{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:36:26Z","timestamp":1790811386841,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Cystic fibrosis (CF)\u2010related diabetes (CFRD) affects 50% of CF adults. Gut microbial imbalance (dysbiosis) aggravates their inflammatory response and contributes to insulin resistance (IR). We hypothesized that probiotics may improve glucose tolerance by correcting dysbiosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010center prospective pilot study assessing the effect of Vivomixx\u00ae probiotic (450 billion\/sachet) on clinical status, spirometry, lung clearance index (LCI), and quality of life (QOL) questionnaires; inflammatory parameters (urine and stool metabolomics, blood cytokines); and glucose metabolism (oral glucose tolerance test [OGTT]), continuous glucose monitoring [CGM], and homeostasis model assessment of IR (HOMA\u2010IR) in CF patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three CF patients (six CFRD), mean age 17.7\u2009\u00b1\u20098.2 years. After 4 months of probiotic administration, urinary cysteine (<jats:italic>p<\/jats:italic>\u2009=\u20090.018), lactulose (<jats:italic>p<\/jats:italic>\u2009=\u20090.028), arabinose (<jats:italic>p<\/jats:italic>\u2009=\u20090.036), mannitol (<jats:italic>p<\/jats:italic>\u2009=\u20090.041), and indole 3\u2010lactate (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) significantly increased, while 3\u2010methylhistidine (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) and N\u2010acetyl glutamine (<jats:italic>p<\/jats:italic>\u2009=\u20090.047) decreased. Stool 2\u2010Hydroxyisobutyrate (<jats:italic>p<\/jats:italic>\u2009=\u20090.022) and 3\u2010methyl\u20102\u2010oxovalerate (<jats:italic>p<\/jats:italic>\u2009=\u20090.034) decreased. Principal component analysis, based on urine metabolites, found significant partitions between subjects at the end of treatment compared to baseline (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). After 2 months of probiotics, the digestive symptoms domain of Cystic Fibrosis Questionnaire\u2010Revised improved (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). In the nondiabetic patients, a slight decrease in HOMA\u2010IR, from 2.28 to 1.86, was observed. There was no significant change in spirometry results, LCI, blood cytokines and CGM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Changes in urine and stool metabolic profiles, following the administration of probiotics, may suggest a positive effect on glucose metabolism in CF. Larger long\u2010term studies are needed to confirm our findings. Understanding the interplay between dysbiosis, inflammation, and glucose metabolism may help preventing CFRD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26037","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T04:34:20Z","timestamp":1654749260000},"page":"2335-2343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effect of probiotic administration on metabolomics and glucose metabolism in CF patients"],"prefix":"10.1002","volume":"57","author":[{"given":"Michal","family":"Gur","sequence":"first","affiliation":[{"name":"Pediatric Pulmonary Institute and CF Center Rappaport Children's Hospital, Rambam Health Care Campus  Haifa Israel"},{"name":"Rappaport Faculty of Medicine Technion\u2013Israel Institute of Technology  Haifa 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