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Multispecies probiotic may improve liver function for patients with cirrhosis

A probiotic, bacteria-based powder may preserve and increase liver function by enhancing serum neopterin levels and neutrophils’ production of reactive oxygen species in patients with cirrhosis according to research published in Alimentary Pharmacology and Therapeutics.

“High adherence to the study protocol and significantly lower dropout rate in the probiotic group suggest an improvement in the overall well-being of patients by the probiotics,” Angela Horvath, MSc, of the department of gastroenterology and hepatology, Medical University of Graz in Austria, and colleagues wrote.

Of the 80 patients in the Austrian-based study, 46 received the powder, which consisted of Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19 and Lactococcus lactis W58; the others received a placebo for 6 months.

Researchers used the amount of zonulin and calprotectin in stool, diamine oxidase in serum, sucrose recovery and lactulose–mannitol ratio to evaluate gut permeability; Phagotest/Bursttest to evaluate phagocytosis and burst function; nuclear magnetic resonance spectroscopy gauged differentiated sugar absorption tests; HEK-Blue LPS Detection Kit to measure endotoxins; and an enzyme-linked immunosorbent assay that evaluated serum and stool markers and neopterin, according to Horvath and colleagues.

“We found a significant but subclinical increase in neutrophil resting burst (2.6-3.2%; P = .0134) and neopterin levels (7.7-8.4 nmol/L; P = .001) with probiotics but not with placebo,” researchers wrote.

In the probiotic group, researchers found liver function and anti-microbial activity improved. Regardless of medication or placebo, neutrophil phagocytosis decreased and infection rates were low.

“Compliance to the study was excellent,” Horvath and researchers wrote. “There were significantly less dropouts in the probiotic group than expected and considered in the sample size calculation … and significantly less compared to the placebo group.”

The researchers further stated that side effects were mild and minimal in nature.

“Side effects were mild and most symptoms were gastrointestinal complaints, as expected with probiotics,” Horvath and colleagues wrote. “Most of the side effects appeared in the first 2 weeks of the intervention and subsided after that.”

Researchers noted the powder’s impact on bacterial translocation and barrier function is limited. “Initial gut barrier integrity levels, endotoxin load, endotoxin-like proteins and serum cytokine levels did not change for those in the probiotic group,” they wrote.  – by Janel Miller

Disclosures: Horvath reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.