Results of a study of the effectiveness of the use of a drug containing β-glucan in children with recurrent respiratory infections
DOI:
https://doi.org/10.15574/SP.2025.4(148).718Keywords:
children, recurrent respiratory infections, transcription factors, interleukins, β-glucans, vitamin C, vitamin B, zincAbstract
Recurrent respiratory infections (RRI) in children are the most common cause of visits to paediatricians.
Aim - to evaluate the clinical and immunological efficacy of a 12-week course of a drug containing β-glucan, vitamins and zinc in preschool children with RRI.
Materials and methods. The study involved 120 children aged 5 to 7 years who attended preschool and/or primary school and had a history of at least 4 recorded cases of acute respiratory infections (ARI) in the last 6 months. The main group consisted of children with ARI (n=60) who received a drug containing β-glucan, vitamins and zinc (commercial name: Bewell) for 12 weeks of observation, and the control group consisted of 60 people with ARI who received basic preventive therapy. To determine the effectiveness of the drug containing β-glucan, vitamins and zinc, the level of mRNA expression of transcription factors (TBET, RORyt, FOXP3) of T-cells and NF-kB1, interleukins (IL-1β, IL-17A, IL-10) and cytokine TGF-β1 was determined by reverse transcription polymerase chain reaction.
Results. The use of a complex drug containing β-glucan, vitamins and zinc in children with ARI helps to reduce the risk of recurrent ARI, reduces the duration of subsequent ARI, and prevents the use of antibiotics and antipyretic agents. RRI are characterised by increased expression of the genes of the transcription factor TBET, NF-kB1, and interleukins IL-1β, IL-17A in the buccal mucosa. In children, after treatment with a preparation containing β-glucan, vitamins and zinc, there was a decrease in the expression of the transcription factor NF-kB1, transcription factors of proinflammatory immune cells, in particular Th1- and Th17-cells, proinflammatory interleukins; and an increase in the activity of both the transcription factor Treg-cells and anti-inflammatory IL-10, TGF-β1.
Conclusions. The prevention course with a preparation containing β-glucan, vitamins and zinc inhibits the pro-inflammatory activity of the immune system and promotes the expression of the transcription factor FOXP3 and anti-inflammatory cytokines IL-10, TGF-β1.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Abdelkader A, Wahba AA, El-Tonsy M, Zewail AA, Shams Eldin M. (2022, Aug 19). Recurrent respiratory infections and vitamin A levels: a link? It is cross-sectional. Medicine (Baltimore). 101(33): e30108. https://doi.org/10.1097/MD.0000000000030108; PMid:35984160 PMCid:PMC9388016
Buendía JA, Guerrero Patiño D, Lindarte EF. (2022, Jun 23). Podotimod in pediatric recurrent respiratory tract infections: a cost-utility analysis. BMC Pulm Med. 22(1): 244. https://doi.org/10.1186/s12890-022-02029-4; PMid:35739542 PMCid:PMC9219210
Buendía JA, Patiño DG, Lindarte EF. (2022, Dec 6). OM-85 BV in pediatric recurrent respiratory tract infections: a cost-utility analysis. BMC Pulm Med. 22(1): 465. https://doi.org/10.1186/s12890-022-02264-9; PMid:36474205 PMCid:PMC9724379
Chernyshova LI. (2018). Recurrent respiratory diseases in children: the doctors algorithm of actions (lecture). Sovremenaya pediatriya. 3(91): 92-97. https://doi.org/10.15574/SP.2018.91.92
Chiappini E, Santamaria F, Marseglia GL, Marchisio P, Galli L, Cutrera R et al. (2021, Oct 25). Prevention of recurrent respiratory infections : Inter-society Consensus. Ital J Pediatr. 47(1): 211. https://doi.org/10.1186/s13052-021-01150-0; PMid:34696778 PMCid:PMC8543868
Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. (2023, Apr). Vitamin D and COVID-19: where are we now? Postgrad Med. 135(3): 195-207. Epub 2021 Dec 27. https://doi.org/10.1080/00325481.2021.2017647; PMid:34886758 PMCid:PMC8787834
De Marco Castro E, Calder PC, Roche HM. (2021, Jan). β-1,3/1,6-Glucans and Immunity: State of the Art and Future Directions. Mol Nutr Food Res. 65(1): e1901071. Epub 2020 Apr 27. https://doi.org/10.1002/mnfr.201901071; PMid:32223047 PMCid:PMC7816268
Ding YJ, Li XN, Xiao Z, Li CY, Jia LH. (2024, Feb). Low vitamin D during pregnancy is associated with infantile eczema by up-regulation of PI3K/AKT/mTOR signaling pathway and affecting FOXP3 expression: A bidirectional cohort study. J Nutr Biochem. 124: 109516. Epub 2023 Nov 2. https://doi.org/10.1016/j.jnutbio.2023.109516; PMid:37925089
El-Azami-El-Idrissi M, Lakhdar-Idrissi M, Chaouki S, Atmani S, Bouharrou A, Hida M. (2016, May 12). Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases). Pan Afr Med J. 24: 53. https://doi.org/10.11604/pamj.2016.24.53.3481; PMid:27642394 PMCid:PMC5012823
Esposito S, Cassano M, Cutrera R, Menzella F, Varricchio A, Uberti M. (2022, Nov 30). Expert consensus on the role of OM-85 in the management of recurrent respiratory infections: A Delphi study. Hum Vaccin Immunother. 18(6): 2106720. Epub 2022 Aug 19. https://doi.org/10.1080/21645515.2022.2106720; PMid:35985019 PMCid:PMC9746428
Esposito S, Jones MH, Feleszko W, Martell JAO, Falup-Pecurariu O, Geppe N et al. (2020, Nov 17). Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus Statement. Microorganisms. 8(11): 1810. https://doi.org/10.3390/microorganisms8111810; PMid:33213053 PMCid:PMC7698530
Giannattasio A, Poggi E, Trapani G, Muia C, Zanino L et al. (2022, May 1). Primary care experience on Stimunex® gocce in children with recurrent respiratory infections: a real-world study during the COVID-19 pandemic era. Allergol Immunopathol (Madr). 50(3): 8-14. https://doi.org/10.15586/aei.v50i3.562; PMid:35527651
Huff MO, Klinge CM. (2017). Regulation of Gene Expression by β-Glucans. Am J Immunol. 13(1): 1-10. https://doi.org/10.3844/ajisp.2017.1.10
Ismailova A, White JH. (2022, Apr). Vitamin D, infections and immunity. Rev Endocr Metab Disord. 23(2): 265-277. Epub 2021 Jul 29. https://doi.org/10.1007/s11154-021-09679-5; PMid:34322844 PMCid:PMC8318777
Jaybhaye AP, Sangle AL, Ugra D, Chittal RY. (2022, Aug 10). A Hospital-Based Study of Vitamin D Levels in Children With Recurrent Respiratory Infections. Cureus. 14(8): e27864. https://doi.org/10.7759/cureus.27864; PMid:36110478 PMCid:PMC9462840
Jiang X, Sun L, Wang B, Yang X, Shang L, Zhang Y. (2013). Health-related quality of life among children with recurrent respiratory tract infections in Xi'an, China. PLoS One. 8(2): e56945. Epub 2013 Feb 25. https://doi.org/10.1371/journal.pone.0056945; PMid:23451114 PMCid:PMC3581567
Jin X, Zhang M, Yang YF. (2019, May). Saccharomyces cerevisiae β-glucan-induced SBD-1 expression in ovine ruminal epithelial cells is mediated through the TLR-2-MyD88-NF-κB/MAPK pathway. Vet Res Commun. 43(2): 77-89. Epub 2019 Mar 12. https://doi.org/10.1007/s11259-019-09747-x; PMid:30863917
Kansen HM, Lebbink MA, Mul J, van Erp FC, van Engelen M, de Vries E et al. (2020, Nov). Risk factors for atopic diseases and recurrent respiratory tract infections in children. Pediatr Pulmonol. 55(11): 3168-3179. Epub 2020 Sep 15. https://doi.org/10.1002/ppul.25042; PMid:32841506 PMCid:PMC7589449
Khan Laghari I, Nawaz T, Mustafa S, Jamali AA, Fatima S. (2023, Oct 11). Role of multi-strain probiotics in preventing severity and frequency of recurrent respiratory tract infections in children. BMC Pediatr. 23(1): 505. https://doi.org/10.1186/s12887-023-04338-x; PMid:37817096 PMCid:PMC10566059
Kumar R, Theiss AL, Venuprasad K. (2021, Nov). RORγt protein modifications and IL-17-mediated inflammation. Trends Immunol. 42(11): 1037-1050. Epub 2021 Oct 9. https://doi.org/10.1016/j.it.2021.09.005; PMid:34635393 PMCid:PMC8556362
Ma JG, Wu GJ, Xiao HL, Xiao YM, Zha L. (2021, Dec). Vitamin D has an effect on airway inflammation and Th17/Treg balance in asthmatic mice. Kaohsiung J Med Sci. 37(12): 1113-1121. Epub 2021 Aug 30. https://doi.org/10.1002/kjm2.12441; PMid:34460994 PMCid:PMC11896363
Malagón-Rojas JN, Mantziari A, Salminen S, Szajewska H. (2020, Jan 31). Postbiotics for Preventing and Treating Common Infectious Diseases in Children: A Systematic Review. Nutrients. 12(2): 389. https://doi.org/10.3390/nu12020389; PMid:32024037 PMCid:PMC7071176
Marengo R, Ortega Martell JA, Esposito S. (2020, Jun). Paediatric Recurrent Ear, Nose and Throat Infections and Complications: Can We Do More? Infect Dis Ther. 9(2): 275-290. Epub 2020 Apr 24. Erratum in: Infect Dis Ther. 2020 Sep; 9(3): 697-700. https://doi.org/10.1007/s40121-020-00289-3; PMid:32333286 PMCid:PMC7237599
Moorlag SJCFM, Khan N, Novakovic B, Kaufmann E, Jansen T et al. (2020, May 19). β-Glucan Induces Protective Trained Immunity against Mycobacterium tuberculosis Infection: A Key Role for IL-1. Cell Rep. 31(7): 107634. https://doi.org/10.1016/j.celrep.2020.107634; PMid:32433977 PMCid:PMC7242907
Rebolledo L, Rodríguez-Vigil C, Carmen L, Llorente E, Guallar M et al. (2023, Oct). Bacterial immunotherapy is highly effective in reducing recurrent upper respiratory tract infections in children: a prospective observational study. Eur Arch Otorhinolaryngol. 280(10): 4519-4530. Epub 2023 May 30. https://doi.org/10.1007/s00405-023-08035-4; PMid:37254001 PMCid:PMC10477114
Rennerova Z, Picó Sirvent L, Carvajal Roca E, Paśnik J, Logar M, Milošević K et al. (2022, Oct 14). Beta-(1,3/1,6)-D-glucan from Pleurotus ostreatus in the prevention of recurrent respiratory tract infections: An international, multicentre, open-label, prospective study. Front Pediatr. 10: 999701. https://doi.org/10.3389/fped.2022.999701; PMid:36324817 PMCid:PMC9619242
Rerksuppaphol S, Rerksuppaphol L. (2019). A randomized controlled trial of zinc supplementation in the treatment of acute respiratory tract infection in Thai children. Pediatr Rep. 11(2): 7954. Published 2019 May 23. https://doi.org/10.4081/pr.2019.7954; PMid:31214301 PMCid:PMC6548996
Richter J, Svozil V, Král V, Rajnohová Dobiášová L, Stiborová I, Vetvicka V. (2014, Feb). Clinical trials of yeast-derived β-(1,3) glucan in children: effects on innate immunity. Ann Transl Med. 2(2): 15. doi: 10.3978/j.issn.2305-5839.2014.02.01. PMID: 25332991; PMCID: PMC4202474.
Richter J, Svozil V, Král V, Rajnohová Dobiášová L, Vetvicka V. (2015, Mar). β-glucan affects mucosal immunity in children with chronic respiratory problems under physical stress: clinical trials. Ann Transl Med. 3(4): 52. doi: 10.3978/j.issn.2305-5839.2015.03.20. PMID: 25861607; PMCID: PMC4381477.
Ruiz-Tagle C, Romero F, Naves R, Balcells ME. (2023, Oct). Vitamin D and cathelicidin levels and susceptibility to Mycobacterium tuberculosis infection acquisition in household contacts. Enferm Infecc Microbiol Clin (Engl Ed). 41(8): 489-493. Epub 2023 Jan 25. https://doi.org/10.1016/j.eimce.2022.04.013; PMid:36707289
Saeed H, Abdelrahim MEA. (2023). A Meta-Analysis of the Effectiveness of Vitamin C in the Prevention and Treatment of Childhood Upper Respiratory Tract Infections. Journal of Clinical and Nursing Research. 7: 30-37. https://doi.org/10.26689/jcnr.v7i1.4403
Saheb Sharif-Askari F, Saheb Sharif-Askari N, Hafezi S, Alsayed HAH, Selvakumar B, Eladham MWA et al. (2023, Oct 13). Increased blood immune regulatory cells in severe COVID-19 with autoantibodies to type I interferons. Sci Rep. 13(1): 17344. https://doi.org/10.1038/s41598-023-43675-w; PMid:37833265 PMCid:PMC10575900
Schaad UB, Esposito S, Razi CH. (2015). Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide. Arch. Pediatr. Infect. Dis. 4: e31039. https://doi.org/10.5812/pedinfect.31039
Stokes JR, Bacharier LB. (2020, Aug). Prevention and treatment of recurrent viral-induced wheezing in the preschool child. Ann Allergy Asthma Immunol. 125(2): 156-162. Epub 2020 May 23. https://doi.org/10.1016/j.anai.2020.05.018; PMid:32454096
Wessels I, Fischer HJ, Rink L. (2021, Oct 11). Dietary and Physiological Effects of Zinc on the Immune System. Annu Rev Nutr. 41: 133-175. Epub 2021 Jul 13. https://doi.org/10.1146/annurev-nutr-122019-120635; PMid:34255547
Williams LM, Stoodley IL, Berthon BS, Wood LG. (2022, Feb 1). The Effects of Prebiotics, Synbiotics, and Short-Chain Fatty Acids on Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis. Adv Nutr. 13(1): 167-192. https://doi.org/10.1093/advances/nmab114; PMid:34543378 PMCid:PMC8803493
Xiao J, He W. (2021, Mar 15). The immunomodulatory effects of vitamin D drops in children with recurrent respiratory tract infections. Am J Transl Res. 13(3): 1750-1756. PMID: 33841698; PMCID: PMC8014391.
Zhao Y, Dong BR, Hao Q. (2022, Aug 24). Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 8(8): CD006895. https://doi.org/10.1002/14651858.CD006895.pub4; PMid:36001877 PMCid:PMC9400717
Zhang M, Jin X, Yang YF, Cao GF. (2020, Oct). β-glucan from Saccharomyces cerevisiae is involved in immunostimulation of ovine ruminal explants. Can J Vet Res. 84(4): 283-293. PMID: 33012977; PMCID: PMC7491007.
Zhou B, Niu W, Liu F, Yuan Y, Wang K, Zhang J et al. (2021, Jul). Risk factors for recurrent respiratory tract infection in preschool-aged children. Pediatr Res. 90(1): 223-231. Epub 2020 Nov 10. https://doi.org/10.1038/s41390-020-01233-4; PMid:33173178
Yurakova TR, Gubernatorova EO, Gorshkova EA, Nosenko MA, Nedospasov SA, Drutskaya MS. (2022, Dec 1). HDM induces distinct immunometabolic phenotype in macrophages in TLR4-dependent manner. Biochim Biophys Acta Mol Basis Dis. 1868(12): 166531. Epub 2022 Aug 28. https://doi.org/10.1016/j.bbadis.2022.166531; PMid:36038040
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Modern pediatrics. Ukraine

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.