Cruz Mosquera Freiser Eceomo, Perlaza Claudia Lorena, Naranjo Rojas Anisbed, Murillo Rios Saray, Carrero Gallego Alejandra, Fischersworring Sara Isabel, Rodríguez Juan Sebastián, Liscano Yamil
Grupo de Investigación en Salud Integral (GISI), Department of Health Sciences Faculty, Universidad Santiago de Cali, Cali 760035, Colombia.
Medicina (Kaunas). 2025 Mar 12;61(3):489. doi: 10.3390/medicina61030489.
: Cystic fibrosis (CF), caused by CFTR gene mutations, primarily affects the respiratory and gastrointestinal systems. Microbiota modulation through probiotics, prebiotics, or synbiotics may help restore microbial diversity and reduce inflammation. This study aimed to evaluate their efficacy in CF. A systematic review and meta-analysis of randomized controlled trials (RCTs) published between 2000 and 2024 was conducted in Cochrane, ScienceDirect, Web of Science, LILAC, BMC, PubMed, and SCOPUS following PRISMA guidelines. Methodological quality was assessed using the Jadad scale, and RevMan 5.4 estimated effects on pulmonary function (FEV), exacerbations, hospitalizations, quality of life, and inflammatory markers. : Thirteen RCTs ( = 552), mostly in pediatric populations, were included. Most examined probiotics (e.g., , ), while four used synbiotics. Several studies reported reduced fecal calprotectin and proinflammatory interleukins (e.g., IL-6, IL-8), suggesting an anti-inflammatory effect. However, no significant differences were observed regarding hospitalizations or quality of life. Additionally, none of the studies documented serious adverse events associated with the intervention. The meta-analysis showed no significant decrease in exacerbations (RR = 0.81; 95% CI = 0.48-1.37; = 0.43) or improvements in FEV (MD = 4.7; 95% CI = -5.4 to 14.8; = 0.37), even in subgroup analyses. Sensitivity analyses did not modify the effect of the intervention on pulmonary function or exacerbation frequency, supporting the robustness of the findings. : Current evidence suggests that probiotics or synbiotics yield inconsistent clinical benefits in CF, although some reduction in inflammatory markers may occur. Larger, multicenter RCTs with longer follow-up are needed for clearer conclusions. Until more definitive evidence is available, these supplements should be considered experimental adjuncts rather than standard interventions for CF management.
囊性纤维化（CF）由CFTR基因突变引起，主要影响呼吸和胃肠道系统。通过益生菌、益生元或合生元进行微生物群调节可能有助于恢复微生物多样性并减轻炎症。本研究旨在评估它们在CF中的疗效。按照PRISMA指南，在Cochrane、ScienceDirect、Web of Science、LILAC、BMC、PubMed和SCOPUS上对2000年至2024年发表的随机对照试验（RCT）进行了系统评价和荟萃分析。使用Jadad量表评估方法学质量，RevMan 5.4估计对肺功能（FEV）、病情加重、住院、生活质量和炎症标志物的影响。：纳入了13项RCT（n = 552），大多数研究对象为儿科人群。大多数研究检测了益生菌（如，），而四项研究使用了合生元。几项研究报告粪便钙卫蛋白和促炎白细胞介素（如IL-6、IL-8）减少，表明具有抗炎作用。然而，在住院或生活质量方面未观察到显著差异。此外，没有研究记录与干预相关的严重不良事件。荟萃分析显示病情加重无显著减少（RR = 0.81；95%CI = 0.48 - 1.37；P = 0.43），FEV也无改善（MD = 4.7；95%CI = -5.4至14.8；P = 0.37），即使在亚组分析中也是如此。敏感性分析未改变干预对肺功能或病情加重频率的影响，支持了研究结果的稳健性。：目前的证据表明，益生菌或合生元在CF中产生的临床益处不一致，尽管炎症标志物可能会有所降低。需要开展更大规模、多中心且随访时间更长的RCT以得出更明确的结论。在获得更确凿的证据之前，这些补充剂应被视为实验性辅助手段，而非CF管理的标准干预措施。
