Van Biervliet Stephanie, Declercq Dimitri, Somerset Shawn
Cystic Fibrosis Centre, University of Ghent, Belgium.
School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia.
Clin Nutr ESPEN. 2017 Apr;18:37-43. doi: 10.1016/j.clnesp.2017.01.007. Epub 2017 Feb 22.
Cystic fibrosis (CF) is characterised by a build-up of thick, intransient mucus linings of the digestive and respiratory mucosa, which disrupts digestive system functioning and microbiota composition. In view of the potential for probiotics to enhance microbiota composition in other contexts, this study investigated the current evidence for probiotics as an adjunct to usual therapy for CF. Electronic clinical databases were interrogated for human randomised, controlled, intervention trials (1985-2015) testing the effects of probiotics on clinical endpoints in CF were reviewed. From 191 articles identified in initial searches, six studies met the critical inclusion criteria, and were reviewed in detail. These studies varied in size (n = 22 to 61) but were generally small and showed substantial diversity in protocol, specific probiotic species used and range of clinical outcomes measured. Probiotic administration showed beneficial effects on fecal calprotectin levels, pulmonary exacerbation risk, and quality of life indicators. In one study, such changes were associated with variations in gut microbiota composition. Despite encouraging preliminary results, the limited number of small and highly varied studies to date do not justify the addition of probiotics as an adjunct to current CF treatment protocols. Importantly, very minimal adverse effects of probiotics have been reported.
囊性纤维化（CF）的特征是在消化和呼吸道黏膜上形成厚厚的、难以消退的黏液内衬，这会扰乱消化系统功能和微生物群组成。鉴于益生菌在其他情况下有增强微生物群组成的潜力，本研究调查了目前将益生菌作为CF常规治疗辅助手段的证据。检索了电子临床数据库，以查找1985年至2015年期间测试益生菌对CF临床终点影响的人类随机对照干预试验，并对其进行了综述。在初步检索中确定的191篇文章中，有6项研究符合关键纳入标准，并进行了详细综述。这些研究规模各异（n = 22至61），但总体规模较小，在方案、使用的特定益生菌种类以及所测量的临床结果范围方面存在很大差异。服用益生菌对粪便钙卫蛋白水平、肺部恶化风险和生活质量指标显示出有益效果。在一项研究中，这些变化与肠道微生物群组成的变化有关。尽管初步结果令人鼓舞，但迄今为止数量有限且差异很大的小型研究并不足以证明将益生菌作为当前CF治疗方案的辅助手段是合理的。重要的是，已报告的益生菌不良反应非常少。
