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Background <p>Allergic rhinitis (AR) is a prevalent inflammatory condition with limited long-term treatment options. Probiotics have been investigated as immunomodulatory agents, yet evidence remains inconsistent. This umbrella review with updated meta-analysis evaluated probiotic efficacy on immunological and clinical outcomes in children and adults with AR.</p> Methods <p>We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase through May 2026. Randomized controlled trials assessing probiotics effects on IgE, antigen-specific IgE, eosinophil count, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Total Rhinitis Symptom Score (RTSS) were included. Weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using random-effects models with REML estimation; Hartung-Knapp-Sidik-Jonkman (HKSJ) was used for outcomes with ≤ 5 studies.</p> Results <p>Twenty-nine RCTs comprising 2,078 participants were included. Probiotic supplementation was associated with significant reductions in total IgE (WMD: -198.35, 95%CI: -291.10 to -105.61), global RQLQ (WMD: -9.43, 95%CI: -11.71 to -7.15), nasal-RQLQ (WMD: -1.52, 95%CI: -2.89 to -0.15), and nasal-RTSS (WMD: -1.97, 95%CI: -3.61 to -0.32). No significant effects were observed for antigen-specific IgE, eosinophil count, eye-RQLQ, global-RTSS, or eye-RTSS. The umbrella review of seven meta-analyses (2008–2025) confirmed consistent benefits for quality of life and nasal symptoms.</p> Conclusions <p>Probiotic supplementation may improve quality of life and nasal symptoms while reducing IgE in AR patients, but evidence is limited by high heterogeneity, fragility of the IgE finding, and pooling of diverse strains. Routine clinical recommendation is not supported by high‑certainty evidence; further strain‑specific RCTs are needed.</p>

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Efficacy of probiotics on immunological and clinical outcomes in allergic rhinitis: an umbrella review and updated meta-analysis of RCTs in children and adults

  • 期刊论文

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  • 发表日期：

    2026年7月17日

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  • Zhe Wang,
  • Yao Lu

摘要

Background

Allergic rhinitis (AR) is a prevalent inflammatory condition with limited long-term treatment options. Probiotics have been investigated as immunomodulatory agents, yet evidence remains inconsistent. This umbrella review with updated meta-analysis evaluated probiotic efficacy on immunological and clinical outcomes in children and adults with AR.

Methods

We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase through May 2026. Randomized controlled trials assessing probiotics effects on IgE, antigen-specific IgE, eosinophil count, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Total Rhinitis Symptom Score (RTSS) were included. Weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using random-effects models with REML estimation; Hartung-Knapp-Sidik-Jonkman (HKSJ) was used for outcomes with ≤ 5 studies.

Results

Twenty-nine RCTs comprising 2,078 participants were included. Probiotic supplementation was associated with significant reductions in total IgE (WMD: -198.35, 95%CI: -291.10 to -105.61), global RQLQ (WMD: -9.43, 95%CI: -11.71 to -7.15), nasal-RQLQ (WMD: -1.52, 95%CI: -2.89 to -0.15), and nasal-RTSS (WMD: -1.97, 95%CI: -3.61 to -0.32). No significant effects were observed for antigen-specific IgE, eosinophil count, eye-RQLQ, global-RTSS, or eye-RTSS. The umbrella review of seven meta-analyses (2008–2025) confirmed consistent benefits for quality of life and nasal symptoms.

Conclusions

Probiotic supplementation may improve quality of life and nasal symptoms while reducing IgE in AR patients, but evidence is limited by high heterogeneity, fragility of the IgE finding, and pooling of diverse strains. Routine clinical recommendation is not supported by high‑certainty evidence; further strain‑specific RCTs are needed.