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Beneficial Effects of a Probiotic VSL#3 on Parameters of Liver Dysfunction in Chronic Liver Diseases

Loguercio, Carmela MD*; Federico, Alessandro MD, PhD*; Tuccillo, Concetta MS*; Terracciano, Fulvia MD*; D'Auria, Mauro Valeriano MD*; De Simone, Claudio MD; Blanco, Camillo Del Vecchio MD*

Journal of Clinical Gastroenterology: July 2005 - Volume 39 - Issue 6 - p 540-543
doi: 10.1097/01.mcg.0000165671.25272.0f
Liver, Pancreas, and Biliary Tract: Clinical Research

Objectives: 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.

Patients and Methods: 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.

Results: 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.

Conclusions: 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:

© 2005 Lippincott Williams & Wilkins, Inc.