CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Gut Bifidobacteria enrichment following oral Lactobacillus-supplementation is associated with clinical improvements in children with cystic fibrosis.

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 (P = 0.04). Children with Bifidobacteria-dominated gut microbiota had a reduced rate of pulmonary exacerbations (IRR = 0.55; 95% CI 0.25 to 0.82; P = 0.01), improved pulmonary function (+ 20.00% of predicted value FEV(1); 95% CI 8.05 to 31.92; P = 0.001), lower intestinal inflammation (Calprotectin; Coef =  - 16.53 μg g(-1) feces; 95% CI - 26.80 to - 6.26; P = 0.002) and required fewer antibiotics (IRR = 0.43; 95% CI 0.22 to 0.69; P = 0.04) 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.

Keywords: Child; Probiotics; Supplementation; Oral; Immunoregulatory; pharmacological_intervention; Adult; Lactobacillus; Synbiotic;