Dataset Information

Soluble fibre supplementation with and without a probiotic in adults with asthma: A 7-day randomised, double blind, three way cross-over trial.

ABSTRACT:

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 (?mol/L) in the placebo versus soluble fibre (?median [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^-?Ct, 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.

SUBMITTER: McLoughlin R

PROVIDER: S-EPMC6712277 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Soluble fibre supplementation with and without a probiotic in adults with asthma: A 7-day randomised, double blind, three way cross-over trial.

McLoughlin Rebecca R Berthon Bronwyn S BS Rogers Geraint B GB Baines Katherine J KJ Leong Lex E X LEX Gibson Peter G PG Williams Evan J EJ Wood Lisa G LG

EBioMedicine 20190731

<h4>Background</h4>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.<h4>Methods</h4>A randomised, double-blinded, placebo controlled 3-way cross-over trial in 17 subjects with stable asthma at the Hunter Medical Research Institute, Newcastle, Australi ...[more]

PMID: 31375426

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Project description:ObjectiveTo evaluate the association of probiotic supplementation during pregnancy or infancy with childhood asthma and wheeze.DesignSystematic review and meta-analysis of randomised controlled trials.Data sourcesMedline, Embase, and Central (Cochrane Library) databases from inception to August 2013, plus the World Health Organization's international clinical trials registry platform and relevant conference proceedings for the preceding five years. Included trials and relevant reviews were forward searched in Web of Science.Review methodsTwo reviewers independently identified randomised controlled trials evaluating probiotics administered to mothers during pregnancy or to infants during the first year of life. The primary outcome was doctor diagnosed asthma; secondary outcomes included wheeze and lower respiratory tract infection.ResultsWe identified 20 eligible trials including 4866 children. Trials were heterogeneous in the type and duration of probiotic supplementation, and duration of follow-up. Only five trials conducted follow-up beyond participants' age of 6 years (median 24 months), and none were powered to detect asthma as the primary outcome. The overall rate of doctor diagnosed asthma was 10.7%; overall rates of incident wheeze and lower respiratory tract infection were 33.3% and 13.9%, respectively. Among 3257 infants enrolled in nine trials contributing asthma data, the risk ratio of doctor diagnosed asthma in participants randomised to receive probiotics was 0.99 (95% confidence interval 0.81 to 1.21, I(2)=0%). The risk ratio of incident wheeze was 0.97 (0.87 to 1.09, I(2)=0%, 9 trials, 1949 infants). Among 1364 infants enrolled in six trials, the risk ratio of lower respiratory tract infection after probiotic supplementation was 1.26 (0.99 to 1.61, I(2)=0%). We adjudicated most trials to be of high (ten trials) or unclear (nine trials) risk of bias, mainly due to attrition.ConclusionsWe found no evidence to support a protective association between perinatal use of probiotics and doctor diagnosed asthma or childhood wheeze. Randomised controlled trials to date have not yielded sufficient evidence to recommend probiotics for the primary prevention of these disorders. Extended follow-up of existing trials, along with further clinical and basic research, are needed to accurately define the role of probiotics in the prevention of childhood asthma.Systematic review registrationPROSPERO (CRD42013004385).

Dataset Information

Soluble fibre supplementation with and without a probiotic in adults with asthma: A 7-day randomised, double blind, three way cross-over trial.

Background

Methods

Findings

Interpretation

Publications

Soluble fibre supplementation with and without a probiotic in adults with asthma: A 7-day randomised, double blind, three way cross-over trial.

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