Immunostimulation using bacterial antigens – mechanism of action and clinical practice in viral respiratory tract infections

1 Department of Paediatric Pneumonology and Allergology, Medical University of Warsaw, Poland
2 Clinic of Gastroenterology and Child Nutrition, Medical University of Warsaw, Poland
Correspondence: Associate Professor Wojciech Feleszko, MD, PhD, Department of Paediatric Pneumonology and Allergology, Medical University of Warsaw, Żwirki i Wigury 63 A, 02-091 Warsaw, Poland, e-mail: wojciech.feleszko@wum.edu.pl

Pediatr Med Rodz 2015, 11 (4), p. 358–364
DOI: 10.15557/PiMR.2015.0033
ABSTRACT

Recurrent respiratory tract infections constitute a significant problem in the practice of a general practitioner and paediatrician. Antibiotic resistance of bacterial strains, which has been growing for years, prompts the search for alternative ways of combating pathogens. One of them is the usage of preparations based on cell lysis of various bacterial strains. Bacterial lysates have been available in Europe for many years. In preclinical trials, they are characterised by the capability of reducing infections caused by bacteria and viruses that are not the components of the preparations. A range of clinical trials have demonstrated their usefulness in reducing the frequency of seasonal respiratory tract infections and antibiotic use. Moreover, patients with chronic obstructive pulmonary disease gain an additional advantage in the form of the reduction of the risk of hospitalization due to disease exacerbations and a positive influence on the survival curve. The action of bacterial lysates is based on oral immunostimulation of gut-associated lymphoid tissue, which results in increased antibody production. Moreover, they activate a range of mucosal mechanisms of non-specific immunity, mainly by enhancing the activity of TLR-dependent mechanisms. The efficacy of this group of drugs has been confirmed in a range of clinical trials, systematic reviews and meta-analyses. Recent studies also indicate their immunoregulatory potential, suggesting that they might be used in the future in preventing allergies, asthma and autoimmune diseases. To conclude, physicians (paediatricians, laryngologists, pulmonologists) should consider reducing the use of antibiotics in their daily practice. Instead, they should offer preparations that promote the immune system, thus controlling infections in a better way.

Keywords: respiratory tract infections, bacterial lysates, OM-85, toll-like receptors