A recent clinical trial revealed that a combination of high-dose vitamin D3 and the prebiotic inulin significantly improved the diversity of bacteria in the airways and lungs of individuals with cystic fibrosis (CF). The study, published in the Journal of Clinical and Translational Endocrinology, sheds light on a potential strategy to address microbiome dysregulation in CF patients.
The human microbiome, comprising trillions of bacteria and other microscopic organisms, plays a crucial role in overall health. These microorganisms inhabit various parts of the body, particularly the lungs and digestive tract. Emerging research indicates that the microbiome in individuals with CF tends to become dysregulated, leading to decreased diversity and an overgrowth of bacteria associated with inflammation and disease. Restoring microbiome balance may offer a therapeutic avenue for CF treatment.
In the pilot study titled “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,” researchers explored the effects of vitamin D3 and inulin on microbiome diversity. Vitamin D3, a form of vitamin D, has been linked to the promotion of healthy bacterial growth. Inulin, a dietary fiber that humans cannot digest but bacteria can utilize as a food source, serves as a prebiotic.
The study involved 40 adult CF patients who were randomly assigned to one of four groups: a placebo group, a vitamin D3-only group, an inulin-only group, or a group receiving both vitamin D3 and inulin. Over 12 weeks, participants in the combined treatment group received a daily dose of 50,000 international units (IU) of vitamin D3 and 12 grams of inulin. For context, the recommended daily dose of vitamin D is 400-800 IU.
Results from the study showed that the combination of vitamin D3 and inulin led to notable improvements in microbiome diversity in both the gut and airways, outperforming the other groups, including the placebo. Importantly, the treatment was well-tolerated, with no severe safety issues reported, and an average tolerability score of 4.06 out of 5.
“This pilot study demonstrated 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,” the researchers concluded. They emphasized that, while the study primarily aimed to assess the feasibility of the intervention, further research is needed to confirm these promising findings.
The trial, conducted amid the COVID-19 pandemic, faced challenges such as limited in-person visits, highlighting the need for additional studies to validate the results and explore the full potential of this combined treatment approach in managing cystic fibrosis.
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