Sang Hak Han1, Ki Tae Suk, Dong Joon Kim, Moon Young Kim, Soon Koo Baik, Young Don Kim, Gab Jin Cheon, Dae Hee Choi, Young Lim Ham, Dong Hoon Shin, Eun Ji Kim. 1. aDepartment of Pathology bDepartment of Internal Medicine cDepartment of Laboratory Medicine, Hallym University College of Medicine dCenter for Efficacy Assessment and Development of Functional Foods and Drugs, Hallym University eDepartment of Internal Medicine, Kangwon University College of Medicine, Chuncheon fDepartment of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju gDepartment of Internal Medicine, Ulsan University College of Medicine, Gangneung hDepartment of Emergency Medical Technology, Daewon University College, Jecheon, South Korea.
Abstract
BACKGROUND:Probiotics might reduce gut-derived microbial lipopolysaccharide (LPS) by restoring bowel flora in patients with alcoholic hepatitis (AH). We evaluated the therapeutic effects of probiotics in patients with AH. PATIENTS AND METHODS: Between September 2010 and April 2012, 117 patients (probiotics 60 and placebo 57) were prospectively randomized to receive the 7 days of cultured Lactobacillus subtilis/Streptococcus faecium (1500 mg/day) or placebo. All patients were hospitalized and were not permitted to consume alcohol for the 7 days of the study. Liver function test, proinflammatory cytokines, LPS, and colony-forming units by stool culture were examined and compared after therapy. RESULTS: In both groups, the mean levels of aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, bilirubin, and prothrombin time were significantly improved after 7 days of abstinence. In the probiotics group (baseline and after), albumin (3.5 ± 0.7 and 3.7 ± 0.6 g/dl, P=0.038) and tumor necrosis factor-α (121 ± 244 and 71 ± 123 pg/ml, P=0.047) showed differences. In addition, the number of colony-forming units of Escherichia coli was significantly reduced (435 ± 287 and 168 ± 210, P=0.002). In the placebo group, the level of LPS (1.7 ± 2.8 and 2.0 ± 2.7 EU/ml) was significantly increased. In the intergroup comparison, significant differences in the levels of tumor necrosis factor-α (P=0.042) and LPS (P=0.028) were observed between the groups. CONCLUSION: Immediate abstinence is the most important treatment for patients with AH. In addition, 7 days of oral supplementation with cultured L. subtilis/S. faecium was associated with restoration of bowel flora and improvement of LPS in patients with AH.
RCT Entities:
BACKGROUND: Probiotics might reduce gut-derived microbial lipopolysaccharide (LPS) by restoring bowel flora in patients with alcoholic hepatitis (AH). We evaluated the therapeutic effects of probiotics in patients with AH. PATIENTS AND METHODS: Between September 2010 and April 2012, 117 patients (probiotics 60 and placebo 57) were prospectively randomized to receive the 7 days of cultured Lactobacillus subtilis/Streptococcus faecium (1500 mg/day) or placebo. All patients were hospitalized and were not permitted to consume alcohol for the 7 days of the study. Liver function test, proinflammatory cytokines, LPS, and colony-forming units by stool culture were examined and compared after therapy. RESULTS: In both groups, the mean levels of aspartate aminotransferase/alanine aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, bilirubin, and prothrombin time were significantly improved after 7 days of abstinence. In the probiotics group (baseline and after), albumin (3.5 ± 0.7 and 3.7 ± 0.6 g/dl, P=0.038) and tumor necrosis factor-α (121 ± 244 and 71 ± 123 pg/ml, P=0.047) showed differences. In addition, the number of colony-forming units of Escherichia coli was significantly reduced (435 ± 287 and 168 ± 210, P=0.002). In the placebo group, the level of LPS (1.7 ± 2.8 and 2.0 ± 2.7 EU/ml) was significantly increased. In the intergroup comparison, significant differences in the levels of tumor necrosis factor-α (P=0.042) and LPS (P=0.028) were observed between the groups. CONCLUSION: Immediate abstinence is the most important treatment for patients with AH. In addition, 7 days of oral supplementation with cultured L. subtilis/S. faecium was associated with restoration of bowel flora and improvement of LPS in patients with AH.
Authors: Saman Khalesi; David Wayne Johnson; Katrin Campbell; Susan Williams; Andrew Fenning; Sonia Saluja; Christopher Irwin Journal: Eur J Nutr Date: 2017-11-08 Impact factor: 5.614
Authors: Ashwani K Singal; Sudha Kodali; Lee A Vucovich; Victor Darley-Usmar; Thomas D Schiano Journal: Alcohol Clin Exp Res Date: 2016-06-02 Impact factor: 3.455