Glucan supplementation, allergy symptoms, and quality of life in selfdescribed ragweed allergy ...

12 Pages·2013·1.05 MB·English

ORIGINAL RESEARCH
b
-Glucan supplementation, allergy symptoms, and quality
of life in self-described ragweed allergy sufferers
Shawn M. Talbott, Julie A. Talbott, Tracy L. Talbott & Elaine Dingler
GLHNutrition,LLC,Draper,UT,84020
Keywords Abstract
Allergy,allergysymptom,b-glucan,IgE,
This randomized, placebo-controlled, double-blind study compared the effects
qualityoflife,ragweed,rhinitis
of daily supplementation for 4 week with 250 mg Wellmune WGP® b-1,3/1,6-
Correspondence Glucan (WGP) with placebo 250 mg/day (rice flour) on physical and psycho-
ShawnM.Talbott,GLHNutrition,LLC, logical health attributes of self-described “moderate” ragweed allergy sufferers.
648RockyKnollLane, Study participants (mean age = 36 (cid:1) 9 year; range 18–53 year) were recruited
Draper,UT84020.
before the beginning of ragweed season (September) in Northeastern Ohio.
Tel:[phone];Fax:[phone];
Serum IgE concentration, allergy symptoms [via self-report, Visual Analog Scale
E-mail:[email protected]
(VAS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ)], psycho-
FundingInformation logical well-being [Profile of Mood States (POMS)], and physical function
ThisresearchwasfundedbyBiothera,Inc. (RAND SF-36 Medical Outcomes Study) were measured immediately prior to
Nopublicfundswereusedinthefundingof and after supplementation with WGP (n = 24) or placebo (n = 24) for
thisstudy. 4 weeks. Data were analyzed using repeated measures analyses of variance
(ANOVA). Compared with placebo, WGP reduced total allergy symptoms
Received:20August2012;Revised:31
(28%), symptom severity (52%), and symptom rating on the VAS (37%)
October2012;Accepted:6November2012
(P < 0.05), but had no effect on serum IgE levels. As measured by the POMS,
FoodScience&Nutrition2013;1(1):90–101 WGP increased participants’ rating of vigor (10%), but reduced tension (34%),
depression (45%), anger (41%), fatigue (38%), and confusion (34%)
doi:10.1002/fsn3.11 (P < 0.05). Study participants given WGP reported increased physical health
(11%), energy (19%), and emotional well-being (7%) compared with study par-
ticipants given the placebo (RAND SF-36 Medical Outcomes Study). The WGP
group also reported decreased sleep problems (53%), reduced nasal symptoms
(59%), eye symptoms (57%), non-nasal symptoms (50%), activities (53%),
emotions (57%), and improved quality of life (QOL) (56%), as well as
improved global mood state (13%). Supplementation with WGP for 4 weeks
improved allergy symptoms, overall physical health, and emotional well-being
compared with placebo in self-described “moderate” ragweed allergy sufferers
during ragweed allergy season.
determined by skin test reactivity (Arbes et al. 2005).
Introduction
Approximately 45% of atopic individuals in the U.S. and
An estimated 40–50 million Americans are affected by Canada are allergic to ragweed (Boulet et al. 1997) and
allergic disease (National Institute of Allergy and Infec- the prevalence of allergy to ragweed is increasing in some
tious Diseases 2003). Pollen from plants of the genus areas of Europe (Zanon et al. 2002; Wopfner et al. 2005;
Ambrosia (which includes ragweed) is a primary cause of Oswalt and Marshall 2008).
allergic rhinitis, also known as hay fever, during summer Allergic disease has various manifestations. Seasonal
and fall (Frenz et al. 1995). In the U.S., ragweed season allergic rhinitis is an IgE-mediated inflammatory disease
can extend from August through October (Pongdee of the nasal mucous membranes that often presents with
2011). The U.S. National Health and Nutrition Examina- rhinorrhea, sneezing, nasal congestion, and itching, as
tion Survey III conducted from 1988 through 1994 well as ocular redness, tearing, and itching (Nathan
reported a prevalence of 26.2% for ragweed allergy as 2003). Allergic rhinitis is associated with reduced quality
90 ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc.Thisisanopenaccessarticleunderthetermsof
theCreativeCommonsAttributionLicense,whichpermitsuse,distributionandreproductioninanymedium,
providedtheoriginalworkisproperlycited.
S.M.Talbottetal. b-GlucanSupplementation
of life (QOL) (Leynaert et al. 2000; Meltzer 2001), and degree of branching, structural modification, conforma-
decreased work productivity, accounting for an estimated tion, and solubility (Kim et al. 2011). Because mamma-
3.5 million work days and 2 million school days lost per lian cells do not synthesize b-glucans, they are recognized
year (Nathan 2007). In addition to local inflammation, as pathogen-associated molecular patterns (PAMPs) by
allergic rhinitis can induce systemic inflammation, which germline-encoded pattern recognition receptors (PRRs)
may result in inflammation of the upper and lower air- on cell surfaces (Willment et al. 2005). PRRs that recog-
ways (Pawankar et al. 2011). Comorbid conditions for nize b-glucans include the toll-like receptors (TLR), C-
allergic rhinitis include asthma, rhinosinusitis, nasal type lectin receptors (CLR) such as dectin-1 (Brown and
polyposis, serous otitis media, and sleep disorders (Young Gordon 2001; Brown et al. 2002, 2003; Taylor et al. 2002;
1998; Bousquet et al. 2001; Pawankar et al. 2011). Allergic Tsoni and Brown 2008), complement receptor 3 (CR3)
conjunctivitis affects more than 20% of the U.S. popula- (Ross et al. 1987; Thornton et al. 1996), lactosylceramide
tion (Nathan 2003) and approximately 18% of children, (Zimmerman et al. 1998), and scavenger receptors (Pear-
aged 12–14 in the U.K. (Austin et al. 1999). Inadequate son et al. 1995; Rice et al. 2002). b-Glucan receptors have
control of allergic rhinoconjunctivitis leads to decreased been identified on the surfaces of immune cells, including
QOL, reduced productivity, and potentially, increased vis- neutrophils, eosinophils, natural killer cells, endothelial
its to doctor’s offices. cells, alveolar epithelial cells, fibroblasts, and various types
Approaches to reduce the physical and psychological of macrophages (Brown 2006; Shah et al. 2008), as well
symptoms of allergic disease include allergen avoidance, as nonimmune cells, such as epithelial cells (Ahren et al.
pharmacotherapy, and immunotherapy (Bousquet et al. 2001), vascular endothelial cells (Lowe et al. 2002), and
1994). Standard allergen immunotherapy can prove prob- fibroblasts (Kougias et al. 2001). b-Glucans are powerful
lematic due to inconvenient dosing regimens and the activators of macrophages/monocytes (Adachi et al. 1994;
potential for induction of systemic allergic reactions, such Lebron et al. 2003) and neutrophils (Zhang and Petty
asanaphylaxis,becauseoftherelativelylargedosesofaller- 1994) and are primarily responsible for stimulating the
gen administered (Lockey et al. 1987; Du Buske et al. reticuloendothelial system (Di Carlo and Fiore 1958; Riggi
1992; Bukantz and Lockey 2004). A safe, effective, and and Di Luzio 1961; Wooles and Diluzio 1963).
convenienttherapyforallergicdiseasewouldproviderelief Identification of b-glucans as nonself molecules by
of the physical and psychological effects of allergies and mammalian cells induces innate and adaptive immune
improvetheQOLofallergysufferers(Kimet al.2011). responses (Vetvicka and Yvin 2004; Brown and Gordon
b-Glucans are a diverse class of long-chain glucose 2005). The initial response to b-glucans occurs via the
polymers that have a backbone of b-(1-3)-linked b-D- innate immune system. This response is rapid and non-
glucopyranosyl units with primarily b-(1,4)- or (1,6)- specific, occurs without memory, and primarily involves
linked side chains. These naturally occurring substances phagocytic cells, such as macrophages and neutrophils.
have been shown to provide health benefits including Following ingestion, b-glucans are bound to PRRs on
wound healing (Delatte et al. 2001), decreasing blood macrophages and are internalized. As reviewed by Vol-
lipid concentration (Bell et al. 1999; Nicolosi et al. 1999), man et al. (2008), b-glucans interact with the mucosal
protection against infection (de Felippe 1993; Babineau immune system including the intestinal intraepithelial
et al. 1994a, b; Dellinger et al. 1999), inhibition of tumor lymphocytes and Peyer’s patches, inducing cytokine pro-
development (Cheung et al. 2002; Hong et al. 2004) and duction and increasing resistance to infection (Suzuki
metastasis (Yoon et al. 2008), and promotion of tumor et al. 1990; Tsukada et al. 2003). Whole glucan particle
regression (Driscoll et al. 2009). b-Glucans are known as (WGP), a purified yeast b-glucan sphere derived from
biological response modifiers. Their effects have been standard food-grade Baker’s yeast, Saccharomyces cerevisi-
investigated by administration through diverse routes; ae, enters the gut and is taken up by Microfold (M) cells
importantly, they exhibit biological activity when con- in the Peyer’s patches. Intestinal macrophages transport
sumed orally (Hong et al. 2004; Rice et al. 2005) and b-glucan to the organs of the immune system (e.g., the
may be combined with other immunotherapies to elicit a spleen, lymph nodes, and bone marrow) via the lympha-
more powerful effect (Hong et al. 2004; Chen and Seviour tic system In the bone marrow, larger WGP are degraded
2007). They activate the entire immune system, which into smaller fragments by macrophages (Hong et al.
may be advantageous for their use as therapy for disease. 2004). b-Glucan-induced signaling is not dependent on
b-Glucans are found abundantly in bacterial and fungal internalization of whole b-glucan particles (McCann et al.
cell walls and in plants, such as oat, barley, and seaweed 2005). b-Glucans are believed to induce phagocytosis
(Akramiene et al. 2007). b-Glucans derived from different (Ladanyi et al. 1993; Kurashige et al. 1997; Brown et al.
sources exhibit structural differences and their biological 2002), stimulate microbial killing by mechanisms such as
activities are determined by molecular structure, size, respiratory burst (Tsoni and Brown 2008), and initiate
ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc. 91
b-GlucanSupplementation S.M.Talbottetal.
production of innate immune system components includ-
ing inflammatory mediators such as tumor necrosis factor 62 screened
alpha (TNF-a), interleukin-1 (IL-1) (Li et al. 2006),
macrophage inflammatory protein 2-alpha (MIP-2), eico-
50 enrolled
sanoids, reactive oxidants (Vassallo et al. 1999, 2000;
Hahn et al. 2003), and local immunomodulators. Effects
of b-glucans on nonimmune cells have also been reported
25 randomized to Placebo 25 randomized to WGP
(Hahn et al. 2003; Ramakers et al. 2007). Other cells are
1 withdrawn 1 withdrawn
recruited to the infection site and activate the adaptive
due to failure to due to failure to
immune system. complete all complete all
surveys and surveys and
The response of the adaptive immune system involves
questionnaires questionnaires
production of antibodies against specific substances by B- 24 completed 24 completed
lymphocytes. Assay of IgE can determine whether an indi-
vidual has been sensitized to a substance such as ragweed. Figure1. Flowofstudyparticipants.
The adaptive immune system response also involves anti-
gen presentation by leukocytes to T-lymphocytes. Cyto-
Table1. Subjectcharacteristics(baseline).
toxicandT-helpercellsattackinfectedbodycells(Volman
et al. 2008) and depending on the antigen presented, Treatmentgroup Placebo WGP3-6b-glucan
results in the development of immature cells to type 1 N 24 24
helper T-lymphocytes (Th1) or type II helper T-lympho- Age
cytes (Th2)(Volman et al. 2008).Individuals experiencing Mean(cid:1)SD 39(cid:1)9 36(cid:1)11
an allergic response of asthma are thought to have an Range 18–66years 18–65years
overactive Th2 response. b-1,3-glucan can stimulate mac- Sex
Men 5(20%) 12(50%)
rophages,whichsecreteanti-inflammatorymediators,such
Female 19(80%) 12(50%)
as prostaglandin E2, tumor growth factor, and IL-10, and
mayinhibittheTh2response(Sarinhoet al.2009). N,numberofsubjects;allsubjectswereself-describedmoderaterag-
In this study, we investigated whether supplementation weedallergysufferers.
with WGP would alleviate the physical and psychological
effects of allergies and improve QOL in self-described biotics or other “immune” support products were excluded
“moderate” ragweed allergy sufferers during ragweed from the study. The Institutional Review Board at Aspire
allergy season. IRB, La Mesa, CA, approved the protocol for the study.
All study participants provided written informed consent
prior to the start of the study. The flow of the study par-
Materials and Methods
ticipants is shown in Figure 1 and demographic informa-
tion about the study population is shown in Table 1.
Recruitment of study participants
The conduct of this study adhered to the Helsinki Decla- Wellmune WGP® b-1,3/1,6-glucan
ration, which was revised in 1983, for clinical research
involving humans. To recruit subjects, we posted flyers at The source of Wellmune WGP® b-1,3/1,6-glucan (WGP)
a walk-in medical clinic where we have conducted previ- was a purified proprietary strain of Baker’s yeast (Saccha-
ous studies, asking that “people with ragweed allergies” romyces cerevisiae). WGP was supplied by Biothera, The
contact us. We screened 62 otherwise healthy self- Immune Company (Eagan, MN). Wellmune WGP is gen-
described “moderate” sufferers of ragweed allergy or indi- erally recognized as safe (GRAS) (U.S. Food and Drug
viduals who considered themselves to have “hay fever” Administration 2008).
before peak ragweed allergy season in Northeastern Ohio
in 2010 during September and October. Subjects were
Study design and intervention
given a description of the study protocol. On the first
visit, we conducted a physical examination of subjects. We conducted a randomized, placebo-controlled, double-
Individuals who had current URTI symptoms, were cur- blind study. Study participants were randomly assigned
rently taking allergy or asthma medications, cited an using a random number generator to one of two treat-
inability to understand the study objective, were unable ment groups and were instructed to ingest a capsule con-
to complete all questionnaires and provide blood samples, taining 250 mg WGP (WGP group) or 250 mg of rice
were pregnant or lactating, or were currently using anti- flour (placebo group) once per day, preferably in the
92 ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc.
S.M.Talbottetal. b-GlucanSupplementation
morning for 4 weeks. Fifty of the 62 individuals that we using JMP 8.0 (SAS Institute, Cary, NC) software and sig-
screened met the inclusion criteria for the study, and 25 nificance was set at P < 0.05. The study was set up as a
study participants were assigned to each treatment group. pilot study to determine design criteria for future
Study participants reported to the test site 7 days prior to rhinoconjunctivitis studies; no power calculations were
the start of the study. We supplied study participants with performed.
sufficient WGP and placebo capsules to last for the dura-
tion of the study. One subject from each group did not
Results
complete the study. The final subject population consisted
of 17 men and 31 women (36 (cid:1) 9; range 18–53 years of Fifty subjects were enrolled in the study; 48 individuals
age) (see Table 1). completed the study. Subject attrition, one from each
treatment group, was due to failure to submit all com-
pleted surveys and questionnaires.
Outcome measures
The outcomes of the study were ragweed-specific blood
Physical Symptoms (Allergy Symptoms and
IgE concentrations and physical and psychological health
RQLQ Survey)
attributes of the study participants. Measurements were
made at baseline and after study participants consumed Figure 2 compares the serum IgE concentrations
WGP or placebo for 4 weeks. IgE concentrations were (reported in kU/L), total number of allergy symptoms,
measured using stored serum samples (N = 48). Measure- allergy symptom severity, and allergy symptom scores on
ments were made for three common ragweed allergens the VAS (Hornblow and Kidson 1976; Price et al. 1983;
(Giant, Common, and False). IgE levels were measured Linder 1988; Hallen et al. 2001; Bousquet et al. 2007)
using the IMMULITE 2000 3gAllergy test kit (Siemens before and 4 weeks after treatment with WGP or placebo.
AG, Eschborn, Germany; as described by Biagini et al. There were no differences in ragweed-specific serum IgE
2006). Subjects were asked to complete study surveys that levels. Compared with the placebo post-treatment group,
provided information about their physical symptoms the total number of allergy symptoms (Sx) for the WGP
(allergy symptoms via self-report, the Visual Analog Scale group was reduced 28% (WGP group post-treatment =
[VAS; Hornblow and Kidson 1976; Price et al. 1983; 4.2, placebo group post-treatment = 5.8, P < 0.001), and
Linder 1988; Hallen et al. 2001; Bousquet et al. 2007]; participants’ ratings of symptom severity were reduced
and Rhinoconjunctivitis Quality of Life Questionnaire 52% (WGP group post-treatment = 6.9, placebo group
[RQLQ; Juniper and Guyatt 1991; Juniper et al. 1996]); post-treatment = 14.3, P < 0.001). The rating of symp-
psychological well-being (Profile of Mood States [POMS; toms on the VAS was reduced by 37% after study partici-
McNair et al. 1971, 2003]); global mood state (POMS); pants were treated with WGP compared with after
and physical function (RAND SF-36 Medical Outcomes treatment with placebo for 4 weeks (WGP group post-
Survey [Ware 1992; Hays et al. 1993]). treatment = 15.2 vs. placebo group post-treatment = 24.2,
P = 0.024).
Compliance and adverse events
Compliance with the study protocol was determined by
completion and return of study surveys and verbal com-
pliance to daily supplementation instruction. Pills were
counted when subjects returned their bottles of capsules
at the last visit. Except for two individuals, study partici-
pants were better than 90% compliant with the study
protocol. The two subjects who did not comply with the
study protocol were dropped from the study. Adverse-
event information was collected by verbal disclosure; no
adverse events (other than allergy symptoms, the primary
outcome of the study design) were reported in this study.
Figure2. Allergy Symptoms. When compared with placebo
Statistical analysis treatment with Wellmune WGP® for 4weeks, there was a reduction
observed in total number of allergy symptoms (28%), in symptom
Data were analyzed using repeated measures analyses of severity (52%), and in the rating of symptoms on the VAS
variance (ANOVA). Statistical analysis was conducted (37%).*P<0.05comparedwithplacebo.
ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc. 93
b-GlucanSupplementation S.M.Talbottetal.
Figure4. Global Mood States. The Global Mood State showed a
34% improvement (P<0.05) following 4weeks of treatment with
Figure3. ProfileofMoodStates.POMSfactorsimprovedfromweek Wellmune WGP. The placebo group did not show a significant
0 to week 4 following treatment with Wellmune WGP® including improvementoverthe4-weektreatmentperiod.Alowernumberisa
reduced tension (34%), depression (45%), anger (41%), fatigue “better”globalmoodstate.
(38%), confusion (34%), and increased vigor (10%). *P<0.05.
Treatment with placebo from week 0 to week 4 did not result in
statisticallysignificantimprovementsinthesesixPOMSfactors. RAND SF-36 (Medical Outcomes Study)
Figure 5 compares study participants’ ratings of physical
health, energy, and emotional well-being using the RAND
Profile of mood states SF-36 (Medical Outcomes Study) before and after treat-
ment with WGP or placebo. After 4 weeks of consuming
Figure 3 shows study participants’ reports of level of
WGP, there was an increase in study participants’ ratings
tension, depression, anger, vigor, fatigue, and confusion
of their energy (+19%, at baseline = 56.1, after treatment
as rated using the POMS before and after treatment
= 66.5; P (cid:3) 0.05) and emotional well-being (+7%, at
with WGP and placebo. When compared with mean
baseline = 76.9, after treatment = 82.6; P = 0.034), and
pretreatment values for Wellmune WGP, treatment with
reduced rating of pain ((cid:4)15%, at baseline = 69.1, after
WGP for 4 weeks reduced tension by 34%: 7.3 versus
treatment = 79.2; P < 0.05). There was a nonsignificant
4.8, P < 0.05; depression by 45%: 5.1 versus 2.8,
effect of WGP on social functioning, limitations due to
P < 0.05; anger by 41%: 6.6 versus 3.9, P < 0.05; fatigue
emotional problems, and general health, and a trend
by 38%: 6.8 versus 5.4, P < 0.05; and confusion by 40%:
toward significance on limitations due to physical health
5.3 versus 3.2, P < 0.05. Subjects reported increased
(+11%, WGP at baseline = 81.3, WGP after treatment =
vigor after WGP treatment compared with before treat-
90.6; P = 0.06).
ment (+10%, WGP pretreatment = 18.3 vs. WGP post-
treatment = 20.3). There were no significant differences
between the placebo pre- and post-treatment groups or
between the WGP post-treatment group and placebo
post-treatment in tension, depression, fatigue, confusion,
and vigor.
Global Mood State (cumulative POMS
measurement)
Figure 4 compares study participants’ reporting of Global
Mood State, a cumulative POMS measurement, pre- and
post-4-week treatment with WGP or placebo. Global
Mood State ratings were 110 and 108 pre- and post-treat-
ment with placebo (n.s.), and 115 and 100 pre- and
post-treatment with WGP (13%) for 4 weeks (P < 0.05).
Figure5. RAND SF-36 Medical Outcomes. After 4weeks of
This demonstrates that subjects on Wellmune WGP had treatment with Wellmune WGP®, there was an elevation in physical
an improved Global Mood State over the 4-week period health (11%), energy (19%), and emotional well-being (7%),
compared with WGP pretreatment levels. comparedwithplacebo.*P<0.05comparedwithplacebo.
94 ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc.
S.M.Talbottetal. b-GlucanSupplementation
has been validated for internal consistency, test–retest and
Rhinoconjunctivitis QOL questionnaire
interobserver reliability, discriminative properties, and
Figure 6 compares study participants’ reporting of sleep evaluative properties (McHorney and Ware 1994; Leplege
problems, nasal and eye symptoms, non-nasal symptoms, et al. 1995). In addition, study participants reported a
practical problems, activities, emotions, and QOL (mean decrease in sleep problems, nasal and eye symptoms, and
of all items) in the placebo and WGP groups as reported QOL in the placebo and WGP treatment groups as
on the Rhinoconjunctivitis QOL questionnaire. In the reported using the Rhinoconjunctivitis QOL question-
WGP group, there was a reduction in sleep problems after naire.
treatment compared with the ratings at baseline (53%, 0.8 The potential usefulness of b-glucan as a food additive
vs. 1.7; P < 0.05), nasal symptoms (59%, 0.7 vs. 1.7; is supported by work showing that yeast b-glucan exhibits
P < 0.0001), eye symptoms (57%, 0.6 vs. 1.4; P < 0.001). immune-modulating function (Ikewaki et al. 2007); how-
Study participants also reported improvements in non- ever, our study is one of few that have investigated
nasal symptoms after treatment with WGP compared whether b-glucan can alleviate the symptoms of allergic
with at baseline (50%, 0.8 vs. 1.6; P < 0.01), activities disease. Yamada et al. (2007) demonstrated a beneficial
(53%, 0.7 vs. 1.5; P < 0.05), emotions (57%, 0.4 vs. 1.3; effect of oral consumption of b-1,3-glucan, derived from
P < 0.01). Treatment with placebo also elicited significant shiitake mushroom (Lentinus edoses Berk [Sing]), on
decreases in ratings for non-nasal symptoms compared symptoms of rhinoconjunctivitis and observed that the
with baseline ratings (31%, 1.1 vs. 1.6; P < 0.05) and size of b-glucan particle influences efficacy. Their ran-
emotions (44%, 0.5 vs. 0.9; P < 0.04), but this was not domized, placebo-controlled, double-blind study showed
the case for activities (100%, 0.9 vs. 0.9; n.s.). that oral administration of superfine dispersed b-1,3-glu-
can (SDG) for 8 weeks improved ongoing symptoms of
rhinoconjunctivitis and rhinitis in Japanese individuals
Discussion
with seasonal allergy to cedar pollen and perennial allergy
In this study, we showed that administration of WGP symptoms (P < 0.0002), compared with an identical
during allergy season reduced the total number of allergy amount of nondispersed b-1,3-glucan (NDG) that was
symptoms, rating of symptom severity, and symptom rat- administered during the same period to a different group
ing on the VAS, but had no effect on IgE concentration of study participants (Yamada et al. 2007). SDG, with a
compared with placebo treatment in self-described rag- particle size of 0.08 lm, is thought to be absorbed easily
weed allergy sufferers. Compared with pretreatment, by the intestinal mucosa, in contrast to NDG, which has
WGP decreased study participants’ ratings of tension, a particle size of 288 lm. SDG reduced symptoms during
depression, anger, fatigue, and confusion and increased the 8-week follow-up period that occurred immediately
vigor as measured by the POMS (P < 0.05 for all). WGP after the intervention (P < 0.0001) and prevented symp-
improved global mood states (POMS) and had an tom development when taken prior to symptom onset
improved effect on physical health, energy, and emotional (P < 0.05). The study also showed that consumption of
well-being according to the SF-36 questionnaire, which SDG decreased allergen-specific and total IgE titers (initial
Figure6. RhinoconjunctivitisQualityofLife.After4weeksoftreatmentwithWellmuneWGP®,therewasareductioninsleepproblems(53%),
nasalsymptoms(59%),andeyesymptoms(57%)andanelevationinQOL(56%);*P<0.05comparedwithplacebo.
ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc. 95
b-GlucanSupplementation S.M.Talbottetal.
high-IgE group, P < 0.043; initial low-IgE group, (P = 0.01). In contrast, IL-12 levels increased after b-glu-
P < 0.03) and exhibited a good correlation with allergen- can treatment compared with pretreatment values (mean
specific and total IgE titers (Yamada et al. 2007). Caveats (cid:1) SEM = 11.08 (cid:1) 2.43 vs. 17.31 (cid:1) 2.75 pg/mL, P = 0.008).
of this study include a short observation period and a There was no change in IFN-c (mean (cid:1) SEM =
small study population. 6.19 (cid:1) 1.18 vs. 7.83 (cid:1) 1.22 pg/mL, P = 0.1) in the b-
Similarly, Szabo et al. (2000) showed that b-glucan glucan group, and no changes in any cytokines for the
alleviated some symptoms of allergic conjunctivitis, Sarin- placebo group. Furthermore, the percentage of eosinoph-
ho et al. (2009) showed the effect of b-glucan on elevat- ils was unchanged for both treatment groups. The authors
ing IL-10 production and relieving asthma symptoms, proposed that b-glucan is potentially an adjunct to stan-
and Damiani et al. (2011) showed the combination of dard therapy in individuals with allergic rhinitis.
colloidal silver and b-glucan on viral rhinitis and upper Human studies have reported that b-glucan can
respiratory symptoms in children. improve QOL for individuals with cancer or upper respi-
Other studies have also reported no increase or a small ratory influenza infections. In a randomized, placebo-
increase in Ig concentrations after b-glucan consumption. controlled, double-blind, parallel group intervention study,
Lehne et al. (2005) reported no increase in IgA or IgG in Feldman et al. (2009) reported an improvement from
serum or saliva after healthy subjects, age 20–30 years, baseline indicated by scores on two QOL measures of the
orally consumed 100 mg/day yeast b-glucan for four con- SF36v-2 questionnaire after study participants, aged 18–
secutive days compared to concentrations at baseline. 65 years, consumed 500 mg/day WGP for 90 days as
Consumption of 400 mg/day b-glucan for the same compared with consuming a rice flour placebo for the
amount of time elicited an increase only in salivary IgA same amount of time. Study participants who consumed
(mean (cid:1) SD = day 1: 39.6 (cid:1) 21.1 vs. 105.4 (cid:1) 73.9, WGP reported an improved Physical Component Sum-
P < 0.05). Browder et al. (1990) observed an increase in mary score (57.5 (cid:1) 4.5 vs. 55.5 (cid:1) 3.5; P = 0.029) and a
serum IL-1 in trauma patients, ages 18–65, 3 days after greater General Health summary score (58.7 (cid:1) 7.0 vs.
they had been treated with b-glucan (143.4 (cid:1) 193% vs. 52.0 (cid:1) 14.6; P < 0.038) compared with study participants
78.6 (cid:1) 11.7%; P < 0.05), but there was no difference who consumed the placebo. The b-glucan, lentinan,
after that time point. b-Glucan had no effect on TNFa improved QOL in individuals with advanced cancer when
concentrations. administered intravenously (Yoshino et al. 2010) or orally
Allergic rhinitis is an IgE-mediated disease that presents for gastric cancer (Nakano et al. 1999; Kataoka et al.
with elevated allergen-specific IgE titers, IgE-dependent 2009), and orally for pancreatic (Shimizu et al. 2009) and
activations of mast cells, recruitment of activated eosin- colorectal cancer (Hazama et al. 2009). Nakano et al.
ophils and T cells to mucosal surfaces, inflammation, and (1999) reported that the total QOL score for gastric can-
disease (Holgate 1999; Kay 2001a, b) T helper (Th) 2 cells cer subjects, in particular appetite and sleep quality,
contribute to the induction of IgE-mediated disease by improved with lentinan consumption. In another study of
overproducing Th2 cytokines (IL-4, IL-5, and IL-13) at 20 individuals between the ages of 38 and 84 years with
the inflammation site (Romagnani et al. 1991; Huang advanced malignancies who were undergoing chemother-
et al. 1995). However, Th-1 cytokines (IL-12 and IFN-c) apy, b-1,3-glucan consumption resulted in a sense of
inhibit the Th2 immune response. In a randomized, pla- well-being for 60% of study participants, and less fatigue
cebo-controlled, double-blind study of 24 subjects with during chemotherapy was reported by 40% of subjects
seasonal allergic rhinitis, Kirmaz et al. (2005) investigated who reported being fatigued (Weitberg 2008).
whether b-glucan from S. cerevisiae reversed the Th2- Immunotherapy has also been used to decrease the
mediated immune response in individuals who were sen- effects of ragweed allergy. A randomized, double-blind,
sitized to Olea europea. Compared with pretreatment val- placebo-controlled study, investigated the effectiveness of
ues, 20 mg b-glucan administered for 12 weeks reduced immunotherapy with a Ragweed-Toll-like receptor 9 ago-
IL-4 (mean (cid:1) SEM = 5.48 (cid:1) 0.92 vs. 3.66 (cid:1) 0.64 pg/mL, nist vaccine for allergic rhinitis (Creticos et al. 2006).
P = 0.027) and IL-5 concentrations (mean (cid:1) SEM = Vaccination with the Ragweed-Toll-like receptor 9 agonist
8.58 (cid:1) 1.58 vs. 5.81 (cid:1) 0.83 pg/mL, P = 0.04). Although did not change the vascular permeability response to
there was no difference between the placebo group nasal provocation in the first season, as reflected in the
(n = 12) and the b-glucan group (n = 12) in the percent- albumin level in nasal lavage fluid, but improved peak-
age of eosinophils in nasal lavage fluid after nasal provo- season rhinitis scores (P = 0.006) on the visual analog
cation with Olea europea, the percentage of eosinophils in score, peak-season daily nasal symptom diary scores
nasal lavage fluid was significantly reduced after a nasal (P = 0.02), and mid-season overall quality-of-life scores
provocation test with Olea europea compared with con- (P = 0.05). The vaccine also inhibited the seasonal eleva-
centrations measured before the nasal provocation test tion of Amb a 1-specific IgE antibody. In a later ragweed
96 ª2012TheAuthors.FoodScience&NutritionpublishedbyWileyPeriodicals,Inc.
S.M.Talbottetal. b-GlucanSupplementation
season, compared with placebo, there were improvements financial conflict with the subject matter or materials dis-
in the peak-season rhinitis visual analog score (P = 0.02) cussed in the manuscript apart from those disclosed. This
and the peak-season daily nasal symptom diary score manuscript has not been or is currently not under consid-
(P = 0.02). As with our study, the authors noted no eration for publication elsewhere, and no portion of the
change in IgE antibody titer during ragweed season manuscript has been previously published or posted on
(P = 0.19). the Internet. This research was funded by Biothera, Inc.
Some studies have reported that airway exposure to b- Nopublicfundswereusedinthefundingofthisstudy.
(1,3)-D-glucan, found in house dust, indoor molds, and
some bacteria, can increase the airway allergic response as
Conflict of Interest
well as induce other health effects (Rylander et al. 1998).
As summarized in Douwes (Douwes 2005), these data are None declared.
inconsistent and further investigation is necessary to
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