{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:08:05Z","timestamp":1791328085472,"version":"4.3.1"},"reference-count":134,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SciSense"},{"DOI":"10.13039\/501100024065","name":"OM Pharma","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100024065","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Respiratory tract infections (RTIs) are a leading cause of morbidity in children under five, with over 75% experiencing recurrent episodes and an increased risk of asthma by school age, particularly following respiratory syncytial virus (RSV) and rhinovirus (RV) infections. While current therapies primarily address acute symptoms, effective preventive strategies remain limited. Bacterial-derived immunomodulators have emerged as promising interventions, but their mechanisms and pediatric clinical evidence remain incompletely characterized. This narrative review examines preclinical mechanisms and clinical findings for four such agents, contextualizing current evidence and identifying key gaps. Methods: A targeted narrative review of PubMed-indexed literature (inception to September 2025) was conducted. Mechanistic studies, pediatric (0\u201318 years) clinical trials, and meta-analyses evaluating OM-85, polyvalent mechanical bacterial lysates (PMBL\/Ismigen), MV130, and Lactobacillus rhamnosus CRL1505 were included. Outcomes of interest comprised immunological mechanisms, RTI incidence, wheezing, and asthma-related outcomes. Results: All four agents share convergent immunomodulatory mechanisms involving epithelial barrier reinforcement, innate immune activation, and adaptive immune modulation. OM-85 has the most extensive preclinical evidence. PMBL enhances epithelial repair via the IL-23\/IL-22 axis, MV130 induces trained immunity, and CRL1505 acts through the gut\u2013lung axis. Clinical evidence varies markedly, with OM-85 showing the most comprehensive data (18 RCTs and 7 meta-analyses), followed by PMBL and MV130, while evidence for CRL1505 remains predominantly preclinical. Conclusions: Despite variable evidence maturity, these agents share a coherent mechanistic rationale and favorable safety profiles, with ongoing studies expected to clarify their clinical role in early-life respiratory prevention.<\/jats:p>","DOI":"10.3390\/children13060737","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:16:08Z","timestamp":1779783368000},"page":"737","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Bacterial-Derived Immunomodulators as a Preventive Strategy for Viral Respiratory Tract Infections and Associated Wheezing or Asthma in Children: A Targeted Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Manuel E.","family":"Soto-Martinez","sequence":"first","affiliation":[{"name":"Servicio de Neumolog\u00eda, Departamento de Pediatr\u00eda, Hospital Nacional de Ni\u00f1os \u201cDr. Carlos S\u00e1enz Herrera\u201d, Caja Costarricense de Seguro Social, San Jos\u00e9 1654-1000, Costa Rica"},{"name":"Departamento de Pediatr\u00eda, Escuela de Medicina, Universidad de Costa Rica, San Jos\u00e9 11501-2060, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6613-2012","authenticated-orcid":false,"given":"Wojciech","family":"Feleszko","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-4251","authenticated-orcid":false,"given":"Alexander","family":"Moeller","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Children\u2019s Hospital Zurich, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107938","DOI":"10.1016\/j.ijid.2025.107938","article-title":"The Morbidity Spectrum of Influenza, Respiratory Syncytial Virus, Human Metapneumovirus and Human Parainfluenza Virus in Young Children by Age and Country Income Level: A Systematic Review and Meta-Analysis","volume":"157","author":"He","year":"2025","journal-title":"Int. J. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Vandini, S., Biagi, C., Fischer, M., and Lanari, M. (2019). Impact of Rhinovirus Infections in Children. Viruses, 11.","DOI":"10.3390\/v11060521"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Suleiman-Martos, N., Caballero-V\u00e1zquez, A., G\u00f3mez-Urquiza, J.L., Albend\u00edn-Garc\u00eda, L., Romero-B\u00e9jar, J.L., and Ca\u00f1adas-De La Fuente, G.A. (2021). Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis. J. Pers. Med., 11.","DOI":"10.2139\/ssrn.3795266"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1016\/S0140-6736(22)00478-0","article-title":"Global, Regional, and National Disease Burden Estimates of Acute Lower Respiratory Infections Due to Respiratory Syncytial Virus in Children Younger than 5 Years in 2019: A Systematic Analysis","volume":"399","author":"Li","year":"2022","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1093\/infdis\/jiaa752","article-title":"Respiratory Syncytial Virus\u2013Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis","volume":"225","author":"McLaughlin","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1093\/infdis\/jiad188","article-title":"Burden of Respiratory Syncytial Virus in the European Union: Estimation of RSV-Associated Hospitalizations in Children under 5 Years","volume":"228","author":"Spreeuwenberg","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Yu, J.C., Khodadadi, H., Malik, A., Davidson, B., da Silva Lopes Salles, \u00c9., Bhatia, J., Hale, V.L., and Baban, B. (2018). Innate Immunity of Neonates and Infants. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.01759"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.jped.2020.10.006","article-title":"Immune System: Development and Acquisition of Immunological Competence","volume":"97","author":"Aranda","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Pieren, D.K.J., Boer, M.C., and De Wit, J. (2022). The Adaptive Immune System in Early Life: The Shift Makes It Count. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1031924"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1016\/j.jinf.2015.04.027","article-title":"Development of Immunity in Early Life","volume":"71","author":"Goenka","year":"2015","journal-title":"J. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1128\/CMR.00032-09","article-title":"Respiratory Viral Infections in Infants: Causes, Clinical Symptoms, Virology, and Immunology","volume":"23","author":"Tregoning","year":"2010","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_12","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":"ref_13","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1016\/j.jaip.2025.08.017","article-title":"How Infections and Immune Development Relate to Preschool Recurrent Wheezing and Asthma","volume":"13","author":"Kloepfer","year":"2025","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.anai.2019.06.020","article-title":"Asthma and Viral Infections","volume":"123","author":"Mikhail","year":"2019","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e013034","DOI":"10.1136\/bmjopen-2016-013034","article-title":"Association between Rhinovirus Wheezing Illness and the Development of Childhood Asthma: A Meta-Analysis","volume":"7","author":"Liu","year":"2017","journal-title":"BMJ Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.anai.2025.05.011","article-title":"The Impact of Respiratory Syncytial Virus on Asthma Development and Exacerbation","volume":"135","author":"Ma","year":"2025","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"43844","DOI":"10.1038\/srep43844","article-title":"OM-85 Is an Immunomodulator of Interferon-\u03b2 Production and Inflammasome Activity","volume":"7","author":"Dang","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jaci.2022.01.001","article-title":"Protection against Severe Infant Lower Respiratory Tract Infections by Immune Training: Mechanistic Studies","volume":"150","author":"Troy","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.pupt.2011.11.002","article-title":"Polyvalent Mechanical Bacterial Lysate for the Prevention of Recurrent Respiratory Infections: A Meta-Analysis","volume":"25","author":"Cazzola","year":"2012","journal-title":"Pulm. Pharmacol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1164\/rccm.202003-0520OC","article-title":"Bacterial Mucosal Immunotherapy with MV130 Prevents Recurrent Wheezing in Children: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial","volume":"204","author":"Nieto","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Montalb\u00e1n-Hern\u00e1ndez, K., Cogollo-Garc\u00eda, A., Gir\u00f3n De Velasco-Sada, P., Caballero, R., Casanovas, M., Subiza, J.L., and Conejero, L. (2024). MV130 in the Prevention of Recurrent Respiratory Tract Infections: A Retrospective Real-World Study in Children and Adults. Vaccines, 12.","DOI":"10.3390\/vaccines12020172"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Du, T., Lei, A., Zhang, N., and Zhu, C. (2022). The Beneficial Role of Probiotic Lactobacillus in Respiratory Diseases. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.908010"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"298","DOI":"10.5492\/wjccm.v11.i4.298","article-title":"Association between Early Viral Lower Respiratory Tract Infections and Subsequent Asthma Development","volume":"11","author":"Kenmoe","year":"2022","journal-title":"World J. Crit. Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1111\/jpc.16197","article-title":"Respiratory Syncytial Virus, Recurrent Wheeze and Asthma: A Narrative Review of Pathophysiology, Prevention and Future Directions","volume":"58","author":"Binns","year":"2022","journal-title":"J. Paediatr. Child Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"170133","DOI":"10.1183\/16000617.0133-2017","article-title":"Viral Infections in Wheezing Disorders","volume":"27","year":"2018","journal-title":"Eur. Respir. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kombe Kombe, A.J., Fotoohabadi, L., Gerasimova, Y., Nanduri, R., Lama Tamang, P., Kandala, M., and Kelesidis, T. (2024). The Role of Inflammation in the Pathogenesis of Viral Respiratory Infections. Microorganisms, 12.","DOI":"10.3390\/microorganisms12122526"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mthembu, N., Ikwegbue, P., Brombacher, F., and Hadebe, S. (2021). Respiratory Viral and Bacterial Factors That Influence Early Childhood Asthma. Front. Allergy, 2.","DOI":"10.3389\/falgy.2021.692841"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Luo, W., Hu, J., Xu, W., and Dong, J. (2022). Distinct Spatial and Temporal Roles for Th1, Th2, and Th17 Cells in Asthma. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.974066"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Semmes, E.C., Chen, J.-L., Goswami, R., Burt, T.D., Permar, S.R., and Fouda, G.G. (2021). Understanding Early-Life Adaptive Immunity to Guide Interventions for Pediatric Health. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.595297"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Di Gioacchino, M., Santilli, F., and Pession, A. (2024). Is There a Role for Immunostimulant Bacterial Lysates in the Management of Respiratory Tract Infection?. Biomolecules, 14.","DOI":"10.3390\/biom14101249"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mastrangelo, P., Chin, A.A., Tan, S., Jeon, A.H., Ackerley, C.A., Siu, K.K., Lee, J.E., and Hegele, R.G. (2021). Identification of RSV Fusion Protein Interaction Domains on the Virus Receptor, Nucleolin. Viruses, 13.","DOI":"10.3390\/v13020261"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ganjian, H., Rajput, C., Elzoheiry, M., and Sajjan, U. (2020). Rhinovirus and Innate Immune Function of Airway Epithelium. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00277"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/imm.13762","article-title":"Role of Airway Epithelium in Viral Respiratory Infections: Can Carbocysteine Prevent or Mitigate Them?","volume":"172","author":"Pace","year":"2024","journal-title":"Immunology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1172\/JCI124606","article-title":"Epithelial Cell\u2013Derived Cytokines: More than Just Signaling the Alarm","volume":"129","author":"Roan","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sasaki, H., Miyata, J., Kawana, A., and Fukunaga, K. (2025). Antiviral Roles of Eosinophils in Asthma and Respiratory Viral Infection. Front. Allergy, 6.","DOI":"10.3389\/falgy.2025.1548338"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"L280","DOI":"10.1152\/ajplung.00300.2023","article-title":"Early-Life Pulmonary Viral Infection Leads to Long-Term Functional and Lower Airway Structural Changes in the Lungs","volume":"326","author":"Malinczak","year":"2024","journal-title":"Am. J. Physiol. Lung Cell. Mol. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/S0140-6736(23)00811-5","article-title":"Respiratory Syncytial Virus Infection during Infancy and Asthma during Childhood in the USA (INSPIRE): A Population-Based, Prospective Birth Cohort Study","volume":"401","author":"Chirkova","year":"2023","journal-title":"Lancet"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13601-020-00322-1","article-title":"Viral Infections and Wheezing\u2013Asthma Inception in Childhood: Is There a Role for Immunomodulation by Oral Bacterial Lysates?","volume":"10","author":"Rossi","year":"2020","journal-title":"Clin. Transl. Allergy"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/ACI.0000000000000244","article-title":"Early-Life Respiratory Infections and Asthma Development: Role in Disease Pathogenesis and Potential Targets for Disease Prevention","volume":"16","author":"Beigelman","year":"2016","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.jaip.2021.12.005","article-title":"Long-Term Respiratory Consequences of Early-Life Respiratory Viral Infections: A Pragmatic Approach to Fundamental Questions","volume":"10","author":"Achten","year":"2022","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kaczynska, A., Klosinska, M., Janeczek, K., Zarobkiewicz, M., and Emeryk, A. (2022). Promising Immunomodulatory Effects of Bacterial Lysates in Allergic Diseases. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.907149"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/cea.12642","article-title":"Genetic Associations with Viral Respiratory Illnesses and Asthma Control in Children","volume":"46","author":"Loisel","year":"2016","journal-title":"Clin. Exp. Allergy"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/j.jaip.2025.07.051","article-title":"Risk Factors and Mechanisms Leading to Preschool Recurrent Wheeze and Asthma","volume":"13","author":"Wolters","year":"2025","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S2213-2600(25)00256-5","article-title":"Genetic and Environmental Risk Factors for Asthma: Towards Prevention","volume":"13","author":"Koppelman","year":"2025","journal-title":"Lancet Respir. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/2049-6958-8-33","article-title":"Prevention of Respiratory Tract Infections with Bacterial Lysate OM-85 Bronchomunal in Children and Adults: A State of the Art","volume":"8","author":"Sevieri","year":"2013","journal-title":"Multidiscip. Respir. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.anai.2015.02.008","article-title":"Immunoregulatory and Immunostimulatory Responses of Bacterial Lysates in Respiratory Infections and Asthma","volume":"114","author":"Kearney","year":"2015","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.imlet.2011.03.006","article-title":"A Mixture of Bacterial Mechanical Lysates Is More Efficient than Single Strain Lysate and of Bacterial-Derived Soluble Products for the Induction of an Activating Phenotype in Human Dendritic Cells","volume":"138","author":"Morandi","year":"2011","journal-title":"Immunol. Lett."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"110184","DOI":"10.1016\/j.celrep.2021.110184","article-title":"Trained Immunity Induction by the Inactivated Mucosal Vaccine MV130 Protects against Experimental Viral Respiratory Infections","volume":"38","author":"Brandi","year":"2022","journal-title":"Cell Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1517\/14712598.2015.980233","article-title":"Probiotics for the Prevention of Pediatric Upper Respiratory Tract Infections: A Systematic Review","volume":"15","author":"Ozen","year":"2015","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Roth, M., Pasquali, C., Stolz, D., and Tamm, M. (2017). Broncho Vaxom (OM-85) Modulates Rhinovirus Docking Proteins on Human Airway Epithelial Cells via Erk1\/2 Mitogen Activated Protein Kinase and cAMP. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0188010"},{"key":"ref_51","first-page":"8826645","article-title":"Distinct Antiviral Properties of Two Different Bacterial Lysates","volume":"2021","author":"Roth","year":"2021","journal-title":"Can. Respir. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1002\/alr.22276","article-title":"Broncho-Vaxom\u00ae (OM-85 BV) Soluble Components Stimulate Sinonasal Innate Immunity","volume":"9","author":"Triantafillou","year":"2019","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.jaci.2021.09.013","article-title":"Airway Administration of OM-85, a Bacterial Lysate, Blocks Experimental Asthma by Targeting Dendritic Cells and the Epithelium\/IL-33\/ILC2 Axis","volume":"149","author":"Pivniouk","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1038\/mi.2010.51","article-title":"The Oral Administration of Bacterial Extracts Prevents Asthma via the Recruitment of Regulatory T Cells to the Airways","volume":"4","author":"Navarro","year":"2011","journal-title":"Mucosal Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Fu, R., Li, J., Zhong, H., Yu, D., Zeng, X., Deng, M., Sun, Y., Wen, W., and Li, H. (2014). Broncho-Vaxom Attenuates Allergic Airway Inflammation by Restoring GSK3\u03b2-Related T Regulatory Cell Insufficiency. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092912"},{"key":"ref_56","first-page":"209","article-title":"Th1-orientated immunological properties of the bacterial extract OM-85-BV","volume":"10","author":"Huber","year":"2005","journal-title":"Eur. J. Med. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.mucimm.2024.02.010","article-title":"The Bacterial Lysate OM-85 Engages Toll-like Receptors 2 and 4 Triggering an Immunomodulatory Gene Signature in Human Myeloid Cells","volume":"17","author":"Khameneh","year":"2024","journal-title":"Mucosal Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Parola, C., Salogni, L., Vaira, X., Scutera, S., Somma, P., Salvi, V., Musso, T., Tabbia, G., Bardessono, M., and Pasquali, C. (2013). Selective Activation of Human Dendritic Cells by OM-85 through a NF-kB and MAPK Dependent Pathway. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0082867"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0165-2478(00)00326-6","article-title":"A Clinically Approved Oral Vaccine against Pneumotropic Bacteria Induces the Terminal Maturation of CD83+ Immunostimulatory Dendritic Cells","volume":"76","author":"Ramoner","year":"2001","journal-title":"Immunol. Lett."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Pasquali, C., Salami, O., Taneja, M., Gollwitzer, E.S., Trompette, A., Pattaroni, C., Yadava, K., Bauer, J., and Marsland, B.J. (2014). Enhanced Mucosal Antibody Production and Protection against Respiratory Infections Following an Orally Administered Bacterial Extract. Front. Med., 1.","DOI":"10.3389\/fmed.2014.00041"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Antunes, K.H., Cass\u00e3o, G., Santos, L.D., Borges, S.G., Poppe, J., Gon\u00e7alves, J.B., Nunes, E.D.S., Recacho, G.F., Sousa, V.B., and Da Silva, G.S. (2022). Airway Administration of Bacterial Lysate OM-85 Protects Mice Against Respiratory Syncytial Virus Infection. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.867022"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s13052-018-0569-7","article-title":"Evidence That a Primary Anti-Viral Stimulation of the Immune Response by OM-85 Reduces Susceptibility to a Secondary Respiratory Bacterial Infection in Mice","volume":"44","author":"Rossi","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1089\/jir.1998.18.817","article-title":"Bacterial Extract OM85-BV Induces Interleukin-12-Dependent IFN-\u03b3 Production by Human CD4+ T Cells","volume":"18","author":"Byl","year":"1998","journal-title":"J. Interferon Cytokine Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/jleuko\/qiad003","article-title":"Mechanical Bacterial Lysate Enhances Antimicrobial Barrier Mechanisms in Human Airway Epithelial Cells","volume":"113","author":"Campana","year":"2023","journal-title":"J. Leukoc. Biol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Ferrara, F., Rial, A., Su\u00e1rez, N., and Chabalgoity, J.A. (2021). Polyvalent Bacterial Lysate Protects Against Pneumonia Independently of Neutrophils, IL-17A or Caspase-1 Activation. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.562244"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7573\/dic.2024-1-5","article-title":"Sublingually Administered Bacterial Lysates: Rationale, Mechanisms of Action and Clinical Outcomes","volume":"13","author":"Braido","year":"2024","journal-title":"Drugs Context"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/039463200501800207","article-title":"In Vitro Effects of an Immunostimulating Bacterial Lysate on Human Lymphocyte Function","volume":"18","author":"Lanzilli","year":"2005","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1177\/039463200601900311","article-title":"In Vivo Effect of an Immunostimulating Bacterial Lysate on Human B Lymphocytes","volume":"19","author":"Lanzilli","year":"2006","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"7129","DOI":"10.1038\/s41467-025-62632-x","article-title":"A Mucosal Vaccine Prevents Eosinophilic Allergic Airway Inflammation by Modulating Immune Responses to Allergens in a Murine Model of Airway Disease","volume":"16","author":"Angelina","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_70","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":"ref_71","doi-asserted-by":"crossref","unstructured":"Del Fresno, C., Garc\u00eda-Arriaza, J., Mart\u00ednez-Cano, S., Heras-Murillo, I., Jarit-Cabanillas, A., Amores-Iniesta, J., Brandi, P., Dunphy, G., Suay-Corredera, C., and Pricolo, M.R. (2021). The Bacterial Mucosal Immunotherapy MV130 Protects Against SARS-CoV-2 Infection and Improves COVID-19 Vaccines Immunogenicity. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.748103"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"V\u00e1zquez, A., Fern\u00e1ndez-Sevilla, L.M., Jim\u00e9nez, E., P\u00e9rez-Cabrera, D., Ya\u00f1ez, R., Subiza, J.L., Varas, A., Valencia, J., and Vicente, A. (2020). Involvement of Mesenchymal Stem Cells in Oral Mucosal Bacterial Immunotherapy. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.567391"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Albarracin, L., Garcia-Castillo, V., Masumizu, Y., Indo, Y., Islam, M.A., Suda, Y., Garcia-Cancino, A., Aso, H., Takahashi, H., and Kitazawa, H. (2020). Efficient Selection of New Immunobiotic Strains with Antiviral Effects in Local and Distal Mucosal Sites by Using Porcine Intestinal Epitheliocytes. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00543"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Zhou, B., Elean, M., Arce, L., Fukuyama, K., Tomotsune, K., Dentice Maidana, S., Saha, S., Namai, F., Nishiyama, K., and Vizoso-Pinto, M.G. (2024). The Mucus-Binding Factor Mediates Lacticaseibacillus rhamnosus CRL1505 Adhesion but Not Immunomodulation in the Respiratory Tract. Microorganisms, 12.","DOI":"10.3390\/microorganisms12061209"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Dentice Maidana, S., Imamura, Y., Elean, M., Albarrac\u00edn, L., Nishiyama, K., Suda, Y., Kurata, S., Jure, M.\u00c1., Kitazawa, H., and Villena, J. (2023). Oral Administration of Lacticaseibacillus rhamnosus CRL1505 Modulates Lung Innate Immune Response against Klebsiella Pneumoniae ST25. Microorganisms, 11.","DOI":"10.3390\/microorganisms11051148"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Tomotsune, K., Raya Tonetti, F., Mizuno, H., Elean, M., Fukuyama, K., Zhou, B., Ikeda-Ohtsubo, W., Nishiyama, K., Yamamura, A., and Karasawa, H. (2022). The Mucus Binding Factor Is Not Necessary for Lacticaseibacillus rhamnosus CRL1505 to Exert Its Immunomodulatory Activities in Local and Distal Mucosal Sites. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232214357"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Clua, P., Kanmani, P., Zelaya, H., Tada, A., Kober, A.K.M.H., Salva, S., Alvarez, S., Kitazawa, H., and Villena, J. (2017). Peptidoglycan from Immunobiotic Lactobacillus rhamnosus Improves Resistance of Infant Mice to Respiratory Syncytial Viral Infection and Secondary Pneumococcal Pneumonia. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.00948"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Clua, P., Tomokiyo, M., Raya Tonetti, F., Islam, M.A., Garc\u00eda Castillo, V., Marcial, G., Salva, S., Alvarez, S., Takahashi, H., and Kurata, S. (2020). The Role of Alveolar Macrophages in the Improved Protection against Respiratory Syncytial Virus and Pneumococcal Superinfection Induced by the Peptidoglycan of Lactobacillus rhamnosus CRL1505. Cells, 9.","DOI":"10.3390\/cells9071653"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Raya Tonetti, F., Clua, P., Fukuyama, K., Marcial, G., Sacur, J., Marranzino, G., Tomokiyo, M., Vizoso-Pinto, G., Garcia-Cancino, A., and Kurata, S. (2022). The Ability of Postimmunobiotics from L. Rhamnosus CRL1505 to Protect against Respiratory Syncytial Virus and Pneumococcal Super-Infection Is a Strain-Dependent Characteristic. Microorganisms, 10.","DOI":"10.3390\/microorganisms10112185"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Esposito, S., Jones, M.H., Feleszko, W., Martell, J.A.O., Falup-Pecurariu, O., Geppe, N., Martin\u00f3n-Torres, F., Shen, K.-L., Roth, M., and Principi, N. (2020). Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus Statement from the World Association of Infectious Diseases and Immunological Disorders (WAidid). Microorganisms, 8.","DOI":"10.3390\/microorganisms8111810"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.jaci.2021.11.019","article-title":"The OM-85 Bacterial Lysate Inhibits SARS-CoV-2 Infection of Epithelial Cells by Downregulating SARS-CoV-2 Receptor Expression","volume":"149","author":"Pivniouk","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Fang, L., Zhou, L., Tamm, M., and Roth, M. (2021). OM-85 Broncho-Vaxom\u00ae, a Bacterial Lysate, Reduces SARS-CoV-2 Binding Proteins on Human Bronchial Epithelial Cells. Biomedicines, 9.","DOI":"10.3390\/biomedicines9111544"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1016\/j.intimp.2010.06.009","article-title":"The Bacterial Extract OM-85 BV Protects Mice against Influenza and Salmonella Infection","volume":"10","author":"Bessler","year":"2010","journal-title":"Int. Immunopharmacol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/039463200702000115","article-title":"Improvement of Clinical Response in Allergic Rhinitis Patients Treated with an Oral Immunostimulating Bacterial Lysate: In Vivo Immunological Effects","volume":"20","author":"Banche","year":"2007","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Villena, J., Chiba, E., Vizoso-Pinto, M., Tomosada, Y., Takahashi, T., Ishizuka, T., Aso, H., Salva, S., Alvarez, S., and Kitazawa, H. (2014). Immunobiotic Lactobacillus rhamnosus Strains Differentially Modulate Antiviral Immune Response in Porcine Intestinal Epithelial and Antigen Presenting Cells. BMC Microbiol., 14.","DOI":"10.1186\/1471-2180-14-126"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Garcia-Castillo, V., Tomokiyo, M., Raya Tonetti, F., Islam, M.A., Takahashi, H., Kitazawa, H., and Villena, J. (2020). Alveolar Macrophages Are Key Players in the Modulation of the Respiratory Antiviral Immunity Induced by Orally Administered Lacticaseibacillus rhamnosus CRL1505. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.568636"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"100684","DOI":"10.1016\/j.waojou.2022.100684","article-title":"Immunostimulants for Preventing Respiratory Tract Infection in Children: A Systematic Review and Meta-Analysis","volume":"15","author":"Berber","year":"2022","journal-title":"World Allergy Organ. J."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"190175","DOI":"10.1183\/16000617.0175-2019","article-title":"Bacterial Lysate Therapy for the Prevention of Wheezing Episodes and Asthma Exacerbations: A Systematic Review and Meta-Analysis","volume":"29","author":"Strzelec","year":"2020","journal-title":"Eur. Respir. Rev."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e13981","DOI":"10.1111\/ijcp.13981","article-title":"Efficacy and Safety of OM-85 in Paediatric Recurrent Respiratory Tract Infections Which Could Have a Possible Protective Effect on COVID-19 Pandemic: A Meta-analysis","volume":"75","author":"Cao","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_90","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":"ref_91","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s12519-010-0001-x","article-title":"OM-85 BV, an Immunostimulant in Pediatric Recurrent Respiratory Tract Infections: A Systematic Review","volume":"6","author":"Schaad","year":"2010","journal-title":"World J. Pediatr."},{"key":"ref_92","first-page":"CD004974","article-title":"Immunostimulants for Preventing Respiratory Tract Infection in Children","volume":"2006","author":"Flenady","year":"2006","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/jcph.1969","article-title":"Whether Immunostimulants Are Effective in Susceptible Children Suffering From Recurrent Respiratory Tract Infections: A Modeling Analysis Based on Literature Aggregate Data","volume":"62","author":"Zhang","year":"2022","journal-title":"J. Clin. Pharma"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"eAO5262","DOI":"10.31744\/einstein_journal\/2020AO5262","article-title":"OM-85 BV for Primary Prevention of Recurrent Airway Infections: A Pilot Randomized, Double-Blind, Placebo-Controlled Study","volume":"18","author":"Souza","year":"2020","journal-title":"Einstein"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1186\/s12967-019-2040-y","article-title":"A Randomized, Placebo-Controlled, Double-Blinded, Single-Centre, Phase IV Trial to Assess the Efficacy and Safety of OM-85 in Children Suffering from Recurrent Respiratory Tract Infections","volume":"17","author":"Esposito","year":"2019","journal-title":"J. Transl. Med."},{"key":"ref_96","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":"ref_97","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1017\/S0022215117000524","article-title":"Bacterial Lysate for the Prevention of Chronic Rhinosinusitis Recurrence in Children","volume":"131","author":"Chen","year":"2017","journal-title":"J. Laryngol. Otol."},{"key":"ref_98","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":"ref_99","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":"ref_100","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":"ref_101","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1016\/j.vaccine.2014.03.055","article-title":"Impact of a Mixed Bacterial Lysate (OM-85 BV) on the Immunogenicity, Safety and Tolerability of Inactivated Influenza Vaccine in Children with Recurrent Respiratory Tract Infection","volume":"32","author":"Esposito","year":"2014","journal-title":"Vaccine"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.jaci.2010.07.038","article-title":"The Immunostimulant OM-85 BV Prevents Wheezing Attacks in Preschool Children","volume":"126","author":"Razi","year":"2010","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_103","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":"ref_104","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1378\/chest.119.6.1742","article-title":"Safety and Efficacy of Two Courses of OM-85 BV in the Prevention of Respiratory Tract Infections in Children During 12 Months","volume":"119","author":"Berber","year":"2001","journal-title":"Chest"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S0149-2918(00)90008-0","article-title":"Primary Prevention of Acute Respiratory Tract Infections in Children Using a Bacterial Immunostimulant: A Double-Masked, Placebo-Controlled Clinical Trial","volume":"22","author":"Berber","year":"2000","journal-title":"Clin. Ther."},{"key":"ref_106","first-page":"17","article-title":"Safety and efficacy of OM-85-BV plus amoxicillin\/clavulanate in the treatment of subacute sinusitis and the prevention of recurrent infections in children","volume":"26","author":"Alvarez","year":"1998","journal-title":"Allergol. Immunopathol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1097\/00006454-199308000-00005","article-title":"Stimulation of Nonspecific Immunity to Reduce the Risk of Recurrent Infections in Children Attending Day-Care Centers. The Epicr\u00e8che Research Group","volume":"12","author":"Collet","year":"1993","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_108","first-page":"150","article-title":"Immunotherapy with an Oral Bacterial Extract (OM-85 BV) for Upper Respiratory Infections","volume":"58","author":"Paupe","year":"1991","journal-title":"Respiration"},{"key":"ref_109","first-page":"397","article-title":"Broncho-Vaxom\u00ae in Children with Rhinosinusitis: A Double-Blind Clinical Trial","volume":"50","author":"Zagar","year":"1988","journal-title":"ORL"},{"key":"ref_110","first-page":"171","article-title":"Strategies for Optimizing Compliance of Paediatric Patients for Seasonal Antibacterial Vaccination with Sublingually Administered Polyvalent Mechanical Bacterial Lysates (PMBL)","volume":"75","author":"Rosaschino","year":"2004","journal-title":"Acta Biomed."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13223-020-00503-4","article-title":"Impact of Polyvalent Mechanical Bacterial Lysate on Lymphocyte Number and Activity in Asthmatic Children: A Randomized Controlled Trial","volume":"17","author":"Emeryk","year":"2021","journal-title":"Allergy Asthma Clin. Immunol."},{"key":"ref_112","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":"ref_113","doi-asserted-by":"crossref","unstructured":"Janeczek, K., Kowalska, W., Zarobkiewicz, M., Suszczyk, D., Miko\u0142ajczyk, M., Markut-Miot\u0142a, E., Morawska-Michalska, I., Bakiera, A., Tomczak, A., and Kaczy\u0144ska, A. (2023). Effect of Immunostimulation with Bacterial Lysate on the Clinical Course of Allergic Rhinitis and the Level of \u03b3\u03b4T, iNKT and Cytotoxic T Cells in Children Sensitized to Grass Pollen Allergens: A Randomized Controlled Trial. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1073788"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"e584","DOI":"10.1002\/iid3.584","article-title":"Nasal Carriage of Staphylococcus Aureus in Children with Grass Pollen-Induced Allergic Rhinitis and the Effect of Polyvalent Mechanical Bacterial Lysate Immunostimulation on Carriage Status: A Randomized Controlled Trial","volume":"10","author":"Janeczek","year":"2022","journal-title":"Immun. Inflamm. Dis."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.ijporl.2013.01.009","article-title":"The Role of OM-85 BV (Broncho-Vaxom) in Preventing Recurrent Acute Tonsillitis in Children","volume":"77","author":"Bitar","year":"2013","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Cantarutti, A., Barbieri, E., Scamarcia, A., Cantarutti, L., Canova, C., and Giaquinto, C. (2021). Use of the Bacterial Lysate OM-85 in the Paediatric Population in Italy: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18136871"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1007\/s10096-014-2086-y","article-title":"Probiotics in Respiratory Virus Infections","volume":"33","author":"Lehtoranta","year":"2014","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"197.e1","DOI":"10.1016\/j.ijantimicag.2008.11.005","article-title":"Probiotics for the Prevention of Respiratory Tract Infections: A Systematic Review","volume":"34","author":"Vouloumanou","year":"2009","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_119","unstructured":"OM Pharma SA (2026, March 20). A Randomised, Placebo-Controlled, 3-Arm, Double-Blind, Multicentre, Phase 4 Study to Assess the Efficacy of OM-85 (Broncho-Vaxom) Short- and Long-Term Treatment vs. Placebo in the Prevention of Respiratory Tract Infections in Children Aged Between 6 Months and 5 Years with Wheezing Lower Respiratory Illness, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05677763."},{"key":"ref_120","unstructured":"Tramper, G. (2026, March 20). Protecting Late-Moderate Preterm Infants From Respiratory Tract Infections and Wheeze in Their First Years of Life by Using Bacterial Lysates. Available online: https:\/\/onderzoekmetmensen.nl\/en\/node\/55914\/pdf."},{"key":"ref_121","unstructured":"Queen Mary University of London (2026, March 20). Oral Bacterial Lysate to Prevent Persistent Wheeze in Infants After Severe Bronchiolitis. A Randomised Placebo-Controlled Trial. Available online: https:\/\/www.menzies.edu.au\/page\/Research\/Projects\/Lungs\/Oral_bacterial_lysate_to_prevent_persistent_wheeze_in_infants_after_severe_bronchiolitis_a_randomised_placebo-controlled_trial\/."},{"key":"ref_122","unstructured":"OM Pharma SA (2026, March 20). A Randomized, Placebo-Controlled, Double-Blind, Multicenter, Phase 2 Study to Assess the Efficacy and Safety of Daily OM-85 Treatment vs. Placebo Given in Children Aged 6 Months to 5 Years with Recurrent Wheezing, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05857930."},{"key":"ref_123","unstructured":"University of Arizona (2026, March 20). Randomized, Placebo-Controlled, Multicenter Study to Assess the Efficacy, Safety and Tolerability of ORal Bacterial EXtract for the Prevention of Wheezing Lower Respiratory Tract Illness (ORBEX), Available online: https:\/\/clinicaltrials.gov\/study\/NCT02148796."},{"key":"ref_124","unstructured":"Bioithas, S.L. (2026, March 20). Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of Lacticaseibacillus rhamnosus, CRL1505 in the Prevention of Upper Respiratory Tract Infections in a Healthy Paediatric Population, Available online: https:\/\/clinicaltrials.gov\/study\/NCT07154992?cond=Prevention%20Upper%20Respiratory%20Tract%20Infections&intr=Lacticaseibacillus%20Rhamnosus%20CRL1505&viewType=Card&rank=1."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"e14186","DOI":"10.1111\/pai.14186","article-title":"A Critical Analysis of the Effect of OM-85 for the Prevention of Recurrent Respiratory Tract Infections or Wheezing\/Asthma from Systematic Reviews with Meta-analysis","volume":"35","author":"Turi","year":"2024","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"13850","DOI":"10.1038\/ncomms13850","article-title":"Innate and Adaptive Immune Traits Are Differentially Affected by Genetic and Environmental Factors","volume":"8","author":"Mangino","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"e13780","DOI":"10.1111\/pai.13780","article-title":"Gene-environment Interactions in Childhood Asthma Revisited; Expanding the Interaction Concept","volume":"33","author":"Kere","year":"2022","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1111\/apa.14270","article-title":"Guidance on the Use of Probiotics in Clinical Practice in Children with Selected Clinical Conditions and in Specific Vulnerable Groups","volume":"107","author":"Hojsak","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Guandalini, S., and Indrio, F. (2024). Current Regulatory Issues for the Use of Probiotics. Probiotics and Child Gastrointestinal Health: Advances in Microbiology, Infectious Diseases and Public Health Volume 19, Springer International Publishing.","DOI":"10.1007\/978-3-031-58572-2"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"100265","DOI":"10.1016\/j.advnut.2024.100265","article-title":"Is There Evidence to Support Probiotic Use for Healthy People?","volume":"15","author":"Merenstein","year":"2024","journal-title":"Adv. Nutr."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13561-019-0230-1","article-title":"Cost-Effectiveness Analysis of OM-85 vs Placebo in the Prevention of Acute Respiratory Tract Infections (ARTIs) in Children That Attend Day-Care Centers","volume":"9","author":"Berber","year":"2019","journal-title":"Health Econ. Rev."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.tim.2021.01.003","article-title":"Shaping the Future of Probiotics and Prebiotics","volume":"29","author":"Cunningham","year":"2021","journal-title":"Trends Microbiol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"00368504251355373","DOI":"10.1177\/00368504251355373","article-title":"Bacterial Lysates in Allergic Rhinitis and Chronic Rhinosinusitis: Mechanisms and Clinical Evidence","volume":"108","author":"Huang","year":"2025","journal-title":"Sci. Prog."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.it.2025.02.012","article-title":"Trained Immunity-Based Mucosal Immunotherapies for the Prevention of Respiratory Infections","volume":"46","author":"Minute","year":"2025","journal-title":"Trends Immunol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/6\/737\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:16:02Z","timestamp":1779941762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/6\/737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":134,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["children13060737"],"URL":"https:\/\/doi.org\/10.3390\/children13060737","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}