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The Effects of Prebiotics on Gut Bacterial Parameters, Immune Function & Exercise-Induced Airway Inflammation.

Primary Purpose

Exercised Induced Asthma, Asthma

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
HOST-DM059
Maltodextrin
Sponsored by
Nottingham Trent University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Exercised Induced Asthma focused on measuring Asthma, Exercise-Induced Asthma, Gut Bacteria, Bimuno® Galactooligosaccharide, Pulmonary Function, Prebiotics, Exercise-Induced Bronchoconstriction, Gut Microbiota, Nutritional Intervention, Eucapnic Voluntary Hyperpnoea, Systemic Inflammation, Systemic Immune Function, Regulatory T Cells, TH1 Cells, TH2 Cells, Short-Chain Fatty Acids, Acetate, Propionate, Butyrate, Metabolomics, Airway Inflammation, Intestinal Permeability

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Be 18-50 years of age at the date of your first visit.

Have a body mass index (BMI) of 18.5-25 kg∙m2 (this will be worked out by the researchers using the participant's height and body weight).

Be physically active (completing 3 or more exercise sessions a week lasting at least 45 minutes each).

Be a non-smoker.

Asthma is defined as Steps 1, 2, or 3 based on British Thoracic Society guidelines.

Asthma sufferers must have a current medication prescription from their GP (e.g. maintenance/reliever inhalers).

In the researcher's opinion, the participant is able and willing to follow all trial requirements.

Exclusion Criteria

Asthma defined as Steps 4 or 5 based on British Thoracic Society guidelines.

Asthma sufferers who do not have a current medication prescription from their GP (e.g. maintenance and reliever inhalers).

Regular consumption of Omega-3 supplements, and/or high levels of Omega-3 intake from food (e.g. consuming more than 1-2 portions of oily fish such as salmon or mackerel a week).

Regularly consume antioxidant supplements.

Standard multivitamin and mineral supplements are acceptable, as long as the product label states the recommended Dietary Reference Values (DRV's).

If a single antioxidant supplement (e.g. Vitamin C), exceeds the recommended daily DRV's this will be checked with the chief investigator.

Take a daily dose of aspirin or other non-steroidal anti-inflammatory drugs such as ibuprofen.

Have consumed prebiotics and/or probiotics, drugs that affect gastrointestinal mobility, or laxatives in the 4 weeks before participation.

Currently taking a daily dose of anti-histamine, which could not be refrained from for 72 hours before each testing session.

Unable to refrain from taking Asthma medication (e.g. maintenance and reliever inhalers) for a prescribed duration before each testing session (e.g. 8-96 hours).

Vegetarian or vegan diet.

Previously diagnosed with chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, or similar respiratory illness.

Participants with asthma that have ever been hospitalised due to asthma (e.g. intensive care unit).

Participants with asthma that have received treatment with oral corticosteroids/been admitted to hospital during the past 12 months for their asthma.

An increase/step-up in asthma medication during the study (e.g. moving from Step 1 to Step 2, Step 2 to Step 3 etc.).

Participants with asthma who do not obtain an additional prescription for a reliever inhaler to be stored securely at NTU if needed during visits. Additional prescriptions must be obtained before familiarisation/visit two. Participants will be reimbursed for the cost of additional reliever inhaler prescriptions.

History of heart failure, pulmonary hypertension, embolism, or other pulmonary heart disease.

History of recurrent chest infections.

Smoker.

Pregnant, planning pregnancy or lactating.

Had an acute infection in the last four weeks, and/or major operation in the past four months.

History of gastrointestinal drug reaction.

Have taken antibiotics in the past 3 months.

History or current evidence of gastrointestinal disease (e.g. chronic constipation, diarrhoea, irritable bowel syndrome, Chrohn's disease).

Have recently taken part in other research projects. Participants will be asked to notify the chief investigator.

Participants are, or believe that they are lactose intolerant.

Sites / Locations

  • Nottingham Trent University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

HOST-DM059 (Prebiotic)

Maltodextrin

Arm Description

HOST-DM059 is the only Second Generation Prebiotic, manufactured by Clasado Biosciences/HOST Therabiomics. HOST-DM059 consists of a specific type of carbohydrate/dietary fibre (GOS), and an enzyme extracted from species of Bifidobacteria (e.g. The β-Galacotosidase Enzyme, & Bifidobacterium Bifidum). The enzyme from which HOST-DM059 is developed provides a highly selective source of energy for certain species of Bifidobacteria. HOST-DM059 encourages the growth and development of Bifidobacteria. Certain species of Bifidobacteria have been demonstrated to exert prominent immunomodulatory effects in terms of regulating systemic inflammation.

Maltodextrin will be administered as a taste/appearance-matched sugar/carbohydrate.

Outcomes

Primary Outcome Measures

Changes In Regulatory T Cell FOXP3 Expression From Baseline To Post Prebiotic Supplementation.
Flow Cytometric Analysis: CD4+ CD25+ IL-10+ Regulatory T Cell FOXP3 Expression (

Secondary Outcome Measures

Change In Systemic Immune Function/Inflammatory Markers
Flow Cytometric Analysis: Interleukin (IL)-10, Hematopoietic Prostaglandin D Synthase Enzyme (Pathogenic Effector/Non-Pathogenic Effector TH2 Cells), CD3 (T Cells), CD25 (Regulatory T Cells), Transforming Growth Factor-Beta (TH2 Cells), Fork-Head Box Protein-3 (Regulatory T Cells), CD161 (PETH2 Cells), Interferon-Gamma (TH1 Cells), Live/Dead, Total & Specific White Blood Cell Counts (Eosinophils, Basophils, Neutrophils, Monocytes, Lymphocytes).
Change In Pulmonary Function (FEV1)
% Drop In Pulmonary Function (FEV1) Post EVH = 100*(Highest Baseline FEV1-Lowest Post EVH FEV1)/Highest Baseline FEV1. Used To Objectively Diagnose Asthma/EIB (> 10% Drop In FEV1 Post EVH At Two Consecutive Time Points), And Classify Severity As Mild (> 10% - < 25% Drop In FEV1), Moderate (> 25% - < 50% Drop In FEV1), Or Severe (> 30%, Or 50% Drop In FEV1 For Patients Receiving/Not Receiving Steroid Based Treatments). All Pulmonary Function Parameters: FEV1, FVC, PEF, FEF25%-75%. > 10% Reduction = Positive Objective Diagnosis (Asthma/EIB).
Change In The Asthma Control Questionnaire - Perceived Symptom Management
Common Asthma Symptoms Management: Night Time Awakening, Upon Waking Symptom Severity, Physical Activity Limitation, Dyspnoea (Breathlessness), Wheezing, Reliever Medication Usage (Rating 0-6).
Change In Urinary Metabolite Concentrations
E.G.: Acetic Acid, Propionic Acid, I-Butyric Acid, N-Butyric Acid, I-Valeric Acid, N-Valeric Acid, N-Caproic Acid.
Change In The Medication Adherence Report Scale For Asthma (MARS-A)
Asthma Medication & Nutritional Interventions Adherence Measurement (12 Questions) (Rating 1-5).
Change In 24 Hour Weighed Nutritional Intake Record
Quantitative Measurement - Habitual Nutritional Consumption (Assess Nutritional Intake Consistency Across Experimental Trials).
Changes In Intestinal Permeability Markers
Blood (Serum/Plasma) Based Measurement.

Full Information

First Posted
August 4, 2016
Last Updated
September 8, 2020
Sponsor
Nottingham Trent University
Collaborators
University of Reading, Clasado Biosciences, Imperial College London, HOST Therabiomics, The John van Geest Cancer Research Centre
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1. Study Identification

Unique Protocol Identification Number
NCT02872675
Brief Title
The Effects of Prebiotics on Gut Bacterial Parameters, Immune Function & Exercise-Induced Airway Inflammation.
Official Title
The Effects of HOST-DM059 Prebiotic Supplementation on Gut Bacterial Metabolites, and Markers of Systemic Inflammation in Adults With and Without Hyperpnoea-Induced Bronchoconstriction: A Double-Blind, Placebo-Controlled, Crossover Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
November 15, 2017 (Actual)
Primary Completion Date
April 30, 2019 (Actual)
Study Completion Date
April 30, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Nottingham Trent University
Collaborators
University of Reading, Clasado Biosciences, Imperial College London, HOST Therabiomics, The John van Geest Cancer Research Centre

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The current study aims to explore the role of prebiotic supplementation in adults with and without Asthma/Exercise-Induced Bronchoconstriction (A/EIB). All participants will be asked to consume a prebiotic supplement, and a placebo, each for a total duration of four weeks, separated by a two-week wash out period. The investigators hypothesise that improvements in pulmonary function observed in adults with Asthma following prebiotic supplementation. We hypothesise that improvements in pulmonary function will be attributed, at least in part, to gut microbiota mediated improvements in human immune function.
Detailed Description
The current study will investigate the effects of prebiotic supplementation on airway inflammation/bronchoconstriction in adults diagnosed with Asthma/Exercise-Induced Bronchoconstriction (A/EIB). Previous research conducted in adults diagnosed with A/EIB has reported significant improvements in pulmonary function following three weeks of prebiotic supplementation. The significant improvements in pulmonary function were attributed to an attenuation of various markers of airway inflammation, potentially regulated by gut microbiota mediated improvements in systemic immune function. Prebiotics are a type of non-digestible carbohydrate/dietary fibre that can only be digested by certain beneficial bacteria. During the fermentation of prebiotics, beneficial bacteria produce energy/metabolites that can be used to support a variety of human immune functions, such as reducing the level of airway inflammation that occurs following exposure to relevant triggers (e.g. exercise). Imbalances and/or deficiencies in gut bacterial composition/metabolic activity have been identified in children/adults diagnosed asthma. However, the potential mechanisms behind prebiotic mediated improvements in the severity of asthma have yet to be investigated. Participants with and without A/EIB will be allocated two separate nutritional supplements following a double-blind, placebo-controlled design. During the first phase of the nutritional intervention, participants will consume the first supplement (either prebiotic or placebo), for a total duration of four weeks. A two-week wash out period will then be completed before the remaining nutritional supplement is administered for an equal duration. Analyses of key human/bacterial metabolite concentrations will be carried out alongside assessments of immune and pulmonary function, and intestinal permeability at baseline, and throughout all phases of the nutritional intervention. Current understandings of the role of the gut microbiota in the pathogenesis of A/EIB will be expanded through the investigation of novel pathophysiological mechanisms, helping to inform future therapeutic prospects for asthma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Exercised Induced Asthma, Asthma
Keywords
Asthma, Exercise-Induced Asthma, Gut Bacteria, Bimuno® Galactooligosaccharide, Pulmonary Function, Prebiotics, Exercise-Induced Bronchoconstriction, Gut Microbiota, Nutritional Intervention, Eucapnic Voluntary Hyperpnoea, Systemic Inflammation, Systemic Immune Function, Regulatory T Cells, TH1 Cells, TH2 Cells, Short-Chain Fatty Acids, Acetate, Propionate, Butyrate, Metabolomics, Airway Inflammation, Intestinal Permeability

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Participants will be administered a prebiotic (galactooligosaccharide; HOST-DM059), and a taste/appearance matched placebo (Maltodextrin) in a, double-blind, placebo-controlled, crossover design. The nutritional intervention will be completed over a twelve week period, consisting of two, four-week supplementation phases separated by a four-week wash out period. Participants will be randomly allocated one of the nutritional supplements during phase one (labelled as either 'L', or 'X'), and asked to consume one powdered sachet every morning (3.6g). Participants will then complete a four week wash out period, before being assigned the remaining nutritional supplement during phase two. Sachets can be reconstituted in tea/coffee/fruit juice, or sprinkled over cereal etc.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Only the company providing the nutritional supplements (HOST Therabiomics) will be aware of the supplement blinding protocol. Upon trial completion (e.g. the final visit of the final participant), the chief investigator will contact HOST Therabiomics to obtain information on the supplement blinding protocol. Should any participants, care providers, investigators, or outcome assessors become aware of the blinding protocol during the trial they will be informed not to disclose this information to any other relevant personnel. Participants who become aware of the blinding protocol during participation would be withdrawn from the trial.
Allocation
Non-Randomized
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HOST-DM059 (Prebiotic)
Arm Type
Experimental
Arm Description
HOST-DM059 is the only Second Generation Prebiotic, manufactured by Clasado Biosciences/HOST Therabiomics. HOST-DM059 consists of a specific type of carbohydrate/dietary fibre (GOS), and an enzyme extracted from species of Bifidobacteria (e.g. The β-Galacotosidase Enzyme, & Bifidobacterium Bifidum). The enzyme from which HOST-DM059 is developed provides a highly selective source of energy for certain species of Bifidobacteria. HOST-DM059 encourages the growth and development of Bifidobacteria. Certain species of Bifidobacteria have been demonstrated to exert prominent immunomodulatory effects in terms of regulating systemic inflammation.
Arm Title
Maltodextrin
Arm Type
Placebo Comparator
Arm Description
Maltodextrin will be administered as a taste/appearance-matched sugar/carbohydrate.
Intervention Type
Dietary Supplement
Intervention Name(s)
HOST-DM059
Other Intervention Name(s)
Bimuno, B-GOS, Prebiotic, Galactooligosaccharide.
Intervention Description
Experimental Supplement: HOST-DM059. Participants will be asked to orally consume one powdered sachet each day, at the same time in the morning, reconstituted in tea/coffee/fruit juice, or sprinkled over cereal etc. Whichever method of consumption is chosen, this must be kept consistent across both supplementation phases.
Intervention Type
Dietary Supplement
Intervention Name(s)
Maltodextrin
Other Intervention Name(s)
Placebo
Intervention Description
Placebo Comparator: Maltodextrin.
Primary Outcome Measure Information:
Title
Changes In Regulatory T Cell FOXP3 Expression From Baseline To Post Prebiotic Supplementation.
Description
Flow Cytometric Analysis: CD4+ CD25+ IL-10+ Regulatory T Cell FOXP3 Expression (
Time Frame
Week 0, Week 4, Week 6, Week 10 (Collected At Rest).
Secondary Outcome Measure Information:
Title
Change In Systemic Immune Function/Inflammatory Markers
Description
Flow Cytometric Analysis: Interleukin (IL)-10, Hematopoietic Prostaglandin D Synthase Enzyme (Pathogenic Effector/Non-Pathogenic Effector TH2 Cells), CD3 (T Cells), CD25 (Regulatory T Cells), Transforming Growth Factor-Beta (TH2 Cells), Fork-Head Box Protein-3 (Regulatory T Cells), CD161 (PETH2 Cells), Interferon-Gamma (TH1 Cells), Live/Dead, Total & Specific White Blood Cell Counts (Eosinophils, Basophils, Neutrophils, Monocytes, Lymphocytes).
Time Frame
Week 0, Week 4, Week 6, Week 10 (Blood Sample Collected At Rest).
Title
Change In Pulmonary Function (FEV1)
Description
% Drop In Pulmonary Function (FEV1) Post EVH = 100*(Highest Baseline FEV1-Lowest Post EVH FEV1)/Highest Baseline FEV1. Used To Objectively Diagnose Asthma/EIB (> 10% Drop In FEV1 Post EVH At Two Consecutive Time Points), And Classify Severity As Mild (> 10% - < 25% Drop In FEV1), Moderate (> 25% - < 50% Drop In FEV1), Or Severe (> 30%, Or 50% Drop In FEV1 For Patients Receiving/Not Receiving Steroid Based Treatments). All Pulmonary Function Parameters: FEV1, FVC, PEF, FEF25%-75%. > 10% Reduction = Positive Objective Diagnosis (Asthma/EIB).
Time Frame
Week 0, Week 4, Week 6, Week 10 (At Rest & In Duplicate At 3, 6, 10, 15, 20, & 30 Minutes Post EVH).
Title
Change In The Asthma Control Questionnaire - Perceived Symptom Management
Description
Common Asthma Symptoms Management: Night Time Awakening, Upon Waking Symptom Severity, Physical Activity Limitation, Dyspnoea (Breathlessness), Wheezing, Reliever Medication Usage (Rating 0-6).
Time Frame
Weeks 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. (Upon Experimental Trial Arrival During Weeks 0, 4, 6, & 10).
Title
Change In Urinary Metabolite Concentrations
Description
E.G.: Acetic Acid, Propionic Acid, I-Butyric Acid, N-Butyric Acid, I-Valeric Acid, N-Valeric Acid, N-Caproic Acid.
Time Frame
Week 0, Week 4, Week 6, Week 10 (Urine Sample) (Collected At Rest & 60 Minutes Post EVH).
Title
Change In The Medication Adherence Report Scale For Asthma (MARS-A)
Description
Asthma Medication & Nutritional Interventions Adherence Measurement (12 Questions) (Rating 1-5).
Time Frame
Weeks 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. (Upon Experimental Trial Arrival During Weeks 0, 4, 6, & 10).
Title
Change In 24 Hour Weighed Nutritional Intake Record
Description
Quantitative Measurement - Habitual Nutritional Consumption (Assess Nutritional Intake Consistency Across Experimental Trials).
Time Frame
Week 0, Week 4, Week 8, Week 12 (24 Hours Before Experimental Trial).
Title
Changes In Intestinal Permeability Markers
Description
Blood (Serum/Plasma) Based Measurement.
Time Frame
Week 0, Week 4, Week 6, Week 10 (Blood Sample Collected At Rest).
Other Pre-specified Outcome Measures:
Title
Principal Component Analysis/Cluster Analysis - Primary/Secondary Outcome Measures
Description
All Relevant Meta-Data.
Time Frame
Post Data Collection.
Title
Partial Least Squares Discriminant Analysis.
Description
Urinary Metabolite Profiles. Untargetted Metabolomics. 1H Nuclear Magnetic Resonance (NMR) Spectroscopy.
Time Frame
Post Data Collection.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Be 18-50 years of age at the date of your first visit. Have a body mass index (BMI) of 18.5-25 kg∙m2 (this will be worked out by the researchers using the participant's height and body weight). Be physically active (completing 3 or more exercise sessions a week lasting at least 45 minutes each). Be a non-smoker. Asthma is defined as Steps 1, 2, or 3 based on British Thoracic Society guidelines. Asthma sufferers must have a current medication prescription from their GP (e.g. maintenance/reliever inhalers). In the researcher's opinion, the participant is able and willing to follow all trial requirements. Exclusion Criteria Asthma defined as Steps 4 or 5 based on British Thoracic Society guidelines. Asthma sufferers who do not have a current medication prescription from their GP (e.g. maintenance and reliever inhalers). Regular consumption of Omega-3 supplements, and/or high levels of Omega-3 intake from food (e.g. consuming more than 1-2 portions of oily fish such as salmon or mackerel a week). Regularly consume antioxidant supplements. Standard multivitamin and mineral supplements are acceptable, as long as the product label states the recommended Dietary Reference Values (DRV's). If a single antioxidant supplement (e.g. Vitamin C), exceeds the recommended daily DRV's this will be checked with the chief investigator. Take a daily dose of aspirin or other non-steroidal anti-inflammatory drugs such as ibuprofen. Have consumed prebiotics and/or probiotics, drugs that affect gastrointestinal mobility, or laxatives in the 4 weeks before participation. Currently taking a daily dose of anti-histamine, which could not be refrained from for 72 hours before each testing session. Unable to refrain from taking Asthma medication (e.g. maintenance and reliever inhalers) for a prescribed duration before each testing session (e.g. 8-96 hours). Vegetarian or vegan diet. Previously diagnosed with chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, or similar respiratory illness. Participants with asthma that have ever been hospitalised due to asthma (e.g. intensive care unit). Participants with asthma that have received treatment with oral corticosteroids/been admitted to hospital during the past 12 months for their asthma. An increase/step-up in asthma medication during the study (e.g. moving from Step 1 to Step 2, Step 2 to Step 3 etc.). Participants with asthma who do not obtain an additional prescription for a reliever inhaler to be stored securely at NTU if needed during visits. Additional prescriptions must be obtained before familiarisation/visit two. Participants will be reimbursed for the cost of additional reliever inhaler prescriptions. History of heart failure, pulmonary hypertension, embolism, or other pulmonary heart disease. History of recurrent chest infections. Smoker. Pregnant, planning pregnancy or lactating. Had an acute infection in the last four weeks, and/or major operation in the past four months. History of gastrointestinal drug reaction. Have taken antibiotics in the past 3 months. History or current evidence of gastrointestinal disease (e.g. chronic constipation, diarrhoea, irritable bowel syndrome, Chrohn's disease). Have recently taken part in other research projects. Participants will be asked to notify the chief investigator. Participants are, or believe that they are lactose intolerant.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Graham R Sharpe, PhD
Organizational Affiliation
Nottingham Trent University
Official's Role
Study Director
Facility Information:
Facility Name
Nottingham Trent University
City
Nottingham
State/Province
Nottinghamshire
ZIP/Postal Code
NG11 8NS
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Individual participant data may be made available to other researchers following completion of the current trial in an anonymised/pseudonymised format to prevent individual participant identification. Data will be provided in response to certain requests (e.g. if a systematic review and meta-analysis/statistical power calculation is being conducted that requires access to certain raw data).
Citations:
PubMed Identifier
26303339
Citation
Williams NC, Johnson MA, Hunter KA, Sharpe GR. Reproducibility of the bronchoconstrictive response to eucapnic voluntary hyperpnoea. Respir Med. 2015 Oct;109(10):1262-7. doi: 10.1016/j.rmed.2015.08.006. Epub 2015 Aug 13.
Results Reference
background
PubMed Identifier
26218845
Citation
Vulevic J, Juric A, Walton GE, Claus SP, Tzortzis G, Toward RE, Gibson GR. Influence of galacto-oligosaccharide mixture (B-GOS) on gut microbiota, immune parameters and metabonomics in elderly persons. Br J Nutr. 2015 Aug 28;114(4):586-95. doi: 10.1017/S0007114515001889. Epub 2015 Jul 28.
Results Reference
background
PubMed Identifier
27523186
Citation
Williams NC, Johnson MA, Shaw DE, Spendlove I, Vulevic J, Sharpe GR, Hunter KA. A prebiotic galactooligosaccharide mixture reduces severity of hyperpnoea-induced bronchoconstriction and markers of airway inflammation. Br J Nutr. 2016 Sep;116(5):798-804. doi: 10.1017/S0007114516002762.
Results Reference
background
PubMed Identifier
26840903
Citation
Hevia A, Milani C, Lopez P, Donado CD, Cuervo A, Gonzalez S, Suarez A, Turroni F, Gueimonde M, Ventura M, Sanchez B, Margolles A. Allergic Patients with Long-Term Asthma Display Low Levels of Bifidobacterium adolescentis. PLoS One. 2016 Feb 3;11(2):e0147809. doi: 10.1371/journal.pone.0147809. eCollection 2016.
Results Reference
background
PubMed Identifier
26424567
Citation
Arrieta MC, Stiemsma LT, Dimitriu PA, Thorson L, Russell S, Yurist-Doutsch S, Kuzeljevic B, Gold MJ, Britton HM, Lefebvre DL, Subbarao P, Mandhane P, Becker A, McNagny KM, Sears MR, Kollmann T; CHILD Study Investigators; Mohn WW, Turvey SE, Finlay BB. Early infancy microbial and metabolic alterations affect risk of childhood asthma. Sci Transl Med. 2015 Sep 30;7(307):307ra152. doi: 10.1126/scitranslmed.aab2271.
Results Reference
background

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The Effects of Prebiotics on Gut Bacterial Parameters, Immune Function & Exercise-Induced Airway Inflammation.

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