Horvath A, Leber B, Schmerboeck B, Tawdrous M, Zettel G, Hartl A, Madl T, Stryeck S, Fuchs D, Lemesch S, Douschan P, Krones E, Spindelboeck W, Durchschein F, Rainer F, Zollner G, Stauber R E, Fickert P, Stiegler P, Stadlbauer V
Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.
Department of Transplantation Surgery, Medical University of Graz, Graz, Austria.
Aliment Pharmacol Ther. 2016 Nov;44(9):926-935. doi: 10.1111/apt.13788. Epub 2016 Sep 4.
Probiotics may correct intestinal dysbiosis and proinflammatory conditions in patients with liver cirrhosis.
To test the effects of a multispecies probiotic on innate immune function, bacterial translocation and gut permeability.
In a randomised, double blind, placebo-controlled study, stable cirrhotic out-patients either received a daily dose of a probiotic powder containing eight different bacterial strains (Ecologic Barrier, Winclove, Amsterdam, The Netherlands) (n = 44) or a placebo (n = 36) for 6 months and were followed up for another 6 months.
We found a significant but subclinical increase in neutrophil resting burst (2.6-3.2%, P = 0.0134) and neopterin levels (7.7-8.4 nmol/L, P = 0.001) with probiotics but not with placebo. Probiotic supplementation did not have a significant influence on neutrophil phagocytosis, endotoxin load, gut permeability or inflammatory markers. Ten severe infections occurred in total; one during intervention in the placebo group, and five and four after the intervention has ended in the probiotic and placebo group, respectively. Liver function showed some improvement with probiotics but not with placebo.
Probiotic supplementation significantly increased serum neopterin levels and the production of reactive oxygen species by neutrophils. These findings might explain the beneficial effects of probiotics on immune function. Furthermore, probiotic supplementation may be a well-tolerated method to maintain or even improve liver function in stable cirrhosis. However, its influence on gut barrier function and bacterial translocation in cirrhotic patients is minimal.
益生菌可能纠正肝硬化患者的肠道菌群失调和促炎状态。
测试一种多菌种益生菌对固有免疫功能、细菌移位和肠道通透性的影响。
在一项随机、双盲、安慰剂对照研究中，病情稳定的肝硬化门诊患者接受每日一剂含八种不同菌株的益生菌粉（Ecologic Barrier，Winclove，荷兰阿姆斯特丹）（n = 44）或安慰剂（n = 36），为期6个月，并再随访6个月。
我们发现，使用益生菌后中性粒细胞静息爆发显著但仍处于亚临床水平增加（2.6 - 3.2%，P = 0.0134），新蝶呤水平升高（7.7 - 8.4 nmol/L，P = 0.001），而使用安慰剂则无此现象。补充益生菌对中性粒细胞吞噬作用、内毒素负荷、肠道通透性或炎症标志物无显著影响。总共发生了10次严重感染；安慰剂组在干预期间发生1次，益生菌组和安慰剂组在干预结束后分别发生5次和4次。益生菌使肝功能有所改善，而安慰剂则无此作用。
补充益生菌显著提高血清新蝶呤水平以及中性粒细胞的活性氧生成。这些发现可能解释了益生菌对免疫功能的有益作用。此外，补充益生菌可能是维持甚至改善稳定期肝硬化患者肝功能的一种耐受性良好的方法。然而，其对肝硬化患者肠道屏障功能和细菌移位的影响极小。
