TY - JOUR
T1 - RCT of the effect of berryfruit polyphenolic cultivar extract in mild steroid-naive asthma : a cross-over, placebo-controlled study
AU - Power, Sharon
AU - Williams, Mathew
AU - Semprini, Alex
AU - Munro, Claire
AU - Caswell-Smith, Rachel
AU - Pilcher, Janine
AU - Holliday, Mark
AU - Fingleton, James
AU - Harper, Jacquie
AU - Hurst, Roger
AU - Weatherall, Mark
AU - Beasley, Richard
AU - Braithwaite, Irene
PY - 2017
Y1 - 2017
N2 - Objective: There is preclinical evidence that consumption of berryfruit extract may reduce chronic airways inflammation and modify airway remodelling in allergen-induced models of lung inflammation. We investigated the effect of berryfruit extract on the fractional expired nitric oxide (FeNO), a biomarker of eosinophilic airways inflammation, in adults with steroid-naïve asthma. Design: Randomised placebo-controlled cross-over double-blind trial. Setting: Single-centre community-based trial. Participants: 28 steroid-naïve mild asthmatics with FeNO >40 ppb, of whom 25 completed both study interventions. Interventions: Participants were randomised to receive, according to the cross-over design, 100 mg berryfruit polyphenolic extract (BFPE) or placebo for 4 weeks, with a 4-week washout period between the interventions. Primary outcome measure: The primary outcome variable was FeNO at 4 weeks, analysed by a mixed linear model, with a random effect for participant and baseline FeNo as a covariate. Results: The mean (SD) natural logarithm transformed (ln) FeNO after 4 weeks of treatment for the BFPE and placebo groups was 4.28 (0.47) and 4.22 (0.47), respectively. The paired change from baseline mean (SD) BFPE minus placebo ln FeNO was -0.03 (0.39), N=25. The mixed linear model estimate, with baseline covariate adjustment, difference in ln FeNO, was -0.002 (95% CI -0.15 to 0.14), p=0.98. This is equivalent to a ratio of geometric mean FeNO of 1.0 (95% CI 0.86 to 1.15). Conclusions: In steroid-naïve participants with mild asthma and elevated FeNO, there was no effect of BFPE on FeNO, a biomarker of eosinophilic airways inflammation. Caution is required in the extrapolation of apparent benefit in murine models of lung eosinophilia to clinical efficacy in patients with asthma.
AB - Objective: There is preclinical evidence that consumption of berryfruit extract may reduce chronic airways inflammation and modify airway remodelling in allergen-induced models of lung inflammation. We investigated the effect of berryfruit extract on the fractional expired nitric oxide (FeNO), a biomarker of eosinophilic airways inflammation, in adults with steroid-naïve asthma. Design: Randomised placebo-controlled cross-over double-blind trial. Setting: Single-centre community-based trial. Participants: 28 steroid-naïve mild asthmatics with FeNO >40 ppb, of whom 25 completed both study interventions. Interventions: Participants were randomised to receive, according to the cross-over design, 100 mg berryfruit polyphenolic extract (BFPE) or placebo for 4 weeks, with a 4-week washout period between the interventions. Primary outcome measure: The primary outcome variable was FeNO at 4 weeks, analysed by a mixed linear model, with a random effect for participant and baseline FeNo as a covariate. Results: The mean (SD) natural logarithm transformed (ln) FeNO after 4 weeks of treatment for the BFPE and placebo groups was 4.28 (0.47) and 4.22 (0.47), respectively. The paired change from baseline mean (SD) BFPE minus placebo ln FeNO was -0.03 (0.39), N=25. The mixed linear model estimate, with baseline covariate adjustment, difference in ln FeNO, was -0.002 (95% CI -0.15 to 0.14), p=0.98. This is equivalent to a ratio of geometric mean FeNO of 1.0 (95% CI 0.86 to 1.15). Conclusions: In steroid-naïve participants with mild asthma and elevated FeNO, there was no effect of BFPE on FeNO, a biomarker of eosinophilic airways inflammation. Caution is required in the extrapolation of apparent benefit in murine models of lung eosinophilia to clinical efficacy in patients with asthma.
UR - https://hdl.handle.net/1959.7/uws:65043
U2 - 10.1136/bmjopen-2016-013850
DO - 10.1136/bmjopen-2016-013850
M3 - Article
SN - 2044-6055
VL - 7
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e013850
ER -