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Probiotics and Cystic Fibrosis

8/13/2019 4:22:07 PM
cystic fibrosisCystic Fibrosis is a progressive genetic disorder that leads to mucus accumulation in the lungs, pancreas, and other organs. Patients with cystic fibrosis are at an increased risk of respiratory infections as well as pancreatic insufficiency and intestinal inflammation. Probiotics might support respiratory and digestive health in patients with cystic fibrosis by exerting immunomodulatory effects or interfering with biofilm formation.

Review examines use of probiotics for cystic fibrosis

A review was published in 2019 in the Journal of Pediatric Gastroenterology and Nutrition to summarize the clinical trials of probiotics in patients with cystic fibrosis. The review included 9 studies and 411 patients (aged 1 to 44). Two primary outcomes were chosen: number or frequency of acute pulmonary exacerbations and effects on intestinal inflammation (measured by fecal calprotectin).

Of 5 studies that reported an outcome of pulmonary exacerbation frequency, 4 reported a positive result (80%). Of 5 studies that reported an outcome of intestinal inflammation, 4 reported a positive result (80%). Results did not differ based on the probiotic type (Lactobacillus reuteri, Lactobacillus rhamnosus GG, or a mix of the strains), dosage (less than or greater than 1 billion CFUs per day), or duration of the intervention (1 month to 1 year).

Results reveal positive outcomes, but more information needed

All of the included studies were considered to have a high risk of bias, so a meta-analysis was not performed. The studies were small and heterogeneous in their interventions and designs. Although most studies reported positive results, the authors acknowledge that the amount of data currently available is not adequate to draw major conclusions.
 
The authors of the review suggest that future clinical trials evaluate LGG in dosages higher than 1 billion CFUs per day to be consistent with the majority of published studies. They recommend study durations of at least 6 months and evaluating exacerbations rates and intestinal inflammation markers as outcomes. Finally, they suggest evaluating participants under the age of 3. The microbiota reaches an adult pattern by the age of 2-3, so infancy might be a critical window of opportunity to influence lifelong health.
 
Reference
Neri LCL, Taminato M, Silva Filho LVRFD. Systematic Review of Probiotics for Cystic Fibrosis Patients: Moving Forward. J Pediatr Gastroenterol Nutr. 2019; 68: 394-399.