Probiotics for people with cystic fibrosis

Coffey, Michael J.; Garg, Millie; Homaira, Nusrat; Jaffé, Adam; Ooi, Chee Y.

doi:10.1002/14651858.cd012949.pub2

Cited by 25 publications

(29 citation statements)

References 64 publications

(16 reference statements)

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“…Regarding potential tools and methods for future therapeutics, probiotics could serve as a cost-effective approach for targeted manipulations, and there have already been several trials of probiotic usage in CF [13], some of which have incorporated Bifidobacterium species. However, none of these trials have investigated the impact of probiotics on bile acids.…”

Section: Discussionmentioning

confidence: 99%

Infants with cystic fibrosis have altered fecal functional capacities with potential clinical and metabolic consequences

et al. 2021

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Background Infants with cystic fibrosis (CF) suffer from gastrointestinal (GI) complications, including pancreatic insufficiency and intestinal inflammation, which have been associated with impaired nutrition and growth. Recent evidence identified altered fecal microbiota taxonomic compositions in infants with CF relative to healthy infants that were characterized by differences in the abundances of taxa associated with GI health and nutrition. Furthermore, these taxonomic differences were more pronounced in low length infants with CF, suggesting a potential link to linear growth failure. We hypothesized that these differences would entail shifts in the microbiome’s functional capacities that could contribute to inflammation and nutritional failure in infants with CF. Results To test this hypothesis, we compared fecal microbial metagenomic content between healthy infants and infants with CF, supplemented with an analysis of fecal metabolomes in infants with CF. We identified notable differences in CF fecal microbial functional capacities, including metabolic and environmental response functions, compared to healthy infants that intensified during the first year of life. A machine learning-based longitudinal metagenomic age analysis of healthy and CF fecal metagenomic functional profiles further demonstrated that these differences are characterized by a CF-associated delay in the development of these functional capacities. Moreover, we found metagenomic differences in functions related to metabolism among infants with CF that were associated with diet and antibiotic exposure, and identified several taxa as potential drivers of these functional differences. An integrated metagenomic and metabolomic analysis further revealed that abundances of several fecal GI metabolites important for nutrient absorption, including three bile acids, correlated with specific microbes in infants with CF. Conclusions Our results highlight several metagenomic and metabolomic factors, including bile acids and other microbial metabolites, that may impact nutrition, growth, and GI health in infants with CF. These factors could serve as promising avenues for novel microbiome-based therapeutics to improve health outcomes in these infants.

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Section: Discussionmentioning

confidence: 99%

Infants with cystic fibrosis have altered fecal functional capacities with potential clinical and metabolic consequences

et al. 2021

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“…In that context, the efficacy of probiotics for improving health outcomes in children and adults with CF has been a much-debated issue [ 101 ]. A recent meta-analysis confirmed that probiotics significantly reduce fecal CLP in children and adults with CF; however, probiotics may make little or no difference to pulmonary exacerbation rates.…”

Section: Clp In Cystic Fibrosis and Non-cystic Fibrosis Bronchiectmentioning

confidence: 99%

“…A recent meta-analysis confirmed that probiotics significantly reduce fecal CLP in children and adults with CF; however, probiotics may make little or no difference to pulmonary exacerbation rates. Nevertheless, further evidence is required before firm conclusions can be made [ 101 ].…”

Section: Clp In Cystic Fibrosis and Non-cystic Fibrosis Bronchiectmentioning

confidence: 99%

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Calprotectin in Lung Diseases

Kotsiou

Papagiannis

Papadopoulou

et al. 2021

IJMS

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Calprotectin (CLP) is a heterodimer formed by two S-100 calcium-binding cytosolic proteins, S100A8 and S100A9. It is a multifunctional protein expressed mainly by neutrophils and released extracellularly by activated or damaged cells mediating a broad range of physiological and pathological responses. It has been more than 20 years since the implication of S100A8/A9 in the inflammatory process was shown; however, the evaluation of its role in the pathogenesis of respiratory diseases or its usefulness as a biomarker for the appropriate diagnosis and prognosis of lung diseases have only gained attention in recent years. This review aimed to provide current knowledge regarding the potential role of CLP in the pathophysiology of lung diseases and describe how this knowledge is, up until now, translated into daily clinical practice. CLP is involved in numerous cellular processes in lung health and disease. In addition to its anti-microbial functions, CLP also serves as a molecule with pro- and anti-tumor properties related to cell survival and growth, angiogenesis, DNA damage response, and the remodeling of the extracellular matrix. The findings of this review potentially introduce CLP in daily clinical practice within the spectrum of respiratory diseases.

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“…A recent Cochrane review included 12 randomised controlled trials that looked at probiotics for CF but none of the trials reported on GI symptoms. 13 Early work using MRI is aiming to identify physiological markers of where the CF GI system differs from that of healthy controls. 14 New treatments that correct the underlying defect in CF transmembrane conductance regulator (CFTR) proteins have been shown to be effective in pwCF who have specific gene mutations.…”

Section: Open Accessmentioning

confidence: 99%

How can we relieve gastrointestinal symptoms in people with cystic fibrosis? An international qualitative survey

Smith

Rowbotham

Davies³

et al. 2020

BMJ Open Resp Res

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IntroductionRelieving gastrointestinal (GI) symptoms was identified as a ‘top ten’ priority by our James Lind Alliance Priority Setting Partnership in cystic fibrosis (CF). We conducted an online survey to find out more about the effect of GI symptoms in CF.MethodsWe co-produced an online survey distributed to the CF community via web-based platforms. The survey consisted of open and closed questions designed to help us learn more about the effects of GI symptoms for people with CF (pwCF). We analysed the data using descriptive statistics and thematic analysis. We promoted the survey via social media and web-based platforms which allowed respondents from any country to take part. Our participants came from the CF community, including: adults and children with CF, parents and close family of pwCF and healthcare professionals (HCPs) working with pwCF.ResultsThere were 276 respondents: 90 (33%) pwCF, 79 (29%) family, 107 (39%) HCPs. The most commonly reported symptoms by lay respondents were stomach cramps/pain, bloating and a ‘combination of symptoms’. The top three symptoms that HCPs said were reported to them were reduced appetite, bloating and constipation. Almost all (94% (85/90)) HCPs thought medications helped to relieve GI symptoms but only 58% (82/141) of lay respondents agreed.ConclusionsOur survey has shown that GI symptoms among our participants are prevalent and intrude on daily lives of pwCF. There is a need for well-designed clinical studies to provide better evidence for management of GI symptoms and complications.

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Probiotics for people with cystic fibrosis

Abstract: Analysis 1.4. Comparison 1 Probiotic versus placebo, Outcome 4 Faecal calprotectin (µg/g) -change from baseline -sensitivity analysis..

Cited by 25 publications

References 64 publications

Infants with cystic fibrosis have altered fecal functional capacities with potential clinical and metabolic consequences

Infants with cystic fibrosis have altered fecal functional capacities with potential clinical and metabolic consequences

Calprotectin in Lung Diseases

How can we relieve gastrointestinal symptoms in people with cystic fibrosis? An international qualitative survey

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