Probiotics on Intestinal Inflammation in Cystic Fibrosis

Federico II University

Status and phase: Completed; Phase 3

Conditions: Cystic Fibrosis

Treatments: Dietary Supplement: Lactobacillus rhamnosus GG; Dietary Supplement: placebo

Study type: Interventional

Funder types: Other

Identifiers

NCT01961661

CF pilot

Details and patient eligibility

About

Cystic fibrosis (CF) is a complex systemic disease that mainly involves the respiratory and gastrointestinal (GI) tracts. The polymicrobial community composition of respiratory and GI tracts is influenced by both genetic and environmental factors. Children with CF may harbor an abnormal intestinal microflora, because of altered Cystic fibrosis transmembrane conductance regulator (CFTR) function and heavy drug load (antibiotics, pancreatic enzymes and acid suppressors). The investigators previously demonstrated that intestinal inflammation is highly frequent in CF children, being a major feature of intestinal involvement. In addition, specific probiotics significantly improved airway and GI inflammation in a preliminary trial. The aim of the study is to characterize intestinal and respiratory microflora in CF patients and to investigate the effects of daily Lactobacillus GG (LGG) supplementation on both GI and airway microflora and the eventual relationship between probiotic assumption and clinical and inflammation markers. The aim is to study the effect of microflora modification on intestinal and extraintestinal inflammation to eventually improve the quality of life of CF patients, who often suffer from intestinal and respiratory progressive disease, through a non invasive intervention consisting in the supplementation of probiotic bacteria.

Enrollment: 22 patients

Sex: All

Ages: 2 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Diagnosis of CF documented by sweat chloride test over 60 mmol/L and confirmed by genotype analysis with the presence of F508del/F508del or F508del/other;
• Boys and girls between 2 and 16 years of age;
• Clinical stability at enrolment, defined as no clinical evidence of acute exacerbation, no modifications in the therapeutic regimen and no hospitalization in the last 2 weeks;
• Pancreatic insufficiency;
• Basal Forced expiratory volume 1 second (FEV1) above 50% of predicted value.

Exclusion Criteria

• Colonization of respiratory tract with Burkholderia cepacia spp.;
• Steroid therapy within one month before enrolment;
• Pregnancy and fertile women taking oral contraceptives;
• Parenteral or oral antibiotics therapy within 2 weeks before enrolment;
• Regular assumption of probiotics;
• Regular assumption of azythromycin.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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22 participants in 2 patient groups, including a placebo group

probiotic

Experimental group

Description:

Lactobacillus rhamnosus GG 5x10\^9 colony forming units (CFU)per day

Treatment:

Dietary Supplement: Lactobacillus rhamnosus GG

placebo

Placebo Comparator group

Description:

maltodextrins

Treatment:

Dietary Supplement: placebo