Current possibilities for the prevention of acute respiratory infections in preschoolers using a multi-strain and multi-species immunoprobiotic
Zakharova I.N., Berezhnaya I.V., Makhaeva A.V., Cherednikova T.A., Koshechkin S.I., Odintsova V.E., Romanov V.A.
Background: Research in recent decades has demonstrated the relationship between the microbiota and the human immune system. In early childhood, the development of a child’s microbiota and the development of child’s immune system occur synchronously, and minor changes in their combined development can have serious consequences. The influence of prenatal, perinatal, and early postnatal factors on the formation of the microbiota has been proven, manifesting in early childhood and having long-term consequences.
The microbiota of the oral cavity and other parts of the body are interconnected; with the development of oral inflammation, similar changes occur simultaneously in all mucous membranes of the body. Disruption of intercellular contacts between epithelial cells in the first hours of a respiratory infection leads to increased permeability of the intestinal and pulmonary mucosa. The use of antiseptics in the combination therapy of acute respiratory infections in children suppresses the immune response and significantly disrupts intercellular interactions, which triggers the activation of a cascade of immune reactions, leading to a more severe and protracted course of infection, as well as the unnecessary use of antibacterial drugs. Thus, a «vicious cycle» arises. The use of probiotics in the combination therapy of acute respiratory infections (ARI) in children can reduce the severity and duration of the disease. The potential for preventing ARIs with probiotics, especially during epidemic periods, is being explored worldwide.
This article presents the results of a study based on genetic analysis of the gut microbiota using 16S rRNA gene sequencing in children aged 2–7 years who had experienced at least four episodes of acute respiratory infection (ARI) in the past year.
Objective: Analysis of the frequency of ARIs in preschool-aged children using a developed program that utilizes a prophylactic dose of vitamin D and a multi-strain immunoprobiotic.
Materials and methods: The study was conducted at the clinical facilities of Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Postgraduate Education, and the Children’s City Polyclinic No. 140, Moscow Healthcare Department. At the first stage, outpatient records and medical history collection were used to select children who attended the same kindergarten and had experienced ARIs more than four times during the previous epidemic season. The study included 82 children aged 2 to 7 years (mean age 5.15 ± 1y): Group A (49 children) (main group) and Group B (32 children) (placebo). The groups were homogeneous; the children attended the same kindergarten, which suggests a uniform diet, conditions of stay in the preschool institution, and daily routine. All children received a prophylactic dose of vitamin D. Group A received the multi-strain and multi-species immunoprobiotic Bac-Set Cold/Flu for prophylactic purposes, while Group B received a placebo, two 14-day courses with a 2-week break. The effect was assessed 3 months after the end of the immunoprobiotic course. To assess the immune status, blood samples were taken from the children at the first visit, 1.5 months after the end of the probiotic therapy course, and 3 months after the end of the placebo course. Microbiota status was assessed using 16S rRNA gene sequencing of stool samples collected before and immediately after treatment with the immunoprobiotic or placebo.
Results: The annual incidence of acute respiratory infections decreased by 49% in children in Group A and by 28.7% in Group B. The reduction in the incidence of acute respiratory infections in children taking the immunoprobiotic was statistically significant, averaging 1.96 cases per year, compared to 1.15 cases in the placebo group, yielding a difference of 0.81 cases per year per child (p<0.05). This study demonstrated the positive effects of a comprehensive respiratory infection prevention program in preschool-aged children using the multi-strain, multi-species immunoprobiotic Bac-Set Cold/Flu. Immunoglobulin A (IgA) levels increased by 1.5-2 times in more than half of the children in both groups. During the follow-up period, IgA levels in both groups A and B approached normal levels, both in those with initially low and those with initially elevated levels. In group A, while taking probiotic bacteria, IgA levels approached normal values, both in those with initially high and those with initially low levels. In group B, these indicators changed little. In terms of intestinal microbiota, a significant decrease in the content of the genus Eubacterium was noted after the course of therapy in group A, compared with group B. In group A, beta diversity was more pronounced. but already at the second control point, that is, after 1.5 months, which was maintained after 3 months.
Conclusions: This study demonstrated the positive effects of a comprehensive program for the prevention of respiratory infections in preschool-aged children using the multi-strain, multi-species immunoprobiotic Bac-Set Cold/Flu.
For citations: Zakharova I.N., Berezhnaya I.V., Makhaeva A.V., Cherednikova T.A., Koshechkin S.I., Odintsova V.E., Romanov V.A. Current possibilities for the prevention of acute respiratory infections in preschoolers using a multi-strain and multi-species immunoprobiotic. Pharmateca. 2026;33(3):85-93. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.3.85-93
Authors’ contribution: All authors made an equivalent contribution to the preparation of the publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
Keywords
children
acute respiratory infections
intestinal microbiota
multi-strain immunoprobiotics
children’s immune system
About the Authors
Irina N. Zakharova, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; zakharova-rmapo@yandex.ru, ORCID: https://orcid.org/0000-0003-4200-4598Irina V. Berezhnaya, Cand. Sci. (Med.), Associate Professor, Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education; Pediatrician, Gastroenterologist, Z.A. Bashlyaeva Children’s City Clinical Hospital, Moscow, Russia; berezhnaya-irina26@yandex.ru, ORCID: https://orcid.org/0000-0002-2847-6268 (corresponding author)
Anastasia V. Makhaeva, Head of the Pediatric Department, Pediatrician, Children’s City Polyclinic No. 140, Moscow Healthcare Department; Postgraduate Student, Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; AVmakhaeva305@yandex.ru, ORCID: https://orcid.org/0000-0002-0006-5889
Tatyana A. Cherednikova, Pediatrician, Chief Physician, Children’s City Polyclinic No. 140, Moscow Healthcare Department, Russia;
tcherednikova@list.ru
Stanislav I. Koshechkin, Cand. Sci. (Biol.), Director of Science, Nobias Technologies, Moscow, Russia; st.koshechkin@gmail.com, ORCID:
https://orcid.org/0000-0002-7389-0476
Vera E. Odintsova, Chief Bioinformatician, Nobias Technologies, Moscow, Russia; vera.odints@gmail.com, ORCID: https://orcid.org/0000-0003-1897-4033
Vladimir A. Romanov, Clinical Research Manager, Nobias Technologies, Moscow, Russia; romanov@nobiastech.com, ORCID:
https://orcid.org/0000-0002-7540-5884
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