.4 ppb), p=0.008], as well as in asthma symptoms (P=0 .001) and medication scores (P=0.001). CONCLUSIONS: SIT with D. pteronyssinus improves immunological and clinical parameters in mite-allergic asthmatic children after 1 year of treatment. Vitamin D(3) associated to Lactobacillus Reuteri increases clinical effects of SIT on asthma better than without Lactobacilli Reuteri.