Department of Pharmacology, S.S.R. College of Pharmacy, Silvassa, Dadra and Nagar Haveli, India, 396230.
Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, India.
Metab Brain Dis. 2022 Jan;37(1):185-195. doi: 10.1007/s11011-021-00862-w. Epub 2021 Nov 3.
Hepatic encephalopathy (HE) or hepatic coma is a demanding, not utterly understood complication of acute and chronic liver dysfunction and portosystemic shunting. In HE, hyperammonemia and inflammatory responses are believed to act in synergism. Probiotics, Lactobacillus plantarum UBLP40 and Bacillus clausii UBBC07 reduce small intestinal bacterial overgrowth and hyperammonemia, thereby preventing HE development.
The effect of probiotics-Lactobacillus plantarum UBLP40 (10 CFU/day, 14 days) and Bacillus clausii UBBC07 (10 CFU/day, 14 days) combination and standard drug-lactulose (2.5 ml/kg in 3 divided doses, 14 days) was studied in thioacetamide (250 mg/kg for three days) induced acute HE in rats by measuring behavioural parameters, biochemical parameters (serum AST, ALT, ALP and ammonia level), neurochemical parameters and histopathology study in brain and liver.
In contrast to only thioacetamide treated rats, probiotics treatment substantially (p < 0.001) reduced liver function parameters, i.e. serum AST, ALT, ALP, and ammonia, improved behaviour parameters, i.e. decreased motor disruption, improved memory impairment. Probiotics treated rats have also shown a substantial improvement in oxidative stress parameters i.e. reduced lipid peroxidation and increased glutathione level in brain tissue and ameliorated the histopathological changes induced by thioacetamide in the brain and liver.
It can be concluded based on the findings that the combination therapy of Lactobacillus plantarum UBLP40 and Bacillus clausiiUBBC07 proves to be effective in acute hepatic encephalopathy in the preclinical stage, and further studies are required to assess this therapy potential in the clinical setting.
肝性脑病(HE)或肝性昏迷是急性和慢性肝功能障碍和门体分流的一种严重但尚未完全被理解的并发症。在 HE 中,高血氨症和炎症反应被认为具有协同作用。益生菌、植物乳杆菌 UBLP40 和凝结芽孢杆菌 UBBC07 可减少小肠细菌过度生长和高血氨症,从而预防 HE 的发生。
通过测量行为学参数、生化参数(血清天冬氨酸转氨酶、丙氨酸转氨酶、碱性磷酸酶和血氨水平)、神经化学参数和大脑及肝脏组织病理学研究,研究了益生菌-植物乳杆菌 UBLP40(每天 10 CFU,14 天)和凝结芽孢杆菌 UBBC07(每天 10 CFU,14 天)联合标准药物乳果糖(每天 2.5 ml/kg,分 3 次服用,14 天)对硫代乙酰胺(250 mg/kg,连续 3 天)诱导的急性 HE 大鼠的作用。
与仅用硫代乙酰胺处理的大鼠相比,益生菌治疗显著(p<0.001)降低了肝功能参数,即血清天冬氨酸转氨酶、丙氨酸转氨酶、碱性磷酸酶和血氨,改善了行为参数,即减少运动障碍,改善记忆障碍。益生菌治疗的大鼠还显示出氧化应激参数的显著改善,即脑组织中脂质过氧化减少和谷胱甘肽水平增加,并改善了硫代乙酰胺在大脑和肝脏中引起的组织病理学变化。
根据这些发现可以得出结论,植物乳杆菌 UBLP40 和凝结芽孢杆菌 UBBC07 的联合治疗在临床前阶段对急性肝性脑病有效,需要进一步的研究来评估这种治疗方法在临床环境中的潜力。