可溶性纤维补充剂联合或不联合益生菌对哮喘成人患者的影响：一项为期 7 天的随机、双盲、三向交叉试验。
Soluble fibre supplementation with and without a probiotic in adults with asthma: A 7-day randomised, double blind, three way cross-over trial.
机构信息
Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
South Australian Health and Medical Research Institute, Microbiome & Host Health Programme, South Australia, Australia; College of Medicine and Public Health, Flinders University, South Australia, Australia.
出版信息
EBioMedicine. 2019 Aug;46:473-485. doi: 10.1016/j.ebiom.2019.07.048. Epub 2019 Jul 31.
BACKGROUND
Soluble fibre modulates airway inflammation in animal models. The aim of this study was to investigate the effects of soluble fibre supplementation, with and without a probiotic, on plasma short chain fatty acids (SCFA), airway inflammation, asthma control and gut microbiome in adults with asthma.
METHODS
A randomised, double-blinded, placebo controlled 3-way cross-over trial in 17 subjects with stable asthma at the Hunter Medical Research Institute, Newcastle, Australia. Subjects received 3 × 7 day oral interventions in random order; soluble fibre (inulin 12 g/day), soluble fibre + probiotic (inulin 12 g/day + multi-strain probiotic >25 billion CFU) and placebo. Plasma SCFA, sputum cell counts and inflammatory gene expression, asthma control gut microbiota, adverse events including gastrointestinal symptoms were measured.
FINDINGS
There was no difference in change in total plasma SCFA levels (μmol/L) in the placebo versus soluble fibre (Δmedian [95% CI] 16·3 [-16·9, 49·5], p = 0·335) or soluble fibre+probiotic (18·7 [-14·5, 51·9], p = 0·325) group. Following the soluble fibre intervention there was an improvement in the asthma control questionnaire (ACQ6) (∆median (IQR) -0·35 (-0·5, -0·13), p = 0·006), sputum %eosinophils decreased (-1.0 (-2·5, 0), p = 0·006) and sputum histone deacetylase 9 (HDAC9) gene expression decreased (-0.49 (-0.83, -0.27) 2, p = .008). Individual bacterial operational taxonomic units changed following both inulin and inulin+probiotic arms.
INTERPRETATION
Soluble fibre supplementation for 7 days in adults with asthma did not change SCFA levels. Within group analysis showed improvements in airway inflammation, asthma control and gut microbiome composition following inulin supplementation and these changes warrant further investigation, in order to evaluate the potential of soluble fibre as a non-pharmacological addition to asthma management. FUND: John Hunter Hospital Charitable Trust.
背景
可溶性纤维可调节动物模型中的气道炎症。本研究旨在探讨可溶性纤维补充剂（添加或不添加益生菌）对哮喘成人的血浆短链脂肪酸（SCFA）、气道炎症、哮喘控制和肠道微生物组的影响。
方法
在澳大利亚新南威尔士州纽卡斯尔的亨特医学研究所，对 17 名稳定期哮喘患者进行了一项随机、双盲、安慰剂对照的三向交叉试验。受试者以随机顺序接受 3 次为期 7 天的口服干预；可溶性纤维（菊粉 12g/天）、可溶性纤维+益生菌（菊粉 12g/天+多菌株益生菌>250 亿 CFU）和安慰剂。测量血浆 SCFA、痰细胞计数和炎症基因表达、哮喘控制、肠道微生物组、不良反应（包括胃肠道症状）。
结果
与安慰剂相比，可溶性纤维（中位数 [95%CI] 16.3 [-16.9, 49.5]，p=0.335）或可溶性纤维+益生菌（18.7 [-14.5, 51.9]，p=0.325）组的总血浆 SCFA 水平变化无差异。在接受可溶性纤维干预后，哮喘控制问卷（ACQ6）得到改善（中位数（IQR）-0.35（-0.5，-0.13），p=0.006），痰中嗜酸性粒细胞百分比降低（-1.0（-2.5，0），p=0.006），组蛋白去乙酰化酶 9（HDAC9）基因表达降低（-0.49（-0.83，-0.27），p=0.008）。在接受菊粉和菊粉+益生菌治疗后，个体细菌分类单元发生了变化。
结论
在哮喘成人中，7 天的可溶性纤维补充剂并未改变 SCFA 水平。组内分析显示，在接受菊粉补充后，气道炎症、哮喘控制和肠道微生物组组成得到改善，这些变化值得进一步研究，以评估可溶性纤维作为哮喘管理的非药物附加治疗的潜力。资金来源：约翰·亨特医院慈善信托基金。
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