Study design (if review, criteria of inclusion for studies)
Multi-center, double-blind, randomized placebo-controlled trial
Participants
CF patients
Interventions
Lactobacillus supplementation. Daily Lactobacillus rhamnosus strain GG (LGG) probiotic supplementation over a 12-month period.
Outcome measures
Fecal 16S rRNA biomarker sequencing was used to profile fecal bacterial microbiota and analyses were performed in QiiME.
Main results
Bifidobacteria-dominated fecal microbiota were more likely to arise in LGG-treated children with CF (Pâ=â0.04). Children with Bifidobacteria-dominated gut microbiota had a reduced rate of pulmonary exacerbations (IRRâ=â0.55; 95% CI 0.25 to 0.82; Pâ=â0.01), improved pulmonary function (+â20.00% of predicted value FEV(1); 95% CI 8.05 to 31.92; Pâ=â0.001), lower intestinal inflammation (Calprotectin; Coefâ=ââ-â16.53 μg g(-1) feces; 95% CIâ-â26.80 toâ-â6.26; Pâ=â0.002) and required fewer antibiotics (IRRâ=â0.43; 95% CI 0.22 to 0.69; Pâ=â0.04) compared to children with Bacteroides-dominated microbiota who were less likely to have received LGG.
Authors' conclusions
The majority of pediatric CF patients in this study possessed a Bacteroides- or Bifidobacteria-dominated gut microbiota. Bifidobacteria-dominated gut microbiota were more likely to be associated with LGG-supplementation and with better clinical outcomes.