Vitamin D3 plus prebiotic improves CF microbiome diversity: Study
Evidence suggests gut, lung microbiome becomes dysregulated in CF
A high dose of vitamin D combined with inulin, a prebiotic, led to improvements in the diversity of bacteria living in the airway and lungs of people with cystic fibrosis (CF) in a small clinical trial.
The findings in the study, “Impact of high-dose cholecalciferol (vitamin D3) and inulin prebiotic on intestinal and airway microbiota in adults with cystic fibrosis: A 2 × 2 randomized, placebo-controlled, double-blind pilot study,” were published in the Journal of Clinical and Translational Endocrinology.
The human body is home to trillions of bacteria and other microscopic organisms, collectively known as the microbiome. These bacteria live all throughout the body, with many of them making their home in the lungs or digestive tract. The microbiome has profound effects on human health that are only beginning to be understood.
A growing body of evidence suggests the microbiome of the gut and lungs becomes dysregulated in CF. A dysregulated microbiome tends to be less diverse than a typical microbiome; bacteria associated with inflammation and disease tend to grow to unusually high levels. Normalizing the microbiome may be a useful strategy for treating CF.
Increasing microbiome diversity
A small pilot trial (NCT04118010) tested an intervention to increase the diversity of the microbiome using vitamin D3 and the prebiotic inulin. A form of vitamin D, vitamin D3 has been associated with healthy bacterial growth. A prebiotic is a dietary fiber that can’t be digested by people, but bacteria can use it as a source of food.
The study enrolled 40 adults with CF. For 12 weeks, the participants were randomly assigned to a placebo, to vitamin D3 only, inulin only, or vitamin D combined with inulin. The dose of inulin was 12 grams a day and the dose of vitamin D was 50,000 international units (IU) per day. The recommended daily dose of vitamin D is 400-800 IU/day).
There were no severe safety issues as a result of the intervention. A tolerability rating score of 4.06 out of 5 indicated the treatment was moderately acceptable.
In both the gut and the airway, patients given the inulin and vitamin D combination tended to see greater changes in microbiome diversity relative to either inulin or vitamin D alone, or the placebo, microbiome analyses showed.
“This pilot study established that the combination of oral vitamin D3 and the prebiotic inulin was well tolerated over 12 weeks in adults with CF and altered gut and airway bacterial communities,” wrote the scientists, who emphasized that the study was mainly designed to test the feasibility of the intervention, so more studies are needed to verify the results. The study was conducted during the COVID-19 pandemic, limiting in-person visits.
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