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Treatment efficacy of a probiotic preparation for non-alcoholic steatohepatitis: a pilot trial
Elina Manzhalii1, Oleksandr Virchenko2, Tetyana Falalyeyeva2, Tetyana Beregova2 andWolfgang Stremmel3,*
DOI: 10.1111/1751-2980.12561
This article is protected by copyright. All rights reserved.
Vol. 18 Issue 9
Journal of Digestive Diseases
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
Article has an altmetric score of 8
1 Department of Internal Medicine of Propedeutics No. 2, Bogomolets National Medical University and Diagnostic Center of Podil Community, Kiev, Ukraine
2 Institute of Biology and Medicine, Taras Shevchenko National University, Kiev, Ukraine
3 Department of Internal Medicine (Gastroenterology), University Clinics of Heidelberg, Heidelberg, Germany
Email: Wolfgang Stremmel ([email protected])
**Correspondence to: Wolfgang Stremmel, University Clinics of Heidelberg, 69120 Heidelberg, Germany. E-mail: [email protected]; telephone: +49-6221-568700; Fax: +49-6221-564116 (on behalf of Elina Manzhalii)
Keywords:
clinical trial;inflammation;low-fat/low-calorie diet;probiotic;non-alcoholic steatohepatitis (NASH)
Abstract
AIM
To evaluate the therapeutic effect of a probiotic cocktail containing lactobacilli, bifidobacteria, and Streptococcus thermophilus on non-alcoholic steatohepatitis (NASH).
METHODS
In this open-label trial, 75 patients with NASH fed a low-fat/low-calorie diet were randomly divided into the control group (n = 37) and the experimental group (n = 38) also receiving the probiotic cocktail once daily for 12 weeks.
RESULTS
All patients were diagnosed with fatty liver by ultrasound examination and had elevated levels of gamma-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 to control, indicating improvement of the inflammation state. Accordingly, liver stiffness was decreased in the probiotic-treated group compared to 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 to 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 examined bacterial species. No adverse events were observed in any patient during the trial.
CONCLUSION
Short-term treatment with the probiotic cocktail caused significant improvement of liver inflammation status without adverse events and, thus, may represent a promising candidate therapeutic approach for NASH.
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