Keith Ooi, a University of New South Wales pediatric gastroenterologist, will look at whether daily probiotics can improve the gut bacteria mix and digestion of children 6 years and under who have CF. Continuous use of antibiotics for lung infections can disrupt CF patients’ digestion.
Ooi will also examine probiotics’ effect on patients’ lung function.
Probiotics are bacteria and other microorganisms that are similar to the good bacteria in the intestines. Because antibiotics kill good as well as bad bacteria, people who take them often tend to have more gastrointestinal problems. Certain foods are rich in probiotics, like yogurt, kefir, soy or nut milks, fermented soft cheeses, kombucha tea, and sourdough bread.
Probiotics are not the same as prebiotics, or foods that resist digestion and promote the growth of good bacteria in the large intestine. Leeks, asparagus, chicory, kale, garlic, and bananas are examples of prebiotic foods.
“One of the major issues children with CF face is gut inflammation that leads to an inability to grow and put on weight,” Ooi said in a University of New South Wales news story. “Our previous work has shown that digestive problems in CF start in very early childhood, and their degree of severity are linked with growth outcomes.” In other words, digestive problems can affect children’s growth.
The gut microbiome works differently in children with CF than in other children. Problems arising from the difference tend to increase as children grow. This means that the first few years of these children’s lives are the ideal time to modify their microbiome.
Ooi will recruit about 130 children in Australia and New Zealand to see if a year’s worth of probiotics can restore the proper gut microbiome mix and reduce intestinal inflammation. In the second year of the study, his team will determine if the children’s improvements are long-lasting.
The team will use a combination of about 15 strains of probiotics.
“In healthy children, the first few years of life is when the gut bacterial community evolves,” Ooi said. “Beyond 4 years old, the gut microbiome — an ecosystem of bacteria, yeasts and fungi — is set for life. Previous studies in CF have shown probiotics can reduce inflammation and improve weight gain, but none have been done on this scale, over a two-year period or exclusively in young children.”
The team also noted that due to this chronic, low-grade gut inflammation that starts early in life, CF patients are at a higher risk of developing bowel cancer than the general population.
“In last few years, we’ve had a revolution in treating CF, with the development of medicines which treat the underlying genetic defect,” Ooi said. “We have data to show that by correcting the underlying defect in CF using such a medication, the microbiome and severity of inflammation in the gut also improves.
“Our hope is that we can modify the natural course of CF disease using a safe and easily accessible intervention such as probiotics,” he concluded.