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Is there a role for probiotics in liver diseases?

New Research

Non alcoholic fatty liver disease is the most common chronic liver disease worldwide. Could probiotics offer a novel therapeutic option for the treatment of this condition?

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Nonalcoholic liver disease (NAFLD)  is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells. It's usually seen in people who are overweight or obese. Early-stage NAFLD doesn't usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse. Having high levels of fat in the liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes. Currently, NAFLD has become the most common cause of chronic liver disease worldwide (1,2).

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There is an anatomical link between the intestine and the liver via the hepatic portal system. Based on the connection between the intestine and the liver, also termed gut-liver axis, gut microbiota and their metabolic by-products may influence liver pathology (3). It is unsurprising that gut microbiota dysbiosis has been linked with NAFLD. A recently published study in Nature, describes the characteristics of gut microbiota in the progression of NAFLD and analyses the relationship between gut microbiota and LPS/TLR4 in this process. (Higher levels of LPS are seen when the intestinal barrier is impaired. LPS is the main bacterial byproduct that is likely to be involved in NAFLD pathogenesis. TLR4 is a receptor for LPS.)  Furthermore, the researchers investigated the effect of probiotic intervention on gut flora structure, intestinal integrity, and liver pathology. 

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Different microbial innate immune mechanisms affect host metabolism in the gut and liver. Source Nature.

 

 

The researchers found that probiotics could improve the integrity of the gut, suggesting that probiotics could protect the intestinal barrier. Therebye, probiotics may reduce the hepatic and systemic inflammatory response caused by endotoxin and inflammatory cytokines through LPS/TLR4 signalling. Consequently, probiotics could ameliorate liver inflammation and thus delay or prevent NFLD progression.

The researchers conclude that; “Our finding revealed that probiotics supplementation could realize the balance of gut flora. Suggesting that dietary intervention targeting gut flora would provide a new approach to prevent and treat NAFLD”.

 

This new research is in line with previous research from the University of Graz in collaboration with Institute Allergosan and Winclove Probiotics .  The results of this study show that administration of probiotics for 6 months significantly improved antimicrobial activity and immune function, and improved liver function (4). 

 

 

Read the scientific article 

References

1. Ahmed M. Non-alcoholic fatty liver disease in 2015World journal of hepatology 7, 1450–1459, doi: 10.4254/wjh.v7.i11.1450 (2015)

2. Williams C. D. et al. . Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective studyGastroenterology 140, 124–131

3. Compare D. et al.  Gut–liver axis: the impact of gut microbiota on non alcoholic fatty liver diseaseNutrition, metabolism, and cardiovascular diseases: NMCD 22, 471–476,

4. Horvat A., et al. Randomised clinical trial: the effects of a multispecies probiotic vs. placebo on innate immune function, bacterial translocation and gut permeability in patients with cirrhosis. Aliment Pharmacol Ther. 2016 Nov;44(9):926-935.

 

 

 

Liver Cirrhosis

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