{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:08:04Z","timestamp":1791328084771,"version":"4.3.1"},"reference-count":53,"publisher":"European Respiratory Society (ERS)","issue":"158","license":[{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2020,5,26]]},"published-print":{"date-parts":[[2020,12,31]]},"abstract":"<jats:p>Wheezing and asthma are a growing cause of morbidity in children and adults. Treatment is aimed at prevention of disease exacerbations and preservation of lung function. Respiratory viruses are involved in \u223c40\u201360% of exacerbations. Bacterial lysates prevent recurrent respiratory tract infections and might reduce exacerbations. Moreover, immunomodulatory effects have been observed in human and animal studies.<\/jats:p><jats:p>Here we aimed to assess the effects of bacterial lysate therapy on preschool wheezing episodes and asthma exacerbation frequency. We performed a systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and a meta-analysis using Cochrane Review Manager. Out of 2016 retrieved articles, 22 studies were included, of which five provided sufficient data for a meta-analysis.<\/jats:p><jats:p>The use of bacterial lysates showed a decrease of both wheezing episodes (mean difference \u22122.35 (\u22123.03\u2013\u200a\u22121.67), p&lt;0.001) and asthma exacerbations in children (mean difference \u22120.90 (\u22121.23\u2013\u200a\u22120.57), p&lt;0.001). Additionally, antibiotic use was reduced, and the duration of wheezing episodes was also decreased. No data for adults with asthma are currently available. The immunomodulatory effect seems to be dependent on increased T-helper (Th)1-cell activation and Th2-cell suppression.<\/jats:p><jats:p>These favourable effects of bacterial lysates indicate that they show promise as add-on therapy in preschool wheezing and childhood asthma.<\/jats:p>","DOI":"10.1183\/16000617.0175-2019","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T14:15:14Z","timestamp":1606486514000},"page":"190175","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":69,"title":["Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9615-1123","authenticated-orcid":false,"given":"Geertje Maria","family":"de Boer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2711-0579","authenticated-orcid":false,"given":"Jakub","family":"\u017b\u00f3\u0142kiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad Piotr","family":"Strzelec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0352-6609","authenticated-orcid":false,"given":"Marek","family":"Ruszczy\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudi W.","family":"Hendriks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7671-3742","authenticated-orcid":false,"given":"Gert-Jan","family":"Braunstahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6613-2012","authenticated-orcid":false,"given":"Wojciech","family":"Feleszko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0228-5375","authenticated-orcid":false,"given":"Gerdien. A.","family":"Tramper-Stranders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"2024102403493158000_29.158.190175.1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.00008114"},{"key":"2024102403493158000_29.158.190175.2","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/S0140-6736(17)33311-1","article-title":"Asthma","volume":"391","author":"Papi","year":"2018","journal-title":"Lancet"},{"key":"2024102403493158000_29.158.190175.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31222-9"},{"key":"2024102403493158000_29.158.190175.4","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.jaci.2017.08.003","article-title":"Role of viral infections in the development and exacerbation of asthma in children","volume":"140","author":"Jartti","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"2024102403493158000_29.158.190175.5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jaci.2012.04.025","article-title":"Diagnosis and management of early asthma in preschool-aged children","volume":"130","author":"Bacharier","year":"2012","journal-title":"J Allergy Clin Immunol"},{"key":"2024102403493158000_29.158.190175.6","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00199913"},{"key":"2024102403493158000_29.158.190175.7","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/pai.13142","article-title":"Preschool wheezing diagnosis and management: survey of physicians\u2019 and caregivers\u2019 perspective","volume":"31","author":"Adamiec","year":"2020","journal-title":"Pediatr Allergy Immunol"},{"key":"2024102403493158000_29.158.190175.8","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/all.13257","article-title":"The potential of anti-infectives and immunomodulators as therapies for asthma and asthma exacerbations","volume":"73","author":"Edwards","year":"2018","journal-title":"Allergy"},{"key":"2024102403493158000_29.158.190175.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.08.042"},{"key":"2024102403493158000_29.158.190175.10","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201312-448LD"},{"key":"2024102403493158000_29.158.190175.11","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-11-74"},{"key":"2024102403493158000_29.158.190175.12","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0133-2017"},{"key":"2024102403493158000_29.158.190175.13","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/ACI.0000000000000433","article-title":"Nonspecific immunomodulators for recurrent respiratory tract infections, wheezing and asthma in children: a systematic review of mechanistic and clinical evidence","volume":"18","author":"Esposito","year":"2018","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"2024102403493158000_29.158.190175.14","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/eji.201747024","article-title":"Human dendritic cells activated with MV130 induce Th1, Th17 and IL-10 responses via RIPK2 and MyD88 signalling pathways","volume":"48","author":"Cirauqui","year":"2018","journal-title":"Eur J Immunol"},{"key":"2024102403493158000_29.158.190175.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2007.11.002"},{"key":"2024102403493158000_29.158.190175.16","first-page":"CD004974","article-title":"Immunostimulants for preventing respiratory tract infection in children","volume":"4","author":"Del-Rio-Navarro","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"issue":"Suppl. 2","key":"2024102403493158000_29.158.190175.17","first-page":"117","article-title":"Broncho-vaxom in the treatment and prophylaxis of recurrent respiratory tract infections in bronchial asthma","volume":"60","author":"Chyrek-Borowska","year":"1992","journal-title":"Pneumonol Alergol Pol"},{"key":"2024102403493158000_29.158.190175.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2015.02.008"},{"key":"2024102403493158000_29.158.190175.19","first-page":"41","article-title":"Enhanced mucosal antibody production and protection against respiratory infections following an orally administered bacterial extract","volume":"1","author":"Pasquali","year":"2014","journal-title":"Front Med (Lausanne)"},{"key":"2024102403493158000_29.158.190175.20","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.intimp.2017.10.032","article-title":"Broncho-Vaxom in pediatric recurrent respiratory tract infections: a systematic review and meta-analysis","volume":"54","author":"Yin","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"2024102403493158000_29.158.190175.21","doi-asserted-by":"crossref","first-page":"e82867","DOI":"10.1371\/journal.pone.0082867","article-title":"Selective activation of human dendritic cells by OM-85 through a NF-kB and MAPK dependent pathway","volume":"8","author":"Parola","year":"2013","journal-title":"PLoS One"},{"key":"2024102403493158000_29.158.190175.22","doi-asserted-by":"publisher","DOI":"10.1038\/mi.2010.51"},{"key":"2024102403493158000_29.158.190175.23","doi-asserted-by":"publisher","DOI":"10.1038\/mi.2010.43"},{"key":"2024102403493158000_29.158.190175.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"2024102403493158000_29.158.190175.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"2024102403493158000_29.158.190175.26","unstructured":"Review Manager (RevMan) . Version 5.3. Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration. 2014."},{"key":"2024102403493158000_29.158.190175.27","unstructured":"Higgins J , Green S . Cochrane Handbook for Systematic Reviews of Interventions. Chichester, Wiley-Blackwell, 2011."},{"key":"2024102403493158000_29.158.190175.28","unstructured":"OM-Pharma . 2016. Summary of Product Characteristics. https:\/\/myhealthbox.eu\/nl\/view\/1717481\/1229962e24dc324b4c23f24db468f6ec\/leaflet."},{"key":"2024102403493158000_29.158.190175.29","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/pai.12894","article-title":"Mechanical bacterial lysate administration prevents exacerbation in allergic asthmatic children: The EOLIA study","volume":"29","author":"Emeryk","year":"2018","journal-title":"Pediatr Allergy Immunol"},{"key":"2024102403493158000_29.158.190175.30","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s00408-016-9880-5","article-title":"Clinical and immunological benefits of OM-85 bacterial lysate in patients with allergic rhinitis, asthma, and COPD and recurrent respiratory infections","volume":"194","author":"Koatz","year":"2016","journal-title":"Lung"},{"key":"2024102403493158000_29.158.190175.31","first-page":"1612","article-title":"[Immunoregulants improves the prognosis of infants with wheezing]","volume":"27","author":"Chen","year":"2007","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"2024102403493158000_29.158.190175.32","first-page":"2151","article-title":"Study on clinical effect and immunologic mechanism of infants capillary bronchitis secondary bronchial asthma treated with bacterial lysates Broncho-Vaxom","volume":"20","author":"Han","year":"2016","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2024102403493158000_29.158.190175.33","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.jaci.2019.05.032","article-title":"Primary prevention of severe lower respiratory illnesses in at-risk infants using the immunomodulator OM-85","volume":"144","author":"Sly","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"2024102403493158000_29.158.190175.34","first-page":"508","article-title":"[Influence of OM-85 BV on hBD-1 and immunoglobulin in children with asthma and recurrent respiratory tract infection]","volume":"16","author":"Liao","year":"2014","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"2024102403493158000_29.158.190175.35","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1159\/000377683","article-title":"Bacterial lysate increases the percentage of natural killer T cells in peripheral blood and alleviates asthma in children","volume":"95","author":"Lu","year":"2015","journal-title":"Pharmacology"},{"key":"2024102403493158000_29.158.190175.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.07.038"},{"key":"2024102403493158000_29.158.190175.37","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.congress-2019.PA4998"},{"key":"2024102403493158000_29.158.190175.38","first-page":"3","article-title":"Effect and analysis of clinical efficacy of immunomodulator on serum levels of IL-4 and IFN-gamma in asthmatic children","volume":"30","author":"Chen","year":"2009","journal-title":"J Sun Yat-sen Univ Med Sci"},{"key":"2024102403493158000_29.158.190175.39","first-page":"1063","article-title":"[Effects of montelukast sodium and bacterial lysates on airway remodeling and expression of transforming growth factor-beta1 and Smad7 in guinea pigs with bronchial asthma]","volume":"20","author":"Liao","year":"2018","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"2024102403493158000_29.158.190175.40","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.aller.2016.04.010","article-title":"Bacterial extract (OM-85) with human-equivalent doses does not inhibit the development of asthma in a murine model","volume":"44","author":"Rodrigues","year":"2016","journal-title":"Allergol Immunopathol (Madr)"},{"key":"2024102403493158000_29.158.190175.41","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/BF02222193","article-title":"Broncho-Vaxom inhibits histamine release from rat mast cells induced by compound 48\/80 and ionophore A23187","volume":"27","author":"Nemeth","year":"1989","journal-title":"Agents Actions"},{"key":"2024102403493158000_29.158.190175.42","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s00408-017-0003-8","article-title":"The immunotherapeutic role of bacterial lysates in a mouse model of asthma","volume":"195","author":"Liu","year":"2017","journal-title":"Lung"},{"key":"2024102403493158000_29.158.190175.43","doi-asserted-by":"crossref","first-page":"e92912","DOI":"10.1371\/journal.pone.0092912","article-title":"Broncho-Vaxom attenuates allergic airway inflammation by restoring GSK3beta-related T regulatory cell insufficiency","volume":"9","author":"Fu","year":"2014","journal-title":"PloS One"},{"key":"2024102403493158000_29.158.190175.44","doi-asserted-by":"crossref","first-page":"e0188010","DOI":"10.1371\/journal.pone.0188010","article-title":"Broncho Vaxom (OM-85) modulates rhinovirus docking proteins on human airway epithelial cells via Erk1\/2 mitogen activated protein kinase and cAMP","volume":"12","author":"Roth","year":"2017","journal-title":"PloS One"},{"key":"2024102403493158000_29.158.190175.45","doi-asserted-by":"publisher","DOI":"10.1136\/thx.51.2.150"},{"key":"2024102403493158000_29.158.190175.46","first-page":"1514","article-title":"[Effect of Broncho-Vaxom on serum IgE and IgG levels in patients with bronchial asthma and chronic obstructive lung disease. A placebo-controlled double-blind study]","volume":"117","author":"Weiss","year":"1987","journal-title":"Schweiz Med Wochenschr"},{"key":"2024102403493158000_29.158.190175.47","doi-asserted-by":"crossref","first-page":"110","DOI":"10.2500\/ajra.2013.27.4021","article-title":"A bacterial extract of OM-85 Broncho-Vaxom prevents allergic rhinitis in mice","volume":"28","author":"Han","year":"2014","journal-title":"Am J Rhinol Allergy"},{"key":"2024102403493158000_29.158.190175.48","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/ACI.0b013e328360ede9","article-title":"Bacterial lysates in food allergy prevention","volume":"13","author":"Lau","year":"2013","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"2024102403493158000_29.158.190175.49","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2006.02629.x"},{"key":"2024102403493158000_29.158.190175.50","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0246"},{"key":"2024102403493158000_29.158.190175.51","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f6471"},{"key":"2024102403493158000_29.158.190175.52","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01046-2019"},{"key":"2024102403493158000_29.158.190175.53","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jaci.2015.07.046","article-title":"Acute and chronic systemic corticosteroid-related complications in patients with severe asthma","volume":"136","author":"Lefebvre","year":"2015","journal-title":"J Allergy Clin Immunol"}],"container-title":["European Respiratory Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/16000617.0175-2019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:02:18Z","timestamp":1740373338000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/16000617.0175-2019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,27]]},"references-count":53,"journal-issue":{"issue":"158","published-online":{"date-parts":[[2020,11,27]]},"published-print":{"date-parts":[[2020,12,31]]}},"alternative-id":["10.1183\/16000617.0175-2019"],"URL":"https:\/\/doi.org\/10.1183\/16000617.0175-2019","relation":{},"ISSN":["0905-9180","1600-0617"],"issn-type":[{"value":"0905-9180","type":"print"},{"value":"1600-0617","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,27]]}}}