Abstract
Due to the alarming spread of bacterial resistance to conventional drugs, the sole use of antibiotics to fight lung infections in cystic fibrosis (CF) is not resolutive, and novel strategies to replace or complement the use of antibiotics are highly desirable. Among these strategies, the use of probiotics is emerging as a particularly attractive approach. Probiotic administration via the oral route has demonstrated an ability to improve lung function and to reduce infection and exacerbation rates in CF patients through mechanisms mainly attributable to the gut–lung axis. Nevertheless, some studies reported no beneficial effect of probiotic intake suggesting that there is margin for improvement of such innovative intervention in CF. The present review aims to address the rationale behind probiotic use in CF and discuss the hypothesis that nasal/aerosol administration of appropriate probiotic strains may help to exert a direct beneficial effect on the respiratory tract, increasing the effectiveness of probiotic interventions in CF patients.
Highlights
In the era of antibiotic resistance, the search for new therapeutic strategies as alternatives or adjuvants of antibiotic use is a widely recognized priority
The interest in the use of bacteriotherapy to prevent or cure human diseases has been markedly boosted by the advent of high throughput molecular analyses such as generation sequencing and “omics” technologies that have revealed that each body site has its own health-associated microbiota and that disturbance of this microbiota might be associated with a number of infectious and non-infectious human disorders
Most probiotics currently in use are Gram-positive bacteria belonging to the Lactobacillus and Bifidobacterium genera, but the list of genera/species with potential beneficial effects is rapidly expanding and generation of probiotics are being evaluated for future use [4]
Summary
In the era of antibiotic resistance, the search for new therapeutic strategies as alternatives or adjuvants of antibiotic use is a widely recognized priority. The continuous exposure of patients to antibiotics in the attempt to control the infections contributes to the insurgence of multidrug-resistant pathogens supporting the loss of microbiome diversity with age due to antibiotics use, with a parallel increase in disease severity [12]. In this scenario, the potential use of probiotic bacteria, either as prophylactic agents for preventing or delaying pulmonary colonization with CF pathogens, or as therapeutic tools to fight established pulmonary infections in CF has attracted considerable interest in recent years [13,14]. The aim of the present review is to highlight the rationale behind the use of probiotics in CF, and to discuss the hypothesis that a lung-directed bacteriotherapy, through airway administration of probiotics, could represent an alternative to probiotic diet supplementation to improve the benefits and clinical outcomes of this kind of intervention in CF
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
