What Do We Know about the Microbiome in Cystic Fibrosis? Is There a Role for Probiotics and Prebiotics?
1
Discipline of Paediatrics & Child Health, Randwick Clinical Campus, School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney 2031, Australia
2
Molecular and Integrative Cystic Fibrosis (miCF) Research Centre, Sydney 2031, Australia
3
Department of Gastroenterology, Sydney Children’s Hospital Randwick, Sydney 2031, Australia
*
Author to whom correspondence should be addressed.
Academic Editors: Maria R. Mascarenhas and Jessica Alvarez
Nutrients 2022, 14(3), 480; https://doi.org/10.3390/nu14030480
Received: 22 November 2021
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Revised: 13 January 2022
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Accepted: 17 January 2022
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Published: 22 January 2022
(This article belongs to the Special Issue Nutritional Management of Cystic Fibrosis)
Cystic fibrosis (CF) is a life-shortening genetic disorder that affects the cystic fibrosis transmembrane conductance regulator (CFTR) protein. In the gastrointestinal (GI) tract, CFTR dysfunction results in low intestinal pH, thick and inspissated mucus, a lack of endogenous pancreatic enzymes, and reduced motility. These mechanisms, combined with antibiotic therapies, drive GI inflammation and significant alteration of the GI microbiota (dysbiosis). Dysbiosis and inflammation are key factors in systemic inflammation and GI complications including malignancy. The following review examines the potential for probiotic and prebiotic therapies to provide clinical benefits through modulation of the microbiome. Evidence from randomised control trials suggest probiotics are likely to improve GI inflammation and reduce the incidence of CF pulmonary exacerbations. However, the highly variable, low-quality data is a barrier to the implementation of probiotics into routine CF care. Epidemiological studies and clinical trials support the potential of dietary fibre and prebiotic supplements to beneficially modulate the microbiome in gastrointestinal conditions. To date, limited evidence is available on their safety and efficacy in CF. Variable responses to probiotics and prebiotics highlight the need for personalised approaches that consider an individual’s underlying microbiota, diet, and existing medications against the backdrop of the complex nutritional needs in CF.
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Keywords:
cystic fibrosis; dysbiosis; inflammation; nutrition; prebiotic; probiotic
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MDPI and ACS Style
van Dorst, J.M.; Tam, R.Y.; Ooi, C.Y. What Do We Know about the Microbiome in Cystic Fibrosis? Is There a Role for Probiotics and Prebiotics? Nutrients 2022, 14, 480. https://doi.org/10.3390/nu14030480
AMA Style
van Dorst JM, Tam RY, Ooi CY. What Do We Know about the Microbiome in Cystic Fibrosis? Is There a Role for Probiotics and Prebiotics? Nutrients. 2022; 14(3):480. https://doi.org/10.3390/nu14030480
Chicago/Turabian Stylevan Dorst, Josie M., Rachel Y. Tam, and Chee Y. Ooi. 2022. "What Do We Know about the Microbiome in Cystic Fibrosis? Is There a Role for Probiotics and Prebiotics?" Nutrients 14, no. 3: 480. https://doi.org/10.3390/nu14030480
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