https://doi.org/10.5812/jjnpp-157026

Enhancing Respiratory Health: Inhaled Synbiotic Administration

authors:

avatar Sara Bahrainian 1 , 2 , *

Nanotechnology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Food and Drug Control, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Jundishapur Journal of Natural Pharmaceutical Products: Vol.19, issue 4; e157026
published online: November 27, 2024
article type: Editorial
received: October 12, 2024
revised: November 4, 2024
accepted: November 4, 2024

How To Cite Bahrainian S. Enhancing Respiratory Health: Inhaled Synbiotic Administration. Jundishapur J Nat Pharm Prod. 2024;19(4):e157026. https://doi.org/10.5812/jjnpp-157026.

Respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, various infections, and allergic conditions, pose significant global health challenges, increasing the demand for effective and sustainable treatment options. Studies have demonstrated that patients with respiratory disorders have distinct lung microbiome compositions compared to healthy individuals. Examples of microorganisms that show increased prevalence in these patients include Chlamydiapneumoniae, Streptococcuspneumoniae, Haemophilusinfluenzae, Aspergillusfumigatus, Pseudomonasaeruginosa, and Staphylococcusaureus, which are associated with persistent wheezing, as well as immune and inflammatory responses (1-3).

Dysregulation of microbiota in these individuals often coexists with chronic gastrointestinal tract diseases. This may result from disruptions in gut microbiome composition caused by antibiotics, diet, and lifestyle factors, highlighting a significant bidirectional relationship between the lung and gut, known as the gut-lung axis (2, 4). Consequently, the use of probiotics, prebiotics, and synbiotics is being explored as a potential intervention to improve the quality of life for patients with respiratory conditions.

Dietary probiotics are live microorganisms that confer health benefits when administered in adequate amounts (2, 4). Prebiotics are non-digestible food substances that can be selectively fermented by the host microbiota, resulting in specific changes in the composition and/or activity of the gut microflora (4, 5). Most prebiotics are carbohydrates, such as oligosaccharides, characterized by their resistance to stomach acidity, lack of gastrointestinal absorption, ability to be fermented, and selective stimulation of intestinal bacteria growth and/or activity (5). Synbiotics, a combination of probiotics and prebiotics, are defined as “a mixture of live microorganisms and substrates selectively utilized by host microorganisms that confer health benefits to the host” (6, 7).

Synbiotics were initially and extensively administered orally, showing effects on both gastrointestinal and respiratory diseases. More recently, direct application of synbiotics to the respiratory system, particularly through dry powder inhalers, has emerged as a promising approach to enhance the pulmonary microflora. Direct lung administration could improve the lung microbiome, acting as a first line of defense against foreign pathogens (2).

In conclusion, synbiotic treatment shows potential in reducing pulmonary exacerbations and decreasing the need for additional antibiotic treatments by inhibiting the pathogenic activity of harmful bacteria (1). A variety of probiotics may be beneficial for this purpose, including Bifidobacteriumlactis, Bifidobacteriumbreve, Bifidobacteriumlongum, Bacillusclausii, Enterococcusfaecalis, Lactobacilluscasei, Lactobacillusrhamnosus, Lactobacillusacidophilus, Lactobacillusplantarum, Lactobacillusgasseri, Lactobacillusfermentum, Lactobacillusbulgaricus, and Streptococcusthermophilus (1, 2, 7-10). However, further research is essential to explore their clinical efficacy and potential applications in treating various respiratory disorders.

References

  • 1.

    Weiss B, Bujanover Y, Yahav Y, Vilozni D, Fireman E, Efrati O. Probiotic supplementation affects pulmonary exacerbations in patients with cystic fibrosis: a pilot study. Pediatr Pulmonol. 2010;45(6):536-40. [PubMed ID: 20503277]. https://doi.org/10.1002/ppul.21138.

  • 2.

    Jamalkandi SA, Ahmadi A, Ahrari I, Salimian J, Karimi M, Ghanei M. Oral and nasal probiotic administration for the prevention and alleviation of allergic diseases, asthma and chronic obstructive pulmonary disease. Nutr Res Rev. 2021;34(1):1-16. [PubMed ID: 32281536]. https://doi.org/10.1017/S0954422420000116.

  • 3.

    Bahrainian S, Rouini M, Gilani K. Preparation and evaluation of vancomycin spray-dried powders for pulmonary delivery. Pharm Dev Technol. 2021;26(6):647-60. [PubMed ID: 33896355]. https://doi.org/10.1080/10837450.2021.1915331.

  • 4.

    Pei C, Wu Y, Wang X, Wang F, Liu L. Effect of probiotics, prebiotics and synbiotics for chronic bronchitis or chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis. Med J (Baltimore). 2020;99(45). e23045. [PubMed ID: 33157958]. [PubMed Central ID: PMC7647592]. https://doi.org/10.1097/MD.0000000000023045.

  • 5.

    Davani-Davari D, Negahdaripour M, Karimzadeh I, Seifan M, Mohkam M, Masoumi SJ, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Food J. 2019;8(3). [PubMed ID: 30857316]. [PubMed Central ID: PMC6463098]. https://doi.org/10.3390/foods8030092.

  • 6.

    Swanson KS, Gibson GR, Hutkins R, Reimer RA, Reid G, Verbeke K, et al. The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics. Nat Rev Gastroenterol Hepatol. 2020;17(11):687-701. [PubMed ID: 32826966]. [PubMed Central ID: PMC7581511]. https://doi.org/10.1038/s41575-020-0344-2.

  • 7.

    Bilan N, Marefat E, Nouri-Vaskeh M, Nikniaz L, Nikniaz Z. Effects of synbiotic supplementation on the pulmonary manifestations and anthropometric measurements in children with cystic fibrosis- a randomized clinical trial. Europ J Integr Med. 2020;33. https://doi.org/10.1016/j.eujim.2019.101027.

  • 8.

    de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, et al. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial. Clin Nutr. 2005;24(4):481-91. [PubMed ID: 16054520]. https://doi.org/10.1016/j.clnu.2005.02.006.

  • 9.

    Di Pierro F, Basile I, Danza ML, Venturelli L, Contini R, Risso P, et al. Use of a probiotic mixture containing Bifidobacterium animalis subsp. lactis BB12 and Enterococcus faecium L3 in atopic children. Minerva Pediatr J. 2018;70(5). https://doi.org/10.23736/s0026-4946.18.05203-9.

  • 10.

    Bezemer GFG, Diks MAP, Mortaz E, van Ark I, van Bergenhenegouwen J, Kraneveld AD, et al. A synbiotic mixture of Bifidobacterium breve M16-V, oligosaccharides and pectin, enhances Short Chain Fatty Acid production and improves lung health in a preclinical model for pulmonary neutrophilia. Front Nutr. 2024;11:1371064. [PubMed ID: 39006103]. [PubMed Central ID: PMC11239554]. https://doi.org/10.3389/fnut.2024.1371064.