The Effect of House Dust Mite Immunotherapy, Probiotic and Nigella sativa in The Number of CD4+ IL-4 + Cell, Total IgE level and Asthma Control Test (ACT) Score

Abstract

Asthma is a chronic inflammatory disorder of the airways dominated by Th2. Immunotherapy has benefits for asthmatic patients. Its long duration of treatment is often caused drop out of treatment. Probiotics and Nigella sativa as immunomodulator for asthma expectantly could increase the efficacy of immunotherapy. The aims of this study was to evaluate the therapeutic efficacy of immunotherapy combined with probiotics and Nigella sativa in the number of CD4+ IL-4+ cells, Total IgE level and Asthma Scoring Test. A total of 31 children with mild asthma were evaluated and then randomized to receive immunotherapy or immunotherapy plus Nigella sativa or immunotherapy plus probiotic or immunotherapy plus Nigella sativa plus probiotic openly for 14 weeks.We used subcutaneus HDM immunotherapy (build up phase), 2×109 mixed live bacteria Lactobacillus acidophilus and Bifidobacterium lactis and 15 mg/kgBW/day Nigella sativa. Number of CD4+ IL-4+ cells was evaluated using flowcytometri of PBMC isolated from peripheral blood and analyzed using BD Cell quest Pro software. Total IgE level was measured using Enzyme Chemiluminescence Immunoassay by Roche Elecsys 2010. the children were accompanied by their parents while they answer ACT questions. There was no significant difference in the pre and post test mean number of CD4+ IL-4+ cells in all three treatment group. The Total IgE level was decreased significantly in the immunotherapy+ probiotic+ Nigella sativa group (p 0.022). The ACT score were increased in the immunotherapy+ Nigella sativa group (p 0.001), in the immunotherapy+ probiotics group (p 0.004), and immunotherapy+ Nigella sativa+ probiotics group (p 0.000). Correlation test found a significant association between the number of CD4+ IL-4+ cells, Total IgE level and ACT score in all groups. The combination of immunotherapy, Nigella sativa and probiotics could decrease the Total IgE level thus improve the clinical symptoms.