Lorenza Putignani1, Anna Alisi, Valerio Nobili. 1. *Units of Parasitology †Human Microbiome ‡Liver Research Unit §Hepato-metabolic Disease Unit, Bambino Gesù Children's Hospital and IRCCS, Rome, Italy.
Abstract
PURPOSE OF REVIEW: Clinical evidence of the use of probiotics in pediatric NAFLD, framed within gut microbiota response, is herein discussed. RECENT FINDINGS: The assistance of a new microbiological approach in probiotics' design is playing a central role in NAFLD clinical management. Experimental studies demonstrated the effect of gut microbiota manipulation in NAFLD and recent clinical evidence reported their beneficial effect in pediatric patients. SUMMARY: Epidemiology suggests that NAFLD is the most frequent pediatric chronic liver disease evolving from simple steatosis to a more severe form that may progress toward fibrosis. The goal of pharmacological treatment of NAFLD-related fibrosis is to stop and eventually to reverse liver damage, but no drug tested so far seem to be able to reach this endpoint. A few encouraging clinical studies demonstrated an improvement of hepato-metabolic milieu under probiotic treatment suggesting that they could exert an anti-fibrotic activity.Currently, new insights onto probiotics can be deduced by ad hoc generated NAFLD gut microbiota profiles. These functional maps may unveil gut ecosystem dynamics under probiotics' treatment, selecting the most appropriate for NAFLD gut microbiota amelioration.
PURPOSE OF REVIEW: Clinical evidence of the use of probiotics in pediatric NAFLD, framed within gut microbiota response, is herein discussed. RECENT FINDINGS: The assistance of a new microbiological approach in probiotics' design is playing a central role in NAFLD clinical management. Experimental studies demonstrated the effect of gut microbiota manipulation in NAFLD and recent clinical evidence reported their beneficial effect in pediatric patients. SUMMARY: Epidemiology suggests that NAFLD is the most frequent pediatric chronic liver disease evolving from simple steatosis to a more severe form that may progress toward fibrosis. The goal of pharmacological treatment of NAFLD-related fibrosis is to stop and eventually to reverse liver damage, but no drug tested so far seem to be able to reach this endpoint. A few encouraging clinical studies demonstrated an improvement of hepato-metabolic milieu under probiotic treatment suggesting that they could exert an anti-fibrotic activity.Currently, new insights onto probiotics can be deduced by ad hoc generated NAFLD gut microbiota profiles. These functional maps may unveil gut ecosystem dynamics under probiotics' treatment, selecting the most appropriate for NAFLD gut microbiota amelioration.
Authors: Anna Di Sessa; Grazia Cirillo; Stefano Guarino; Pierluigi Marzuillo; Emanuele Miraglia Del Giudice Journal: Pediatric Health Med Ther Date: 2019-08-23