Probiotics in hepatology

Lata, Jan; Juránková, Jana; Kopáčová, Marcela; Vítek, Petr

doi:10.3748/wjg.v17.i24.2890

Cited by 54 publications

(40 citation statements)

References 53 publications

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“…74 Treatment of hepatic encephalopathy with lactobacillus acidophilus was studied as early as 1965. 75 More recently, Liu and colleagues offered a probiotic and prebiotic mixture to 97 patients with minimal hepatic encephalopathy and observed a reduction in ammonia levels and improvement in encephalopathy.…”

Section: Probiotic Therapy For Gastrointestinal Conditionsmentioning

confidence: 99%

A Gastroenterologist's Guide to Probiotics

Ciorba

2012

Clinical Gastroenterology and Hepatology

124

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The enteric microbiota contributes to gastrointestinal health and its disruption has been associated with many disease states. Some patients consume probiotic products in attempts to manipulate the intestinal microbiota for health benefit. It is important for gastroenterologists to improve their understanding of the mechanisms of probiotics and the evidence that support their use in practice. Clinical trials have assessed the therapeutic effects of probiotics for several disorders, including antibiotic-or Clostridium difficile-associated diarrhea, irritable bowel syndrome, and the inflammatory bowel diseases. Although probiotic research is a rapidly evolving field, there are sufficient data to justify a trial of probiotics for treatment or prevention of some of these conditions. However, the capacity of probiotics to modify disease symptoms is likely to be modest and varies among probiotic strains—not all probiotics are right for all diseases. The current review provides condition-specific rationale for using probiotics as therapy and literature-based recommendations.

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Section: Probiotic Therapy For Gastrointestinal Conditionsmentioning

confidence: 99%

A Gastroenterologist's Guide to Probiotics

Ciorba

2012

Clinical Gastroenterology and Hepatology

124

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“…Probiotics can modulate gut microbiota, the intestinal barrier, and the immune response and could therefore decrease pathological bacterial translocation and ameliorate immune system alterations in cirrhosis . These changes could not only improve liver function and help prevent bacterial infections and other complications, but also ameliorate cognitive dysfunction and avoid its consequences, such as overt hepatic encephalopathy, traffic accidents, deterioration of HRQOL, and falls …”

mentioning

confidence: 99%

Effect of a Multistrain Probiotic on Cognitive Function and Risk of Falls in Patients With Cirrhosis: A Randomized Trial

et al. 2019

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Probiotics can modulate gut microbiota, intestinal permeability, and immune response and could therefore improve cognitive dysfunction and help avoid potential consequences, such as falls, in patients with cirrhosis. The aim of this study was to evaluate the effect of a multistrain probiotic on cognitive function, risk of falls, and inflammatory response in patients with cirrhosis. Consecutive outpatients with cirrhosis and cognitive dysfunction (defined by a Psychometric Hepatic Encephalopathy Score [PHES] < −4) and/or falls in the previous year were randomized to receive either a sachet of a high‐concentration multistrain probiotic containing 450 billion bacteria twice daily for 12 weeks or placebo. We evaluated the changes in cognitive function (PHES); risk of falls (Timed Up and Go [TUG] test, gait speed, and incidence of falls); systemic inflammatory response; neutrophil oxidative burst; intestinal barrier integrity (serum fatty acid–binding protein 6 [FABP‐6] and 2 [FABP‐2] and zonulin and urinary claudin‐3); bacterial translocation (lipopolysaccharide‐binding protein [LBP]); and fecal microbiota. Thirty‐six patients were included. Patients treated with the probiotic (n = 18) showed an improvement in the PHES ( P = 0.006), TUG time ( P = 0.015) and gait speed ( P = 0.02), and a trend toward a lower incidence of falls during follow‐up (0% compared with 22.2% in the placebo group [n = 18]; P = 0.10). In the probiotic group, we observed a decrease in C‐reactive protein ( P = 0.01), tumor necrosis factor alpha ( P = 0.01), FABP‐6 ( P = 0.009), and claudin‐3 ( P = 0.002), and an increase in poststimulation neutrophil oxidative burst ( P = 0.002). Conclusion: The multistrain probiotic improved cognitive function, risk of falls, and inflammatory response in patients with cirrhosis and cognitive dysfunction and/or previous falls.

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“…The use of probiotics has been associated with decreased intestinal permeability and decreased bacterial translocation and endotoxemia in animal models and clinical studies 138. Patients eligible for liver transplants presented with increased intestinal permeability compared with healthy controls, a 30-day treatment with S. boulardii did not improve this intestinal permeability or the severity scores 139…”

Section: Measures To Diminish Increased Intestinal Permeability In Thmentioning

confidence: 99%

Intestinal permeability in a patient with liver cirrhosis

Valadez

Rivera-Espinosa

Méndez-Guerrero

et al. 2016

TCRM

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Liver cirrhosis is a worldwide public health problem, and patients with this disease are at high risk of developing complications, bacterial translocation from the intestinal lumen to the mesenteric nodes, and systemic circulation, resulting in the development of severe complications related to high mortality rate. The intestinal barrier is a structure with a physical and biochemical activity to maintain balance between the external environment, including bacteria and their products, and the internal environment. Patients with liver cirrhosis develop a series of alterations in different components of the intestinal barrier directly associated with the severity of liver disease that finally increased intestinal permeability. A “leaky gut” is an effect produced by damaged intestinal barrier; alterations in the function of tight junction proteins are related to bacterial translocation and their products. Instead, increasing serum proinflammatory cytokines and hemodynamics modification, which results in the appearance of complications of liver cirrhosis such as hepatic encephalopathy, variceal hemorrhage, bacterial spontaneous peritonitis, and hepatorenal syndrome. The intestinal microbiota plays a fundamental role in maintaining the proper function of the intestinal barrier; bacterial overgrowth and dysbiosis are two phenomena often present in people with liver cirrhosis favoring bacterial translocation. Increased intestinal permeability has an important role in the genesis of these complications, and treating it could be the base for prevention and partial treatment of these complications.

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Probiotics in hepatology

Cited by 54 publications

References 53 publications

A Gastroenterologist's Guide to Probiotics

A Gastroenterologist's Guide to Probiotics

Effect of a Multistrain Probiotic on Cognitive Function and Risk of Falls in Patients With Cirrhosis: A Randomized Trial

Intestinal permeability in a patient with liver cirrhosis

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