Protective Effect of Probiotics against Esophagogastric Variceal Rebleeding in Patients with Liver Cirrhosis after Endoscopic Therapy

Zhang, Qun; Gao, Fangyuan; Yang, Xue; Hu, Ying; Liu, Yao; Hou, Yixin; Li, Yuxin; Zhu, Bin; Niu, Sheng; Huang, Yunyi; Wang, Xianbo

doi:10.12659/msm.924040

Cited by 6 publications

(4 citation statements)

References 48 publications

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“…In the present study, probiotic users benefited significantly, especially patients with CTP B and C classes. A similar effect of probiotics use was demonstrated in our previous study in patients with cirrhosis (Zhang et al, 2020b). The MELD score is a parameter of a liver function used to assess the prognosis of patients with cirrhosis (Bernardi et al, 2011).…”

Section: Discussionsupporting

confidence: 80%

Association between probiotic therapy and the risk of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis

Shi

Zhang

et al. 2023

Front. Cell. Infect. Microbiol.

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ObjectiveProbiotics may offer cancer-prevention benefits, based on experimental investigation results. This study aimed to determine the potential association between probiotics and hepatocellular carcinoma (HCC) in patients with hepatitis B-related cirrhosis (HBC) receiving antiviral therapy.DesignThis retrospective study included 1267 patients with HBC treated with entecavir or tenofovir between January 2013 and December 2017. The risk of developing HCC was compared between two cohorts of 449 probiotic users (taking a cumulative defined daily doses [cDDD] of ≥ 28) and 818 non-probiotic users (< 28 cDDD). To eliminate the bias caused by confounding factors, propensity score matching (PSM) was used.ResultsOn multivariate regression analysis, probiotic consumption was an independent protective factor for HCC occurrence. After PSM, the incidence of HCC was significantly lower in the probiotic users than that in the nonusers (adjusted hazard ratio [aHR]: 0.70, 95% confidence interval: 0.59–0.83, P < 0.001). The aHRs for probiotics with 28–89, 90–180, and >180 cDDD were 0.58, 0.28, and 0.12, respectively, indicating a dose-response pattern. In 28–89, 90–180, and >180 cDDD, the 3-year cumulative incidence of HCC was 8.7%, 4.7%, and 3.0%, respectively. A multivariate stratified analysis confirmed that the administration of probiotics could help patients.ConclusionAdjuvant probiotic therapy may reduce the risk of HCC in patients receiving antiviral medication for HBC. However, further clinical research is required to confirm these findings.

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Section: Discussionsupporting

confidence: 80%

Association between probiotic therapy and the risk of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis

Shi

Zhang

et al. 2023

Front. Cell. Infect. Microbiol.

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“…Faisal et al 38 found that an increased INR value can accurately predict early recurrent bleeding after ligation. Zhang et al 39 used a Cox proportional hazards regression model in a study on the correlation between probiotics and recurrent bleeding of EGVB in cirrhosis, and found that the INR was an independent risk factor for recurrent bleeding within 1 year (HR: 1.697). Our study also concluded that the INR is an independent risk factor for recurrent bleeding within 1 year (HR: 1.294).…”

Section: Discussionmentioning

confidence: 99%

The prognostic evaluation of ALBI score in endoscopic treatment of esophagogastric varices hemorrhage in liver cirrhosis

Liu,

Wu,

Cai

et al. 2024

Sci Rep

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To analyze the independent risk factors for recurrent bleeding and death within 1 year after endoscopic treatment of esophagogastric varices hemorrhage (EGVB) in patients with liver cirrhosis, and to validate the predictive value of ALBI score for recurrent bleeding and death within 1 year after endoscopic treatment of EGVB in patients with liver cirrhosis. A total of 338 patients with EGVB who received endoscopic treatment for the first time in the Department of Gastroenterology, First Affiliated Hospital of Nanchang University from January 1, 2016 to March 1, 2020 were selected. A database was established to analyze the patients’ demographic data, surgical variables and postoperative outcomes. All patients were contacted and followed up to verify the predictive value of ALBI score for recurrent bleeding and mortality. 130 patients had rebleeding within 1 year after surgery (38.5%). 66 patients died within 1 year after surgery (19.5%). Patients with ALBI grade 3 had significantly higher rebleeding and mortality rates than those with grades 1 and 2. The AUC was used to compare the predictive value of the four scores for rebleeding and mortality within one year after endoscopic surgery. Both ALBI scores had the largest AUC. The ALBI score has certain predictive value for rebleeding and mortality within 1 year after endoscopic therapy in patients with cirrhotic EGVB.

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“…Since gut microbiome alterations correlated with the severity, prognosis, and several complications of cirrhosis (Soléet al, 2021), probiotic therapy, which improves the composition of gut microbiota, has been increasingly studied in patients with liver cirrhosis in recent years (Pereg et al, 2011). Probiotic-assisted therapy can reduce variceal rebleeding events in cirrhotic patients and delay the occurrence of rebleeding after endoscopic therapy (Zhang et al, 2020). In addition, probiotics are recommended as a primary treatment for patients with hepatic encephalopathy (Agrawal et al, 2012;Lunia et al, 2014), as they could markedly improve the prognostic outcome of patients presenting with decreased Child-Pugh and Model for End-Stage Liver Disease (MELD) scores (Dhiman et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Alterations in the gut microbiota and the efficacy of adjuvant probiotic therapy in liver cirrhosis

Zhou

Liu

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundLiver cirrhosis is the end stage of various chronic liver diseases (CLDs). The gut microbiota can impact the liver environment and trigger chronic liver inflammation through the gut-liver axis. Alteration of the gut microbiota has become an effective strategy in the biological treatment of cirrhosis.MethodsTwenty-eight patients with liver cirrhosis and 16 healthy individuals were included, and fresh stool samples were collected. We analyzed changes in the gut microbiota between groups by 16S rRNA sequencing and evaluated the association between microbiota alterations and hepatic function. Additionally, 102 cirrhotic patients were retrospectively enrolled and divided into a probiotic group (n=44) and a nonprobiotic group (n=58) in addition to standard treatment for cirrhosis. Patients were monitored for hematological parameters and hepatic function during the six-month follow-up.ResultsThe gut microbiota profile of patients with cirrhosis was greatly different from that of healthy individuals, presenting with significantly reduced α diversity and decreased abundance of representative SCFA-producing bacteria including Firmicutes, Coprococcus and Clostridium IV. The pathogenic bacteria Gammaproteobacteria, Veillonella, and Bacilli were greatly enriched in cirrhotic patients. Additionally, patients with decompensated cirrhosis (DCPC) had a significantly reduced abundance of Oscillibacter compared to compensated cirrhosis (CPC), which is also a SCFA-producing bacteria, and the lower Firmicutes to Bacteroidetes ratio and enhanced MDR values were also shown in DCPC patients compared to CPC patients. In addition, the abundance of Firmicutes was negatively related to hepatic function in cirrhotic patients, including the levels of ALT, AST, and DBIL. From the retrospective study, we found that biochemical improvements in alanine transaminase (ALT) and total bilirubin (TBIL) were obtained in DCPC patients who received oral probiotic therapy compared with the nonprobiotic group.ConclusionSevere microbial dysbiosis existed in patients with liver cirrhosis, especially patients who reached the decompensatory stage. SCFA-producing bacteria were significantly reduced in cirrhosis. Altered gut microbiota cause changes in functional modules, which may contribute to cirrhosis progression and are associated with clinical prognosis. Adjuvant probiotic supplementation to enhance SCFA-producing bacteria can be a prospective therapy for patients with cirrhosis.

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Protective Effect of Probiotics against Esophagogastric Variceal Rebleeding in Patients with Liver Cirrhosis after Endoscopic Therapy

Cited by 6 publications

References 48 publications

Association between probiotic therapy and the risk of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis

Association between probiotic therapy and the risk of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis

The prognostic evaluation of ALBI score in endoscopic treatment of esophagogastric varices hemorrhage in liver cirrhosis

Alterations in the gut microbiota and the efficacy of adjuvant probiotic therapy in liver cirrhosis

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