The effects of chronic alcohol consumption on the bowel flora and the potential therapeutic role of probiotics in alcohol-induced liver injury have not previously been evaluated. In this study, sixty-six adult Russian males admitted to a psychiatric hospital with a diagnosis of alcoholic psychosis were enrolled in a prospective, randomized, clinical trial to study the effects of alcohol and probiotics on the bowel flora and alcohol-induced liver injury. Patients were randomized to receive 5 days of Bifidobacterium bifidum and Lactobacillus plantarum 8PA3 vs. standard therapy alone (abstinence plus vitamins). Stool cultures and liver enzymes were performed at baseline and again after therapy. Results were compared between groups and with 24 healthy, matched controls who did not consume alcohol. Compared to healthy controls, alcoholic patients had significantly reduced numbers of bifidobacteria (6.3 vs. 7.5 log CFU/g), lactobacilli (3.15 vs. 4.59 log CFU/g), and enterococci (4.43 vs. 5.5 log CFU/g). The mean baseline AST, ALT and GGT activities were significantly elevated in the alcoholic group when compared to the healthy control group (AST: 104.1 vs. 29.15 U/L; ALT: 50.49 vs. 22.96 U/L; GGT 161.5 vs. 51.88 U/L) indicating that these patients did have mild alcohol-induced liver injury. After 5 days of probiotic therapy, alcoholic patients had significantly increased numbers of both bifidobacteria (7.9 vs. 6.81 log CFU/g) and lactobacilli (4.2 vs. 3.2 log CFU/g) when compared to the standard therapy arm. Despite similar values at study initiation, patients treated with probiotics had significantly lower AST and ALT activity at the end of treatment than those treated with standard therapy alone (AST: 54.67 vs. 76.43 U/L; ALT 36.69 vs. 51.26 U/L). In a subgroup of 26 subjects with well-characterized mild alcoholic hepatitis (defined as AST and ALT greater than 30 U/L with AST to ALT ratio greater than one), probiotic therapy was associated with a significant end of treatment reduction in ALT, AST, GGT, LDH and total bilirubin. In this subgroup, there was a significant end of treatment mean ALT reduction in the probiotic arm vs. the standard therapy arm. In conclusion, patients with alcohol-induced liver injury have altered bowel flora when compared to healthy controls. Short-term oral supplementation with Bifidobacterium bifidum and Lactobacillus plantarum 8PA3 was associated with restoration of the bowel flora and greater improvement in alcohol-induced liver injury than standard therapy alone.
The system of antimicrobial peptides (AMP) is one of the most ancient mechanisms of the macroorganism resistance to infectious pathogens invasion. The aim of the study was to determine the role of the antimicrobial peptides system and periodontal pathogenic markers in the development and progression of inflammatory periodontal diseases. Gingival pocket washes (91 samples in total) for the research were received from patients with inflammatory periodontal diseases (chronic periodontitis and gingivitis) and intact periodontium. Using ELISA, the content of antimicrobial peptides was determined: human alpha-defensin (HNP 1-3), beta-defensin (HBD 1-3) and cathelicidin (LL-37). Periodontal pathogenic markers were isolated during RT-PCR. The study revealed differences in AMP concentrations by groups: level of HBD 2 in patients with chronic periodontitis was 1,36 times higher than those in the group of patients with chronic gingivitis (p=0,023) and 2,39 times higher than those in the control group (p<0,001), the content of HNP 1-3 in the group of patients with chronic periodontitis was reduced by 1,23 times compared with the indicators of the group of patients with gingivitis (p=0,045) and by 1,97 times compared with the indicators of the control group (p<0,001). The frequency of detection of periodontal pathogenic bacteria genes was 88,0% in patients with periodontitis, 76,92% in patients with gingivitis and 33,3% in the group with intact periodontium. HBD 2 content moderately correlated with the definition of P. gingivalis (r=0,612; p=0,022), T. forsythensis (r= 0,434; p=0,015), A. actinomycetemcomitans (r=0,483; p=0,006), a moderate negative correlation was detected between the content of HNP 1-3 and the release of periodontal pathogens in associations (P. gingivalis with T. forsythensis and T. denticola) (r=-0,388; p=0,031) in the group of patients with chronic periodontitis. Thus, the revealed relationships and correlations indicate shifts in the processes of reparative regeneration of the oral cavity and the regulation of local immunity in response to microbial invasion.
The results of biochemical parameters evaluation of blood dynamics and large intestine endoecology in patients with a syndrome of dependence on alcohol are presented. Friendly changes in enzymatic activity of blood serum and quantitative content of the main microflora representatives of large intestine in patients with acute alcoholic psychosis (AAP) are identified. It was produced ranking indicators of serum enzymes, lipids, pigment metabolism with subsequent calculation of the deviations from the physiological norm limits. The total degree of deviation indicators was considered as independent variables, the relationship that reflects a comprehensive assessment of the functional state of the liver to the extent that the large intestine dysbiosis. A mathematical model of regression-type complex quantitative estimation of biochemical status and microbiocenosis rectum at the AAP, based on the scale level, which reflects the cumulative severity of the patient's existing endoecological violations in the values of the analyzed parameters is made. Dynamics assessment of analyzed indicators changes in the course of treatment has allowed to identify the most important biochemical and microbiological parameters for future inclusion as predictors of liver disease progression risk in the development in a mathematical model of the relationship reducing the effectiveness of liver detoxification and dysbiotic shifts the large intestine microflora. The proposed approach can be used to facilitate the evaluation of the recovery of liver function in the process of the treatment on the level of the share of the mutual influence of the recovery in the intestinal microbiocenosis quantitative variables.
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