Does probiotic supplementation affect pulmonary exacerbation and intestinal inflammation in cystic fibrosis: a systematic review of randomized clinical trials
- 167 Downloads
- 1 Citations
Abstract
Background
Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota due to massive exposure to antibiotics. Probiotics could modify the gut microbiota and hence may affect CF management. So the aim of present systematic review was evaluation of the efficacy and safety of probiotic supplementation for the management of cystic fibrosis.
Data sources
We searched PubMed, Science Direct, Google Scholar, Springer Cochrane Library Databases until January 2016 for randomized controlled trials (RCTs) performed in pediatric or adult populations related to the study aim. Key words were selected based on Mesh terms. Based on the Critical Appraisal Skills Programme checklist, eligibility of included articles was evaluated.
Results
Five studies included in this review represent 188 participants with a follow up period ranging from 1 month to 6 months. The results of the included studies supporting the use of probiotics in management of pulmonary exacerbation and intestinal calprotectin in patients with cystic fibrosis. However the level of evidence was limited.
Conclusions
The lack of high quality RCTs makes it impossible to support a general recommendation about the use of probiotics in the treatment of CF pulmonary exacerbation and intestinal inflammation.
Key words
cystic fibrosis intestinal inflammation probiotics pulmonary exacerbationPreview
Unable to display preview. Download preview PDF.
References
- 1.O’Sullivan BP, Freedman SD. Cystic fibrosis. Lancet 2009;373:1891–1904.CrossRefPubMedGoogle Scholar
- 2.Linsdell P, Hanrahan JW. Glutathione permeability of CFTR. Am J Physiol 1998;275:C323–C326.CrossRefPubMedGoogle Scholar
- 3.Gao L, Kim KJ, Yankaskas JR, Forman HJ. Abnormal glutathione transport in cystic fibrosis airway epithelia. Am J Physiol 1999;277:L113–L118.PubMedGoogle Scholar
- 4.Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003;168:918–951.CrossRefPubMedGoogle Scholar
- 5.van Elburg RMI, Uil JJ, van Aalderen WM, Mulder CJ, Heymans HS. Intestinal permeability in exocrine pancreatic insufficiency due to cystic fibrosis or chronic pancreatitis. Pediatr Res 1996;39:985–991.CrossRefPubMedGoogle Scholar
- 6.Reid G, Sanders ME, Gaskins HR, Gibson GR, Mercenier A, Rastall R, et al. New scientific paradigms for probiotics and prebiotics. J Clin Gastroenterol 2003;37:105–118.CrossRefPubMedGoogle Scholar
- 7.Claeys S, Van Hoecke H, Holtappels G, Gevaert P, De Belder T, Verhasselt B, et al. Nasal polyps in patients with and without cystic fibrosis: a differentiation by innate markers and inflammatory mediators. Clin Exp Allergy 2005;35:467–472.CrossRefPubMedGoogle Scholar
- 8.Werlin SL, Benuri-Silbiger I, Kerem E, Adler SN, Goldin E, Zimmerman J, et al. Evidence of intestinal inflammation in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 2010;51:304–308.PubMedGoogle Scholar
- 9.Duytschaever G, Huys G, Bekaert M, Boulanger L, De Boeck K, Vandamme P. Cross-sectional and longitudinal comparisons of the predominant fecal microbiota compositions of a group of pediatric patients with cystic fibrosis and their healthy siblings. Appl Environ Microbiol 2011;77:8015–8024.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Duytschaever G, Huys G, Bekaert M, Boulanger L, De Boeck K, Vandamme P. Dysbiosis of bifidobacteria and Clostridium cluster XIVa in the cystic fibrosis fecal microbiota. J Cyst Fibros 2013;12:206–215.CrossRefPubMedGoogle Scholar
- 11.Gillanders LJ, Elborn JS, Gilpin DF, Schneiders T, Tunney MM. The airway microbiome in cystic fibrosis: challenges for therapy. Therapy 2011;8:645–660.CrossRefGoogle Scholar
- 12.Sánchez-Calvo J, García-Castillo M, Lamas A, Rodriguez-Baños M, Máiz L, Suárez L, et al. Gut microbiota composition in cystic fibrosis patients: molecular approach and classical culture. J Cyst Fibros 2008;7:S50.CrossRefGoogle Scholar
- 13.Thushara RM, Gangadaran S, Solati Z, Moghadasian MH. Cardiovascular benefits of probiotics: a review of experimental and clinical studies. Food Funct 2016;7:632–642.CrossRefPubMedGoogle Scholar
- 14.Jonkers D, Penders J, Masclee A, Pierik M. Probiotics in the management of inflammatory bowel disease. Drugs 2012;72:803–823.CrossRefPubMedGoogle Scholar
- 15.Infante Pina D, Redecillas Ferreiro S, Torrent Vernetta A, Segarra Cantón O, Maldonado Smith M, Gartner Tizziano L, et al. Improvement of intestinal function in cystic fibrosis patients using probiotics. An Pediatr (Barc) 2008;69:501–505. [In Spanish]CrossRefGoogle Scholar
- 16.Fallahi G, Motamed F, Yousefi A, Shafieyoun A, Najafi M, Khodadad A, et al. The effect of probiotics on fecal calprotectin in patients with cystic fibrosis. Turk J Pediatr 2013;55:475–478.PubMedGoogle Scholar
- 17.Bruzzese E, Callegari ML, Raia V, Viscovo S, Scotto R, Ferrari S, et al. Disrupted intestinal microbiota and intestinal inflammation in children with cystic fibrosis and its restoration with Lactobacillus GG: a randomised clinical trial. PLoS One 2014;9:e87796.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Bruzzese E, Raia V, Gaudiello G, Polito G, Buccigrossi V, Formicola V, et al. Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration. Aliment Pharmacol Ther 2004;20:813–819.CrossRefPubMedGoogle Scholar
- 19.Bruzzese E, Raia V, Spagnuolo MI, Volpicelli M, De Marco G, Maiuri L, et al. Effect of Lactobacillus GG supplementation on pulmonary exacerbations in patients with cystic fibrosis: a pilot study. Clin Nutr 2007;26:322–328.CrossRefPubMedGoogle Scholar
- 20.Weiss B, Bujanover Y, Yahav Y, Vilozni D, Fireman E, Efrati O. Probiotic supplementation affects pulmonary exacerbations in patients with cystic fibrosis: a pilot study. Pediatr Pulmonol 2010;45:536–540.PubMedGoogle Scholar
- 21.del Campo R, Garriga M, Pérez-Aragón A, Guallarte P, Lamas A, Máiz L, et al. Improvement of digestive health and reduction in proteobacterial populations in the gut microbiota of cystic fibrosis patients using a Lactobacillus reuteri probiotic preparation: a double blind prospective study. J Cyst Fibros 2014;13:716–722.CrossRefPubMedGoogle Scholar
- 22.Di Nardo G, Oliva S, Menichella A, Pistelli R, De Biase RV, Patriarchi F, et al. Lactobacillus reuteri ATCC55730 in cystic fibrosis. J Pediatr Gastroenterol Nutr 2014;58:81–86.CrossRefPubMedGoogle Scholar
- 23.Jafari SA, Mehdizadeh-Hakkak A, Kianifar HR, Hebrani P, Ahanchian H, Abbasnejad E. Effects of probiotics on quality of life in children with cystic fibrosis; a randomized controlled trial. Iran J Pediatr 2013;23:669–674.PubMedPubMedCentralGoogle Scholar
- 24.Li L, Somerset S. The clinical significance of the gut microbiota in cystic fibrosis and the potential for dietary therapies. Clin Nutr 2014;33:571–580.CrossRefPubMedGoogle Scholar
- 25.Ananthan A, Balasubramanian H, Rao S, Patole S. Probiotic supplementation in children with cystic fibrosis-a systematic review. Eur J Pediatr 2016;175:1255–1266.CrossRefPubMedGoogle Scholar
- 26.Alvarez S, Herrero C, Bru E, Perdigon G. Effect of Lactobacillus casei and yogurt administration on prevention of Pseudomonas aeruginosa infection in young mice. J Food Prot 2001;64:1768–1774.CrossRefPubMedGoogle Scholar
- 27.Valdéz JC, Peral MC, Rachid M, Santana M, Perdigón G. Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected burns: the potential use of probiotics in wound treatment. Clin Microbiol Infect 2005;11:472–479.CrossRefPubMedGoogle Scholar
- 28.Bron PA, van Baarlen P, Kleerebezem M. Emerging molecular insights into the interaction between probiotics and the host intestinal mucosa. Nat Rev Microbiol 2012;10:66–78.CrossRefGoogle Scholar
- 29.Tsay TB, Yang MC, Chen PH, Hsu CM, Chen LW. Gut flora enhance bacterial clearance in lung through toll-like receptors 4. J Biomed Sci 2011;18:68.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Sadikot RT, Zeng H, Joo M, Everhart MB, Sherrill TP, Li B, et al. Targeted immunomodulation of the NF-κB pathway in airway epithelium impacts host defense against Pseudomonas aeruginosa. J Immunol 2006;176:4923–4930.CrossRefPubMedGoogle Scholar
- 31.Boyle RJ, Robins-Browne RM, Tang ML. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 2006;83:1256–1264.CrossRefPubMedGoogle Scholar