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Published on: January 27, 2019
Probiotic supplementation modulates the gut microbiome and improves clinical outcomes in pediatric refractory asthma
Zheng Liu1, Wen Deng2, Wenlin Xu2
1Children's Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents Health and Diseases, Ministry of Education, Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.
Insights
Multi-strain probiotics significantly improved asthma control and gut health in children with refractory asthma. This gut-lung axis therapy offers a promising new approach for managing pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Microbiome Research
- Immunology
Background:
- Refractory asthma in children presents a significant clinical challenge.
- Gut microbiome dysbiosis is increasingly linked to persistent inflammation through the gut-lung axis.
Purpose of the Study:
- To investigate the efficacy of multi-strain probiotic supplementation as an adjunctive therapy for pediatric refractory asthma.
- To assess the impact of probiotics on asthma control, pulmonary function, and gut microbial balance.
Main Methods:
- A prospective randomized controlled trial involving 88 children (aged 4-8 years) with refractory asthma.
- Comparison of conventional therapy versus conventional therapy plus a multi-strain probiotic (Bifidobacterium, Lactobacillus acidophilus, Streptococcus thermophilus) for 4 months.
- Assessment of asthma control (Asthma Control Test scores), pulmonary function (FEV1, FVC, PEF), and gut microbiota composition (16S rRNA gene sequencing).
Main Results:
- Combination therapy led to significantly higher complete asthma control rates (68.18% vs. 36.36%) and improved Asthma Control Test scores.
- Superior improvements in FEV1, FVC, and PEF were observed in the probiotic group.
- Probiotic supplementation resulted in increased gut microbial alpha diversity and beneficial shifts, including increased Bifidobacterium and reduced Bacteroides.
Conclusions:
- Adjunctive multi-strain probiotics enhance clinical outcomes and gut microbiome health in pediatric refractory asthma.
- This supports microbiome-targeted therapies acting via the gut-lung axis.
- Larger trials are needed to confirm long-term benefits.
Background:
Refractory asthma in children remains a clinical challenge despite conventional therapies, with emerging evidence linking gut microbiome dysbiosis to persistent inflammation via the gut-lung axis. This study investigated whether multi-strain probiotic supplementation could improve asthma control and restore microbial balance when added to standard treatment.
Methods:
This prospective randomized controlled trial enrolled 88 children aged 4-8 years with refractory asthma. Participants were allocated into two groups (n = 44 each): a conventional treatment group (bronchodilators and glucocorticoids) and a combination treatment group, which received conventional therapy plus a multi-strain probiotic (Bifidobacterium, Lactobacillus acidophilus, Streptococcus thermophilus) for 4 months. Primary outcomes were asthma control level, Asthma Control Test (ACT) scores, and pulmonary function (FEV₁, FVC, PEF). Secondary outcomes included gut microbiota changes, assessed by 16S rRNA gene sequencing.
Results:
Combination therapy achieved complete asthma control in 68.18% of patients versus 36.36% with conventional therapy (Z = 2.415, p < 0.05). Post-treatment ACT scores were higher in the combination group (22.45 ± 1.20 vs. 19.78 ± 1.45; p < 0.05), with superior improvements in FEV1 (2.65 ± 0.10 L vs. 2.30 ± 0.08 L; p < 0.001), FVC (3.10 ± 0.18 L vs. 2.80 ± 0.15 L; p < 0.001), and PEF (4.00 ± 0.25 L/s vs. 3.50 ± 0.20 L/s; p < 0.001). Symptoms resolved faster with combination therapy (e.g., cough: 5.60 ± 1.50 vs. 10.45 ± 2.30 days; p < 0.05). Microbiome analysis showed increased alpha diversity (e.g., Shannon index: p < 0.05) and beneficial shifts in the combination group, including higher Bifidobacterium (25.00 ± 15.31% vs. 0.98 ± 1.92%; p < 0.001) and reduced Bacteroides, with distinct beta diversity clustering (PERMANOVA p < 0.05).
Conclusion:
Adjunctive multi-strain probiotics enhance clinical outcomes and gut microbiome health in pediatric refractory asthma, supporting microbiome-targeted therapies via the gut-lung axis. Larger, double-blind randomized controlled trials are warranted to confirm long-term benefits.
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