Choice of bacterial lysate in the treatment and prevention of respiratory tract infections: A review

Cover Page

Cite item

Full Text

Abstract

Respiratory tract (RT) infections are among the most common infections in both children and adults, and they can lead to complications involving the ears, nose, throat, and lower respiratory tract. Doctors, patients, and their legal representatives prioritize the treatment and prevention of respiratory tract infections. A broad range of therapeutic and preventative drugs is available, and many current clinical guidelines recommend the use of systemic bacterial lysates for patients with recurrent ENT infections and respiratory diseases, as well as for at-risk groups. The article addresses the types and mechanisms of action of the bacterial lysate produced using the mechanical lysis method, with an emphasis on its immunological and clinical benefits (Ismigen). Sublingual administration of this drug prevents its antigenicity decrease by gastric juice, provides the rapid onset of action and longer contact with the oral and oropharyngeal mucosal membranes. Studies have shown that the use of Ismigen leads to an increase in the concentration of specific antibodies targeting the pathogens it contains. Also, it significantly reduces both the frequency and duration of respiratory infections (RI) in both children and adults. The use of Ismigen to reduce the incidence of RI in children with recurrent RI, as well as in patients with adenoiditis, has been justified. Comparison of the composition of the microbiome of healthy children and children with acute tonsillopharyngitis supports using Ismigen for prophylaxis and as part of complex therapy (to normalize the oropharyngeal microflora), especially in patients with recurrent tonsillopharyngitis.

Full Text

Restricted Access

About the authors

Elena Yu. Radtsig

Pirogov Russian National Research Medical University

Author for correspondence.
Email: radsig_e@rsmu.ru
ORCID iD: 0000-0003-4613-922X

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Maria A. Kulmakova

Pirogov Russian National Research Medical University

Email: radsig_e@rsmu.ru
ORCID iD: 0000-0002-5090-9269

Graduate Student

Russian Federation, Moscow

References

  1. Рязанцев С.В., Коноплев О.И., Сапова К.И. Бактериальные лизаты в лечении заболеваний дыхательных путей и ЛОР-органов. РМЖ. 2015;23(23):1387-90 [Riazantsev SV, Konoplev OI, Sapova KI. Bakterial'nye lizaty v lechenii zabolevanii dykhatel'nykh putei i LOR-organov. RMZh. 2015;23(23):1387-90 (in Russian)].
  2. Маркова Т.П., Ярилина Л.Г., Чувиров Д.Г., и др. Бактериальные лизаты в педиатрии. Педиатрия. Журнал им. Г.Н. Сперанского. 2016;95(5):91-8 [Markova TP, Yarilina LG, Chuvirov DG, et al. Bacterial lysates in pediatrics. Pediatria. 2016; 95(5):91-8 (in Russian)].
  3. Заплатников А.Л., Гирина А.А., Глухарева Н.С., и др. Поливалентный механический бактериальный лизат у детей с рекуррентными инфекциями органов дыхания: опыт применения, эффективность и безопасность. Педиатрия. Журнал им. Г.Н. Сперанского. 2016;95(6):96-101 [Zaplatnikov AL, Girina AA, Gluhareva NS, et al. Polyvalent mechanical bacterial lysate in children with recurrent infections of the respiratory system: using experience, efficacy and safety. Pediatria. 2016;95(6):96-101 (in Russia)].
  4. Заплатников А.Л., Гирина А.А., Глухарева Н.С., и др. Клинико-профилактическая эффективность иммуномодуляторов бактериального происхождения у детей с рекуррентными респираторными инфекциями. Астма и аллергия. 2016;2:21-30 [Zaplatnikov AL, Girina AA, Glukhareva NS, et al. Kliniko-profilakticheskaia effektivnost' immunomoduliatorov bakterial'nogo proiskhozhdeniia u detei s rekurrentnymi respiratornymi infektsiiami. Astma i allergiia. 2016;2:21-30 (in Russian)].
  5. Kaczynska A, Klosinska M, Janeczek K, et al. Promising Immunomodulatory Effects of Bacterial Lysates in Allergic Diseases. Front Immunol. 2022;13:907149. doi: 10.3389/fimmu.2022.907149
  6. Huang X, Zhang X, Zhang Z, et al. Bacterial lysates in allergic rhinitis and chronic rhinosinusitis: Mechanisms and clinical evidence. Sci Prog. 2025;108(2):368504251355373. doi: 10.1177/00368504251355373
  7. Janeczek K, Kaczyńska A, Emeryk A, Cingi C. Perspectives for the Use of Bacterial Lysates for the Treatment of Allergic Rhinitis: A Systematic Review. J Asthma Allergy. 2022;15:839-50. doi: 10.2147/JAA.S360828
  8. Mellioli J. Deciders in pulmonology. Giorn It Mal. 2002;4(56):245-268.
  9. Bouvet JP, Decroix N, Pamonsinlapatham P. Stimulation of local antibody production: parenteral or mucosal vaccination? Trends Immunol. 2002;23(4):209-13. doi: 10.1016/s1471-4906(02)02186-5
  10. Cazzola M. A new bacterial lysate protects by reducing infections exacerbations in moderate to very severe COPD: A double-blind, randomized, placebo-controlled trial. Trends Med. 2006;6(3):191-9.
  11. Kaczynska A, Klosinska M, Chmiel P, et al. The Crosstalk between the Gut Microbiota Composition and the Clinical Course of Allergic Rhinitis: The Use of Probiotics, Prebiotics and Bacterial Lysates in the Treatment of Allergic Rhinitis. Nutrients. 2022;14(20):4328. doi: 10.3390/nu14204328
  12. Lanzilli G, Falchetti R, Tricarico M, et al. In vitro effects of an immunostimulating bacterial lysate on human lymphocyte function. Int J Immunopathol Pharmacol. 2005;18(2):245-54. doi: 10.1177/039463200501800207
  13. Lanzilli G, Traggiai E, Braido F, et al. Administration of a polyvalent mechanical bacterial lysate to elderly patients with COPD: Effects on circulating T, B and NK cells. Immunol Lett. 2013;149(1-2):62-7. doi: 10.1016/j.imlet.2012.11.009
  14. Rosaschino F, Cattaneo L. Strategies for optimizing compliance of paediatric patients for seasonal antibacterial vaccination with sublingually administered Polyvalent Mechanical Bacterial Lysates (PMBL). Acta Biomed. 2004;75(3):171-8.
  15. La Mantia I, Nicolosi F, Maiolino L, Serra A. Immunoprophylaxis of recurring bacterial infections of respiratory tracts in pediatric age: clinical experience through a new immune stimulating vaccine. GIMMOC. 2007;9:1-8.
  16. Aksic О, Cattaneo L, Rosaschino F. Evaluation of the clinical efficacy of a new polyvalent mechanical bacterial lysate in a population 180 school-age children with recurrent respiratory infections. GEA. 2005; 2:1-4.
  17. Арутюнов А.Г., Драгунов Д.О., Соколова А.В. Место бактериальных лизатов в терапии рецидивирующих бактериальных инфекций. РМЖ. 2014;22(31):2176-80 [Arutiunov AG, Dragunov DO, Sokolova A. Mesto bakterial'nykh lizatov v terapii retsidiviruiushchikh bakterial'nykh infektsii. RMZh. 2014;22(31):2176-80 (in Russian)].
  18. Cesta MF. Normal structure, function, and histology of mucosa-associated lymphoid tissue. Toxicol Pathol. 2006;34(5):599-608. doi: 10.1080/01926230600865531
  19. Lanzilli G, Falchetti R, Cottarelli A, et al. In vivo effect of an immunostimulating bacterial lysate on human B lymphocytes. Int J Immunopathol Pharmacol. 2006;19(3):551-9. doi: 10.1177/039463200601900311
  20. Braido F, Schenone G, Pallestrini E, et al. The relationship between mucosal immunoresponse and clinical outcome in patients with recurrent upper respiratory tract infections treated with a mechanical bacterial lysate. J Biol Regul Homeost Agents. 2011;25(3):477-85.
  21. Гизингер О., Коркмазов М., Щетинин С. Иммуностимулирующая терапия при хроническом аденоидите у детей. Врач. 2015;9:25-9 [Gizinger O, Korkmazov M, Shchetinin S. Immunostimuliruiushchaia terapiia pri khronicheskom adenoidite u detei. Vrach. 2015;9:25-9 (in Russian)].
  22. Злобина Н.В. Аденоидит у детей. Автореф. дис. … канд. мед. наук. М. 2019 [Zlobina NV. Adenoidit u detei. Avtoref. dis. … kand. med. nauk. Moscow. 2019 (in Russian)].
  23. Евсикова М.М., Радциг Е.Ю., Гуров А.В. К вопросу об этиологии острой воспалительной патологии глотки у детей. Вестник оториноларингологии. 2024;89(5):10-5 [Evsikova MM, Radtsig EYu, Gurov AV. On the issue of the etiology of acute inflammatory pathology of the pharynx in children. Russian Bulletin of Otorhinolaryngology. 2024;89(5):10-5 (in Russian)]. doi: 10.17116/otorino20248905110

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Efficacy of multivalent bacterial lysate Ismigen in children with recurrent RI (results of 12-month monitoring). Column 1 – before treatment; Column 2 – after treatment; *p < 0.05 (cited from [3]).

Download (75KB)
Indexing metadata
3. Fig. 2. Bacterial pathogens of adenoiditis (cited from: [22]), %.

Download (176KB)
Indexing metadata
4. Fig. 3. Change of symptoms assessed during observation (cited from: [21]), %: a – nasal breathing difficulty; b – morning cough; c – snoring.

Download (155KB)
Indexing metadata
5. Fig.4. Change of pharyngeal tonsil hypertrophy degree in patients of observation groups (cited from: [21]), %: a – before treatment; b – after 3 months; c – after 6 months.

Download (126KB)
Indexing metadata

Copyright (c) 2025 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.