title: Effect of Lactobacillus GG supplementation on pulmonary exacerbations in patients with cystic fibrosis: a pilot study.
abstract: OBJECTIVE
  Probiotics reduce intestinal inflammation in children with cystic fibrosis (CF). We want to determine the effects of Lactobacillus GG (LGG) on pulmonary exacerbations in CF.
  
  
  METHODS
  A prospective, randomized, placebo-controlled, cross-over study was performed. Nineteen children received LGG for 6 months and then shifted to oral rehydration solution (ORS) for 6 months. In parallel nineteen received ORS and then shifted to LGG. Main outcome parameters were: incidence of pulmonary exacerbations and of hospital admissions, forced expiratory volume (FEV1), and modifications of body weight.
  
  
  RESULTS
  Patients treated with LGG showed a reduction of pulmonary exacerbations (Median 1 vs. 2 , range 4 vs. 4, median difference 1, CI 95% 0.5-1.5; p=0.0035) and of hospital admissions (Median 0 vs. 1, range 3 vs. 2, median difference 1, CI 95% 1.0-1.5; p=0.001) compared to patients treated with ORS. LGG resulted in a greater increase in FEV1 (3.6% +/- 5.2 vs. 0.9% +/- 5; p=0.02) and body weight (1.5 kg +/- 1.8 vs. 0.7 kg +/- 1.8; p=0.02).
  
  
  CONCLUSIONS
  LGG reduces pulmonary exacerbations and hospital admissions in patients with CF. These suggest that probiotics may delay respiratory impairment and that a relationship exists between intestinal and pulmonary inflammation.
authors.affiliation: Department of Pediatrics, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Bruzzese
authors.forename: Valeria
authors.initials: V
authors.lastname: Raia
authors.forename: Maria Immacolata
authors.initials: MI
authors.lastname: Spagnuolo
authors.forename: Monica
authors.initials: M
authors.lastname: Volpicelli
authors.forename: Giulio
authors.initials: G
authors.lastname: De Marco
authors.forename: Luigi
authors.initials: L
authors.lastname: Maiuri
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D005440:Fluid Therapy; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007778:Lactobacillus / Q000254:growth & development; D007902:Length of Stay; D008297:Male; D010865:Pilot Projects; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D012129:Respiratory Function Tests; D016037:Single-Blind Method; D016896:Treatment Outcome