{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:55:48Z","timestamp":1789379748198,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    SYN\u201053, a multi\u2010strain probiotic food supplement, was recently shown to significantly alleviate allergic rhinoconjunctivitis (ARC) and its symptoms. The diversity and dosage of bacterial strains administered via SYN\u201053 have been proposed as key drivers of its efficacy. The aim of this study was to assess the role of bacterial diversity and dosage by comparing SYN\u201053 to a low dose variant (SYN\u201053\u2010LD), a low diversity variant (SYN\u20104), and a placebo in the management of ARC. This double\u2010blind, parallel\u2010group, placebo\u2010controlled clinical trial included subjects with moderate\u2010to\u2010severe grass pollen allergy. Following baseline exposure in an allergen exposure chamber (AEC), 166 subjects were randomized to undergo three weekly 3\u2010day intake cycles of SYN\u201053, SYN\u201053\u2010LD, SYN\u20104, or placebo, followed by a final allergen exposure. During AEC exposure, symptoms were continuously measured via assessment of the Total Symptom Score (TSS). SYN\u201053 was significantly superior in reducing TSS\n                    <jats:sub>MAX<\/jats:sub>\n                    compared with its low dose variant SYN\u201053\u2010LD (\u2206TSS\n                    <jats:sub>MAX<\/jats:sub>\n                    [Mean\u2009\u00b1\u2009SE]: \u22125.19\u2009\u00b1\u20090.80 vs. \u22122.27\u2009\u00b1\u20090.65;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0372), its low diversity variant SYN\u20104 (\u22123.41\u2009\u00b1\u20090.52;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0482), and placebo (\u22122.82\u2009\u00b1\u20090.78;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0329). No significant differences to placebo were seen for either SYN\u201053\u2010LD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.7377) or SYN\u20104 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.5152). SYN\u201053 and its variants were well tolerated, and adverse events were not different from placebo. Our findings reaffirm the efficacy of SYN\u201053 in the management of ARC and demonstrate that the effectiveness of this multi\u2010strain probiotic is intricately linked to the diversity of bacterial strains and dosage administered.\n                  <\/jats:p>","DOI":"10.1111\/all.70045","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T06:50:09Z","timestamp":1757573409000},"page":"3310-3318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diversity and Dosage Determine the Efficacy of the Probiotic\n                    <scp>SYN<\/scp>\n                    \u201053 in Allergic Rhinoconjunctivitis: A Randomized, Double\u2010Blind, Placebo\u2010Controlled Trial"],"prefix":"10.1111","volume":"80","author":[{"given":"Karl\u2010Christian","family":"Bergmann","sequence":"first","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 Universit\u00e4tsmedizin, Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1466-8875","authenticated-orcid":false,"given":"Torsten","family":"Zuberbier","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 Universit\u00e4tsmedizin, Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin 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