A Double-Blind, Randomized Placebo-Controlled Trial of Probiotic Lactobacillus casei Shirota in Stable Cirrhotic Patients
| Autor: | Sarah Fairclough, Helen E. Jones, I. Jane Cox, Kaori Suzuki, Rohit Sawhney, Rajiv Jalan, Nathan Davies, Alba Moratella, Joanne T Marsden, Roger Williams, Gavin Wright, Francesco Figorilli, Jane Macnaughtan, Linda Thomas, R.P. Mookerjee, Elisabet Garcia-Lopez, Haw Lu |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Alcoholic liver disease medicine.medical_specialty Lactobacillus casei Cirrhosis Placebo-controlled study lcsh:TX341-641 chemical and pharmacologic phenomena Placebo Gastroenterology law.invention 03 medical and health sciences Probiotic 0302 clinical medicine law Internal medicine medicine cytokine Decompensation Nutrition and Dietetics Intestinal permeability biology integumentary system business.industry cirrhosis neutrophil medicine.disease biology.organism_classification 030104 developmental biology 030211 gastroenterology & hepatology business lcsh:Nutrition. Foods and food supply probiotic Food Science |
| Zdroj: | Nutrients Volume 12 Issue 6 Nutrients, Vol 12, Iss 1651, p 1651 (2020) |
| ISSN: | 2072-6643 |
| DOI: | 10.3390/nu12061651 |
| Popis: | Background: In cirrhosis, a pathological gut microbiome has been linked with immune dysfunction. A pilot study of probiotic Lactobacillus casei Shirota (LcS) in alcoholic cirrhosis demonstrated significant improvement in neutrophil function. This study aimed to evaluate the efficacy of LcS on neutrophil function and significant infection rates in patients with cirrhosis. Methods: 92 cirrhotic patients (Child&ndash Pugh score &le 10) were randomized to receive LcS or placebo, three times daily for six months. Primary end-points were incidence of significant infection and neutrophil function. Secondary end-points were cytokine profile, endotoxin, bacterial DNA positivity, intestinal permeability and quality of life. Results: Rates of infection, decompensation or neutrophil function did not differ between placebo and probiotic groups. LcS significantly reduced plasma monocyte chemotactic protein-1 and, on subgroup analysis, plasma interleukin-1&beta (alcoholic cirrhosis), interleukin-17a and macrophage inflammatory protein-1&beta (non-alcoholic cirrhosis), compared with placebo. No significant differences in intestinal permeability, bacterial translocation or metabolomic profile were observed. Conclusion: LcS supplementation in patients with early cirrhosis is safe. Although no significant infections were observed in either group, LcS improved cytokine profile towards an anti-inflammatory phenotype, an effect which appears to be independent of bacterial translocation. |
| Databáze: | OpenAIRE |
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