Garlic as an inhibitor of Pseudomonas aeruginosa quorum sensing in cystic fibrosis--a pilot randomized controlled trial
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Garlic as an inhibitor of Pseudomonas aeruginosa quorum sensing in cystic fibrosis--a pilot randomized controlled trial. / Smyth, Alan R; Cifelli, Paramita M; Ortori, Catharine A; Righetti, Karima; Lewis, Sarah; Erskine, Penny; Holland, Elaine D; Givskov, Michael; Williams, Paul; Cámara, Miguel; Barrett, David A; Knox, Alan.
In: Pediatric Pulmonology, Vol. 45, No. 4, 01.04.2010, p. 356-62.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Garlic as an inhibitor of Pseudomonas aeruginosa quorum sensing in cystic fibrosis--a pilot randomized controlled trial
AU - Smyth, Alan R
AU - Cifelli, Paramita M
AU - Ortori, Catharine A
AU - Righetti, Karima
AU - Lewis, Sarah
AU - Erskine, Penny
AU - Holland, Elaine D
AU - Givskov, Michael
AU - Williams, Paul
AU - Cámara, Miguel
AU - Barrett, David A
AU - Knox, Alan
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Pseudomonas aeruginosa forms biofilms in the cystic fibrosis lung. Quorum sensing (QS) controls biofilm maturation, immune evasion, antibiotic tolerance and virulence factor production. Garlic shows QS inhibitory activity in vitro and in animal models. We report the first clinical trial in man of a QS inhibitor.We randomized 34 patients to garlic or olive oil capsules (both 656 mg daily). Clinical outcomes and safety bloods were measured at baseline and after 8 weeks treatment. In this exploratory study, analysis was per protocol.Eight patients withdrew, leaving 26 for analysis (13 garlic). With placebo, there was a greater decline in mean (SD) percentage change from baseline FEV(1) [-3.6% (11.3)] than with garlic [-2.0% (12.3)]. This was not significant (mean difference = 1.6, 95% CI -12.7 to 15.9, P = 0.8). The mean (SD) increase in weight was greater with garlic [1.0% (2.0)] than with placebo [0.6% (2.0)]--non-significant (mean difference = 0.4%, 95% CI -1.3 to 2.0, P = 0.6). The median (range) change in clinical score with garlic was -1 (-3 to 5) and 1 (-1 to 4) with placebo (negative score means improvement). This was non-significant [median difference = -1 (-3 to 0), P = 0.16]. In the garlic group, seven patients had IV antibiotics versus five placebo. There was a highly significant correlation between plasma and sputum measurements of the QS molecule 3-oxo-C12-HSL (Pearson correlation coefficient = 0.914, P = 0.004). At the end of treatment five patients in each group had abnormal liver function or triglycerides and five garlic patients (one placebo) reported minor adverse effects.Garlic capsules were well tolerated. Although there was no significant effect of garlic compared to placebo in this pilot study, there was a suggestion of improvement with garlic which should be investigated in a larger trial.
AB - Pseudomonas aeruginosa forms biofilms in the cystic fibrosis lung. Quorum sensing (QS) controls biofilm maturation, immune evasion, antibiotic tolerance and virulence factor production. Garlic shows QS inhibitory activity in vitro and in animal models. We report the first clinical trial in man of a QS inhibitor.We randomized 34 patients to garlic or olive oil capsules (both 656 mg daily). Clinical outcomes and safety bloods were measured at baseline and after 8 weeks treatment. In this exploratory study, analysis was per protocol.Eight patients withdrew, leaving 26 for analysis (13 garlic). With placebo, there was a greater decline in mean (SD) percentage change from baseline FEV(1) [-3.6% (11.3)] than with garlic [-2.0% (12.3)]. This was not significant (mean difference = 1.6, 95% CI -12.7 to 15.9, P = 0.8). The mean (SD) increase in weight was greater with garlic [1.0% (2.0)] than with placebo [0.6% (2.0)]--non-significant (mean difference = 0.4%, 95% CI -1.3 to 2.0, P = 0.6). The median (range) change in clinical score with garlic was -1 (-3 to 5) and 1 (-1 to 4) with placebo (negative score means improvement). This was non-significant [median difference = -1 (-3 to 0), P = 0.16]. In the garlic group, seven patients had IV antibiotics versus five placebo. There was a highly significant correlation between plasma and sputum measurements of the QS molecule 3-oxo-C12-HSL (Pearson correlation coefficient = 0.914, P = 0.004). At the end of treatment five patients in each group had abnormal liver function or triglycerides and five garlic patients (one placebo) reported minor adverse effects.Garlic capsules were well tolerated. Although there was no significant effect of garlic compared to placebo in this pilot study, there was a suggestion of improvement with garlic which should be investigated in a larger trial.
KW - 4-Butyrolactone
KW - Adolescent
KW - Adult
KW - Child
KW - Cystic Fibrosis
KW - Female
KW - Garlic
KW - Homoserine
KW - Humans
KW - Male
KW - Middle Aged
KW - Phytotherapy
KW - Pilot Projects
KW - Plant Oils
KW - Plasma
KW - Pseudomonas Infections
KW - Pseudomonas aeruginosa
KW - Quorum Sensing
KW - Respiratory Function Tests
KW - Sputum
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1002/ppul.21193
DO - 10.1002/ppul.21193
M3 - Journal article
C2 - 20306535
VL - 45
SP - 356
EP - 362
JO - Pediatric pulmonology. Supplement
JF - Pediatric pulmonology. Supplement
SN - 1054-187X
IS - 4
ER -
ID: 33952345