Back to Search
Start Over
Oral probiotic VSL#3 attenuates the circulatory disturbances of patients with cirrhosis and ascites.
- Source :
-
Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2014 Nov; Vol. 34 (10), pp. 1504-12. Date of Electronic Publication: 2014 Apr 04. - Publication Year :
- 2014
-
Abstract
- Background & Aims: The modulation of gut flora constitutes a therapeutic tool in patients with liver disease, but some of its modalities require further investigation. Here, we evaluated the effects of probiotics on the hepatic and systemic haemodynamic alterations of advanced liver disease.<br />Methods: Seventeen patients with cirrhosis and ascites were prospectively included, five of whom abandoned this study prematurely. Hepatic and systemic haemodynamic evaluations were performed at baseline and after 6 weeks of receiving an oral VSL#3 probiotic preparation. Peripheral blood analyses included the evaluation of cytokines (TNF-alpha, IL-1beta, IL-6), bacterial translocation [bacterial DNA and lipopolysaccharide-binding protein (LBP)] and nitric oxide end-products (NOx).<br />Results: In 12 patients completing this study, the oral administration of VSL#3 resulted in reductions of the hepatic venous pressure gradient (HVPG, P < 0.001), cardiac index and heart rate (both P < 0.01) and in increases of the systemic vascular resistance (P < 0.05) and mean arterial pressure (P = 0.06). HVPG decreased at least 10% from baseline in eight patients (67%). Serum sodium increased in most patients (P < 0.01). All these changes were unrelated to the detection of bacterial DNA or to the levels of LBP, pro-inflammatory cytokines or NOx. No significant adverse effects were observed.<br />Conclusion: Administration of the probiotic mixture VSL#3 improved the hepatic and systemic haemodynamics and serum sodium levels in patients with cirrhosis. Our results identify major effects of probiotics in liver disease and provide the rationale for assessing their therapeutic potential against the progression of portal hypertension and its complications in future clinical trials.<br /> (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Acute-Phase Proteins
Administration, Oral
Adult
Aged
Base Sequence
Carrier Proteins blood
Cytokines blood
DNA Primers genetics
DNA, Bacterial blood
DNA, Bacterial genetics
Heart Rate drug effects
Humans
Membrane Glycoproteins blood
Middle Aged
Molecular Sequence Data
Probiotics administration & dosage
Prospective Studies
RNA, Ribosomal, 16S genetics
Sequence Analysis, DNA
Sodium blood
Spain
Statistics, Nonparametric
Vascular Resistance drug effects
Venous Pressure drug effects
Ascites physiopathology
Hemodynamics drug effects
Liver Cirrhosis physiopathology
Probiotics pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 1478-3231
- Volume :
- 34
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 24661740
- Full Text :
- https://doi.org/10.1111/liv.12539