To evaluate whether chronic therapy with probiotics affects plasma levels of cytokines and oxidative/nitrosative stress parameters, as well as liver damage, in patients with various types of chronic liver disease.
A total of 22 nonalcoholic fatty liver disease (NAFLD) and 20 alcoholic liver cirrhosis (AC) patients were enrolled in the study and compared with 36 HCV- positive patients with chronic hepatitis without (20, CH) or with (16, CC) liver cirrhosis. All patients were treated with the probiotic VSL#3. Routine liver tests, plasma levels of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and -10, malondialdehyde (MDA), and 4-hydroxynonenal (4-HNE), S-nitrosothiols (S-NO), were evaluated on days −30, 0, 90, and 120.
Treatment with VSL#3 exerted different effects in the various groups of patients: in NAFLD and AC groups, it significantly improved plasma levels of MDA and 4-HNE, whereas cytokines (TNF-α, IL-6, and IL-10) improved only in AC patients. No such effects were observed in HCV patients. Routine liver damage tests and plasma S-NO levels were improved at the end of treatment in all groups.
Results of the study suggest that manipulation of intestinal flora should be taken into consideration as possible adjunctive therapy in some types of chronic liver disease.
From the *Department of Internistica Clinica e Sperimentale “F. Magrassi e A. Lanzara,” Inter-University Research Center on Foods, Nutrition, and Gastrointestinal Tract (CIRANAD), Second University of Naples, Naples, Italy; and †Department of Medicina Sperimentale, University of L'Aquila, Italy.
Received for publication July 8, 2004; accepted February 16, 2005.
Reprints: Carmela Loguercio, MD, Via Foria 58, 80137 Napoli, Italy (e-mail: email@example.com).