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Title
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Probiotics in cystic fibrosis patients : a double blind crossover placebo controlled study Pilot study from the ESPGHAN Working Group on Pancreas/CF
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Author
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Abstract
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| Background: A potential positive effect of probiotics in cystic fibrosis (CF) on fecal calprotectin (FCP), pulmonary exacerbations and weight has been described in small controlled trials. Methods: A double-blind multicenter cross-over study (2 x 4 m) was performed looking at abdominal pain, nutritional status, pulmonary function, pulmonary exacerbation, FCP and lactulose/mannitol gut permeability test. Patients kept a diary with daily scoring of abdominal pain, stool frequency and consistency as well as treatment changes. Results: 31 CF patients entered the study of which 25 finished it. At start patients aged 9.3yrs (6.9-12.2), had a median BMI z-score of - 0.5 (- 1.5-0.08), height z-score of - 0.4 (- 1.1-0.05) and FEV1% of 100% (87.2-106.6). Median FCP at start was 61 mg/g (17-108) and gut permeability 0.079 (0.051-0.122). No significant changes were observed in the clinical parameters (BMI, FEV1%, abdominal pain, exacerbations). Despite being frequently abnormal (17/28 (61%) > 50 mg/kg), FCP did not change significantly with probiotics. The proportion of patients with normal permeability was 8% during placebo and 32% during probiotic treatment (p = 0.031). FCP correlated to BMI z-score (p = 0.043) and gut permeability to abdominal pain (p = 0.015). The microbiome revealed a high predominance of Actinobacteria and Proteobacteriae. Probiotic supplementation did not result in a shift at the phylum nor at phylogenetic level. Conclusion: Normalization of gut permeability was observed in 13% of patients during probiotic treatment. However, none of the previously described effects could be confirmed. (c) 2018 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. |
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Language
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English
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Source (journal)
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Clinical nutrition ESPEN. - [Oxford], 2015, currens
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Publication
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[Oxford]
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Elsevier Ltd
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2018
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ISSN
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2405-4577
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DOI
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10.1016/J.CLNESP.2018.06.008
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Volume/pages
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27
(2018)
, p. 59-65
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ISI
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000444148600010
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Pubmed ID
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30144894
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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