CD: Prebiotics/Probiotics (2021)

Author and Year:
Pinto-Sanchez M, Smecuol E, et al, 2017
PubMed ID:
Article Title:
Bifidobacterium infantis NLS Super Strain Reduces the Expression of a-Defensin-5, a Marker of Innate Immunity, in the Mucosa of Active Celiac Disease Patients.
Authors:
Pinto-Sánchez M, Smecuol E, Temprano M, Sugai E, González A, Moreno M, Huang X, Bercik P, Cabanne A, Vázquez H, Niveloni S, Mazure R, Mauriño E, Verdú E, Bai J
Journal:
Journal of Clinical Gastroenterology
Year of publication:
2017
Volume:
51
Issue:
9
Page numbers:
814-817
Study Design:
Cross-Sectional Study
Risk of Bias Assessment Rating:
Negative
Inclusion Criteria:
Patients attending Dr. C. Bonorino Udaondo Gastroenterology Hospital; participant in one of the following: Group 1) Recently diagnosed celiac disease (CD) patients who were participants in a previous exploratory, randomized, double-blinded, placebo-controlled study and did not received gluten free diet [(GFD), Smecuol et al., J Clin Gastroenterol 2013;47;139-147] plus participants in a prior observational study (Nachman F, et al, Dig Liver Dis 2010;42:685-691); Group 2) CD patients treated with B. infantis NSL-SS on a gluten-containing diet for 3 weeks (Smecuol et al., J Clin Gastroenterol 2013;47;139-147); and Group 3) CD patients after 1 year of strict gluten free diet (GFD). CD diagnosis based on Marsh III or greater lesion on duodenal biopsies and concomitant positive anti-transglutaminase antibody and antideaminated gliadin peptides. Informed consent.
Exclusion Criteria:
Not reported
Research Purpose:
To investigate the potential mechanisms of a probiotic B. infantis Natren Life Start super strain on the mucosal expression of innate immune markers in adult patients with active untreated CD compared with those treated with B. infantis x 6 weeks and after 1 year of GFD.
Blinding efforts:
Immunohistochemistry and semiquantification was performed in a blinded manner by analyzing 3 fields with the highest positive-staining areas selected from each patient.
Study Location:
Buenos Aires, Argentina
Source(s) of Funding:
Government
Please specify names of funders:
Canadian Institutes of Health Research
Quality Criteria Checklist: Primary Research
Relevance Questions
  1. Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies) Yes
  2. Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about? Yes
  3. Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice? Yes
  4. Is the intervention or procedure feasible? (NA for some epidemiological studies) Yes
 
Validity Questions
1. Was the research question clearly stated? Yes
  1.1. Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified? Yes
  1.2. Was (were) the outcome(s) [dependent variable(s)] clearly indicated? Yes
  1.3. Were the target population and setting specified? Yes
2. Was the selection of study subjects/patients free from bias? ???
  2.1. Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study? No
  2.2. Were criteria applied equally to all study groups? Yes
  2.3. Were health, demographics, and other characteristics of subjects described? Yes
  2.4. Were the subjects/patients a representative sample of the relevant population? ???
3. Were study groups comparable? ???
  3.3. Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.) Yes
  3.4. If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis? ???
  3.5. If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.) N/A
4. Was method of handling withdrawals described? Yes
  4.1. Were follow-up methods described and the same for all groups? Yes
  4.2. Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.) Yes
  4.3. Were all enrolled subjects/patients (in the original sample) accounted for? Yes
5. Was blinding used to prevent introduction of bias? Yes
  5.2. Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.) Yes
  5.3. In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded? Yes
6. Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described? ???
  6.2. In observational study, were interventions, study settings, and clinicians/provider described? No
  6.3. Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect? ???
  6.4. Was the amount of exposure and, if relevant, subject/patient compliance measured? ???
  6.5. Were co-interventions (e.g., ancillary treatments, other therapies) described? No
  6.7. Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups? Yes
7. Were outcomes clearly defined and the measurements valid and reliable? ???
  7.1. Were primary and secondary endpoints described and relevant to the question? Yes
  7.2. Were nutrition measures appropriate to question and outcomes of concern? ???
  7.4. Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures? ???
  7.5. Was the measurement of effect at an appropriate level of precision? ???
  7.6. Were other factors accounted for (measured) that could affect outcomes? ???
  7.7. Were the measurements conducted consistently across groups? ???
8. Was the statistical analysis appropriate for the study design and type of outcome indicators? Yes
  8.1. Were statistical analyses adequately described and the results reported appropriately? Yes
  8.2. Were correct statistical tests used and assumptions of test not violated? Yes
  8.3. Were statistics reported with levels of significance and/or confidence intervals? Yes
  8.4. Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)? Yes
  8.5. Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)? No
  8.6. Was clinical significance as well as statistical significance reported? Yes
  8.7. If negative findings, was a power calculation reported to address type 2 error? No
9. Are conclusions supported by results with biases and limitations taken into consideration? ???
  9.1. Is there a discussion of findings? Yes
  9.2. Are biases and study limitations identified and discussed? No
10. Is bias due to study's funding or sponsorship unlikely? Yes
  10.1. Were sources of funding and investigators' affiliations described? Yes
  10.2. Was the study free from apparent conflict of interest? Yes