Department of Internal Medicine of Propedeutics No. 2, Bogomolets National Medical University and Diagnostic Center of Podil Community, Kiev, Ukraine.
Institute of Biology and Medicine, Taras Shevchenko National University, Kiev, Ukraine.
J Dig Dis. 2017 Dec;18(12):698-703. doi: 10.1111/1751-2980.12561.
To evaluate the therapeutic effect of a probiotic cocktail containing Lactobacilli, Bifidobacteria and Streptococcus thermophilus on non-alcoholic steatohepatitis (NASH).
In this open-label trial, 75 patients with NASH fed a low-fat/low-calorie diet were randomly divided into the control group and experimental group, with the latter receiving the probiotic cocktail once daily for 12 weeks.
All patients were diagnosed with fatty liver by ultrasound examination and had elevated levels of γ-glutamyl transferase (GGT) and alanine aminotransferase (ALT), and slightly increased body mass index (BMI) and cholesterol levels. BMI and serum cholesterol were reduced by the low-fat/low-calorie diet but ALT was not. However, the short-term (12-week) treatment with the probiotic cocktail caused a significant (by >20%) reduction of serum ALT compared with controls, indicating mitigation of inflammation. Accordingly, liver stiffness was decreased in the probiotic-treated group compared with the control group (P < 0.05). Moreover, a more significant decrease in the BMI and serum cholesterol was observed in the probiotic-treated group compared with control (P < 0.05). However, the reduction of GGT as a steatosis marker was insignificant. The composition of stool microbiota in probiotic-treated patients demonstrated a shift towards a normal pattern for all bacterial species examined. No adverse events were observed in any patient during the trial.
Short-term treatment with the probiotic cocktail caused significant improvement of liver inflammation without adverse events and, thus, may represent a promising candidate therapeutic approach for NASH.
评估含有乳杆菌、双歧杆菌和嗜热链球菌的益生菌鸡尾酒治疗非酒精性脂肪性肝炎（NASH）的疗效。
在这项开放标签试验中，75 名接受低脂肪/低热量饮食的 NASH 患者被随机分为对照组和实验组，后者每天接受一次益生菌鸡尾酒治疗，持续 12 周。
所有患者均通过超声检查诊断为脂肪肝，γ-谷氨酰转移酶（GGT）和丙氨酸氨基转移酶（ALT）水平升高，体重指数（BMI）和胆固醇水平略有升高。低脂/低热量饮食可降低 BMI 和血清胆固醇，但不能降低 ALT。然而，益生菌鸡尾酒的短期（12 周）治疗可显著降低血清 ALT 水平（与对照组相比，降幅>20%），表明炎症减轻。因此，与对照组相比，益生菌治疗组的肝硬度降低（P<0.05）。此外，与对照组相比，益生菌治疗组的 BMI 和血清胆固醇降低更为显著（P<0.05）。然而，作为脂肪变性标志物的 GGT 降低不显著。与对照组相比，益生菌治疗患者的粪便微生物组组成向所有检查细菌的正常模式转变。在试验过程中，任何患者均未出现不良反应。
益生菌鸡尾酒的短期治疗可显著改善肝脏炎症，无不良反应，因此可能成为 NASH 的一种有前途的治疗方法。
