Effect of synbiotic supplementation in children and adolescents with cystic fibrosis: a randomized controlled clinical trial

• Published in: European journal of clinical nutrition Vol. 72; no. 5; pp. 736 - 743
• Main Authors: de Freitas, Maiara Brusco, Moreira, Emilia Addison Machado, Oliveira, Diane de Lima, Tomio, Camila, da Rosa, Julia Salvan, Moreno, Yara Maria Franco, Barbosa, Eliana, Ludwig Neto, Norberto, Buccigrossi, Vittoria, Guarino, Alfredo, Fröde, Tânia Silvia
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-05-2018; Nature Publishing Group
• Subjects: 692/308/2778; 692/308/2779/777; Adolescent; Adolescents; Age; Arm; Bacteriology; Bifidobacterium animalis; Biomarkers - blood; Body fat; Body Mass Index; Body size; Care and treatment; Child; Child, Preschool; Children; Clinical Nutrition; Clinical trials; Control methods; Cystic fibrosis; Cystic Fibrosis - blood; Cystic Fibrosis - therapy; Diet therapy; Dietary supplements; Double-Blind Method; Epidemiology; Female; Fibrosis; Humans; Inflammation; Inflammatory response; Interleukin 10; Interleukin 12; Interleukin 6; Interleukin 8; Interleukin-6 - blood; Interleukins; Internal Medicine; Lactobacillus acidophilus; Lactobacillus paracasei; Lungs; Male; Markers; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolites; Muscles; Necrosis; Nitric oxide; Nitrogen oxides; Nutrition Assessment; Nutritional Status; Patient outcomes; Peroxidase; Physiological research; Probiotics; Public Health; Randomization; Respiratory function; Synbiotics - administration & dosage; Teenagers; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Tumors
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/s41430-017-0043-4

Background/objectives
Cystic fibrosis (CF) is characterized by excessive activation of immune processes. The aim of this study was to evaluate the effect of synbiotic supplementation on the inflammatory response in children/adolescents with CF.
Subjects/methods
A randomized, placebo-controlled, double-blind, clinical-trial was conducted with control group (CG,
n
 = 17), placebo-CF-group (PCFG,
n
 = 19), synbiotic CF-group (SCFG,
n
 = 22), PCFG negative (
n
 = 8) and positive (
n
 = 11) bacteriology, and SCFG negative (
n
 = 12) and positive (
n
 = 10) bacteriology. Markers of lung function (FEV
1
), nutritional status [body mass index-for age (BMI/A), height-for-age (H/A), weight-for-age (W/A), upper-arm fat area (UFA), upper-arm muscle area (UMA), body fat (%BF)], and inflammation [interleukin (IL)-12, tumor necrosis factor-alpha (TNF-α), IL-10, IL-6, IL-1β, IL-8, myeloperoxidase (MPO), nitric oxide metabolites (NOx)] were evaluated before and after 90-day of supplementation with a synbiotic.
Results
No significance difference was found between the baseline and end evaluations of FEV
1
and nutricional status markers. A significant interaction (time vs. group) was found for IL-12 (
p
 = 0.010) and myeloperoxidase (
p
 = 0.036) between PCFG and SCFG, however, the difference was not maintained after assessing the groups individually. NOx diminished significantly after supplementation in the SCFG (
p
 = 0.030). In the SCFG with positive bacteriology, reductions were found in IL-6 (
p
 = 0.033) and IL-8 (
p
 = 0.009) after supplementation.
Conclusions
Synbiotic supplementation shown promise at diminishing the pro-inflammatory markers IL-6, IL-8 in the SCFG with positive bacteriology and NOx in the SCFG in children/adolescents with CF.