Medicina alternativa e integrativa

The Use of Streptococcus salivarius K12 in Attenuating PFAPA Syndrome, a Pilot Study

Abstract

Di Pierro Francesco, Campana Andrea, Panatta Maria Laura, Antenucci Valeria, De Vincentiis Giovanni

PFAPA (Periodic Fever with Aphthous stomatitis, Pharyngitis, and Adenitis) syndrome is a rare, poorly understood, clinical entity characterized by a sudden onset of fever, aphthous stomatitis, pharyngitis, and cervical adenitis. PFAPA affects mainly children and generally resolves before puberty with no subsequent consequences for the patient. Use of acetaminophen (APAP), anti-inflammatory drugs, corticosteroids and tonsillectomy are considered potential treatment options. Streptococcus salivarius K12 is a perfectly tolerated, oral-colonizing probiotic strain that releases two lantibiotics (salivaricins A2 and B) known to antagonize the in vitro and in situ growth of many oral pathogenic streptococci, as well as being endowed with anti-viral and anti-inflammatory capabilities. As demonstrated in our study the 90-day administration of strain K12 appears to have reduced specific signs of PFAPA, leading also to a reduction in drug use. Larger prospective and controlled studies are now indicated to more definitively establish the relevance of our assumption and the importance of these preliminary observations.