CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Ranitidine and omeprazole as adjuvant therapy to pancrelipase to improve fat absorption in patients with cystic fibrosis.

Study design (if review, criteria of inclusion for studies)

2 x 6-month period, cross-over trial with no washout period.

Participants

17 children and young adults with CF and pancreatic insufficiency (mean (SD) age 18 (9) years)), 10 male and 7 female. 1 participant discontinued study after 8 months for personal convenience.

Interventions

Liquid dietary supplement containing PUFA mixture (EPA, DHA, GLA and STA) compared with liquid dietary supplement without PUFA mixture over 6 months. Volume of supplementation was determined according to participant's weight; intake ranged from 100 - 300

Outcome measures

number of people experiencing adverse events; number of deaths; changes in peripheral blood neutrophil membrane composition; in vitro neutrophilic response to inflammatory stimuli; changes in in-vitro neutrophil chemotaxis.

Main results

Increase in eicosapentaenoic acid was observed in neutrophil membrane following omega-3 PUFA dietary supplementation (from 0.7+/-0.6 to 1.6+/-0.6 micromol%, P<0.01). The leukotriene B(4) (LTB(4))/leukotriene B(5) (LTB(5)) ratio was decreased (from 72+/-27 to 24+/-7, P<0.001) in CF patients taking omega-3 PUFA supplements. In contrast, omega-3 PUFA supplementation affected neither internalization of IL-8 receptors following IL-8 exposure, nor IL-8-induced neutrophil chemotaxis.

Authors' conclusions

Our results show that omega-3 PUFA are incorporated in neutrophil membranes. The subsequent decrease in LTB(4)/LTB(5) ratio suggests that, in such conditions, neutrophils may produce less pro-inflammatory mediators from the acid arachidonic pathway. These data indicate that omega-3 PUFA intake may have anti-inflammatory effect that still need to be assessed by long-term studies following large groups of patients.

Keywords: Adolescent; Adult; Child; omega-3; non pharmacological intervention - diet; pharmacological_intervention; placebo; essential fatty acids; Supplementation; Docosahexaenoic Acid -DHA-;