BACKGROUND/AIMS: The pathogenesis of nonalcoholic fatty liver disease (NAFLD) may include increased insulin resistance, upregulation of proinflammatory cytokines, lipopolysaccharide, and BMI. Rifaximin is a minimally absorbable antibiotic that might act against a broad spectrum of gut bacteria. This study aimed to investigate the effects of rifaximin on NAFLD. PATIENTS AND METHODS: Fifty participants with biopsy-proven nonalcoholic steatohepatitis (NASH) were registered in this multicentric, double-blind, randomized, placebo-controlled study. BMI, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, lipid profile, serum endotoxin, homeostatic model assessment, toll-like receptor-4, interleukin-10 (IL-10), IL-6, tumor necrosis factor-α, andcytokeratin-18 (CK-18) levels were evaluated at baseline and at 1, 3, and 6 months of rifaximin therapy (1100 mg/day). RESULTS: Patients were randomized into two groups (rifaximin group; n=25 and placebo group; n=25). After 6 months of rifaximin therapy, patients with NASH showed a significant reduction in homeostatic model assessment, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, endotoxin, toll-like receptor-4, IL-6, tumor necrosis factor-α, CK-18, and NAFLD-liver fat score (all P<0.05), but no changes in the lipid profile; moreover, there was a mild nonstatistically significant reduction of BMI. However, in the placebo group, there was no significant difference in these variables at baseline and after therapy. CONCLUSION:Rifaximin therapy appears to be effective and safe in modifying NASH through reduction of serum endotoxin and improvement of insulin resistance, proinflammatory cytokines, CK-18, and NAFLD-liver fat score.
RCT Entities:
BACKGROUND/AIMS: The pathogenesis of nonalcoholic fatty liver disease (NAFLD) may include increased insulin resistance, upregulation of proinflammatory cytokines, lipopolysaccharide, and BMI. Rifaximin is a minimally absorbable antibiotic that might act against a broad spectrum of gut bacteria. This study aimed to investigate the effects of rifaximin on NAFLD. PATIENTS AND METHODS: Fifty participants with biopsy-proven nonalcoholic steatohepatitis (NASH) were registered in this multicentric, double-blind, randomized, placebo-controlled study. BMI, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, lipid profile, serum endotoxin, homeostatic model assessment, toll-like receptor-4, interleukin-10 (IL-10), IL-6, tumor necrosis factor-α, and cytokeratin-18 (CK-18) levels were evaluated at baseline and at 1, 3, and 6 months of rifaximin therapy (1100 mg/day). RESULTS:Patients were randomized into two groups (rifaximin group; n=25 and placebo group; n=25). After 6 months of rifaximin therapy, patients with NASH showed a significant reduction in homeostatic model assessment, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, endotoxin, toll-like receptor-4, IL-6, tumor necrosis factor-α, CK-18, and NAFLD-liver fat score (all P<0.05), but no changes in the lipid profile; moreover, there was a mild nonstatistically significant reduction of BMI. However, in the placebo group, there was no significant difference in these variables at baseline and after therapy. CONCLUSION:Rifaximin therapy appears to be effective and safe in modifying NASH through reduction of serum endotoxin and improvement of insulin resistance, proinflammatory cytokines, CK-18, and NAFLD-liver fat score.
Authors: Giuseppe Losurdo; Fulvio Salvatore D'Abramo; Giuseppe Indellicati; Chiara Lillo; Enzo Ierardi; Alfredo Di Leo Journal: Int J Mol Sci Date: 2020-05-16 Impact factor: 5.923
Authors: Zdeněk Dvořák; Felix Kopp; Hao Li; Aneta Vrzalová; Cait M Costello; Jazmin S Kemp; Martina Štěpánková; Iveta Bartoňková; Eva Jiskrová; Karolína Poulíková; Barbora Vyhlídalová; Lars U Nordstroem; Chamini V Karunaratne; Harmit S Ranhotra; Kyu Shik Mun; Anjaparavanda P Naren; Iain A Murray; Gary H Perdew; Julius Brtko; Lucia Toporova; Arne Schön; Bret D Wallace; William G Walton; Matthew R Redinbo; Katherine Sun; Amanda Beck; Sandhya Kortagere; Michelle C Neary; Aneesh Chandran; Saraswathi Vishveshwara; Maria M Cavalluzzi; Giovanni Lentini; Julia Yue Cui; Haiwei Gu; John C March; Shirshendu Chatterjee; Adam Matson; Dennis Wright; Kyle L Flannigan; Simon A Hirota; Ryan Balfour Sartor; Sridhar Mani Journal: EMBO Mol Med Date: 2020-03-10 Impact factor: 12.137
Authors: Domenico Ferro; Francesco Baratta; Daniele Pastori; Nicholas Cocomello; Alessandra Colantoni; Francesco Angelico; Maria Del Ben Journal: Nutrients Date: 2020-09-10 Impact factor: 5.717