Effect of Lactobacillus Reuteri in Cystic Fibrosis
Effect of Lactobacillus Reuteri in Cystic Fibrosis
The purpose of this study is to evaluate in patients with cystic fibrosis the effect of
 Lactobacillus Reuteri (LR) on the rate of respiratory exacerbations and of the infections of
 both upper respiratory and gastrointestinal tracts.
The hallmarks of cystic fibrosis (CF) are recurrent severe and destructive pulmonary
 inflammation and infection, beginning in early childhood and leading to morbidity and
 mortality due to respiratory failure. During the disease, most children become colonized with
 Pseudomonas aeruginosa (PA) and undergo progressive impairment of respiratory function.
 Therefore, patients colonized with Pseudomonas are at increased risk for pulmonary infections
 and persistent inflammation and have a decrease in survival rate. In an attempt to reduce the
 rate and severity of pulmonary exacerbations, children with CF are put on heavy load of
 antibiotics.

 Intestinal inflammation is another typical finding in CF patients and gut bacterial
 overgrowth may be present.

 Probiotics are live bacteria administered orally, successfully used in children with acute
 gastroenteritis, as well as in preventing and treating atopic diseases in children. In
 addition, probiotics have been used as adjuvant therapy in patients with pouchitis and
 inflammatory bowel diseases. Interestingly, probiotic supplementation is able to reduce the
 incidence of fever, child care absences, antibiotic prescription and to prevent nosocomial
 gastrointestinal and respiratory infections. The effect of probiotics may be through
 improvement of intestinal barrier function and modulation of immune response. The latter
 mechanism could well explain the clinical effects of probiotics observed in extraintestinal
 diseases.
Inclusion Criteria:

 -  Forced expiratory volume in the 1st second (FEV1) > 70%.

 -  No inhaled or systemic steroids.

 -  No anti-inflammatory drugs, antileukotrienes and mast cell membrane stabilizers.

 -  No serious organ involvement.

 Exclusion Criteria:

 -  History of pulmonary exacerbation or upper respiratory infection in the previous two
 months.

 -  Changes in medications in the past two months.

 -  History of hemoptysis in the past two months.