Potential Usage of Probiotic to Manage Liver Health in Patients with Hepatitis B-related Cirrhosis
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on March 19th, 2025
|
Due to the close connection between the gut and the liver, changes in one can significantly impact the other. Metabolites produced by the gut microbiota are absorbed by the large intestine and eventually transported to the liver, so any imbalance in the gut can lead to the production of substances that worsen liver inflammation. A study recently published in the World Journal of Gastroenterology investigated the use of the probiotic Lactobacillus paracasei N1115 in managing liver function in patients with hepatitis-B cirrhosis.
The clinical study was conducted in China and included 160 participants diagnosed with hepatitis B-related cirrhosis. Baseline biochemical assessments revealed a median albumin level of approximately 30 g/L and a median creatinine level of about 60 µmol/L. Hemostatic evaluation showed a median platelet count of roughly 70 trillion per liter, a prothrombin time of 16 seconds, and an INR of 1.3. Baseline inflammatory markers indicated a median white blood cell count of around 3.8 billion cells per liter and a C-reactive protein level of approximately 4.8.
Half of the participants were randomly assigned to receive a probiotic cocktail primarily composed of Lactobacillus plantarum N1115, along with Bifidobacterium bifidum and Lactobacillus acidophilus. The pre-dosed cocktail, packaged in pouches containing lyophilized bacteria, was taken twice daily after being resuspended in warm water or milk.
The researchers observed that patients treated with the probiotic cocktail containing Lactobacillus plantarum N1115 exhibited a more diverse gut microbiota and experienced improved liver function, as well as reduced inflammation—evidenced by lower levels of albumin, creatinine, and C-reactive protein. Overall, while the study presents an intriguing concept for future research, it has several limitations. First, although a placebo was mentioned, details regarding its use were insufficient. Second, the study focused solely on biochemical markers, neglecting other important parameters. Third, the inclusion criteria were poorly defined, with patients only required to have hepatitis B and cirrhosis; future investigations should better characterize the nature of the infection and the degree of cirrhosis. Additional shortcomings include a small sample size from a single, localized hospital, a skewed gender ratio, and a lack of clarity on the duration of treatment and follow-up.
The clinical study was conducted in China and included 160 participants diagnosed with hepatitis B-related cirrhosis. Baseline biochemical assessments revealed a median albumin level of approximately 30 g/L and a median creatinine level of about 60 µmol/L. Hemostatic evaluation showed a median platelet count of roughly 70 trillion per liter, a prothrombin time of 16 seconds, and an INR of 1.3. Baseline inflammatory markers indicated a median white blood cell count of around 3.8 billion cells per liter and a C-reactive protein level of approximately 4.8.
Half of the participants were randomly assigned to receive a probiotic cocktail primarily composed of Lactobacillus plantarum N1115, along with Bifidobacterium bifidum and Lactobacillus acidophilus. The pre-dosed cocktail, packaged in pouches containing lyophilized bacteria, was taken twice daily after being resuspended in warm water or milk.
The researchers observed that patients treated with the probiotic cocktail containing Lactobacillus plantarum N1115 exhibited a more diverse gut microbiota and experienced improved liver function, as well as reduced inflammation—evidenced by lower levels of albumin, creatinine, and C-reactive protein. Overall, while the study presents an intriguing concept for future research, it has several limitations. First, although a placebo was mentioned, details regarding its use were insufficient. Second, the study focused solely on biochemical markers, neglecting other important parameters. Third, the inclusion criteria were poorly defined, with patients only required to have hepatitis B and cirrhosis; future investigations should better characterize the nature of the infection and the degree of cirrhosis. Additional shortcomings include a small sample size from a single, localized hospital, a skewed gender ratio, and a lack of clarity on the duration of treatment and follow-up.