title: Treatment of nonalcoholic steatohepatitis with probiotics. A proof-of-concept study.
abstract: BACKGROUND
  Probiotics have profound effect on nonalcoholic steatohepatitis (NASH) in animal models. We aimed to test the hypothesis that probiotics treatment was superior to usual care in reducing liver fat in NASH patients.
  
  
  METHODS
  Patients with histology-proven NASH were randomized to receive probiotics (n = 10) or usual care (n = 10) for 6 months. The Lepicol probiotic formula contained Lactobacillus plantarum, Lactobacillus deslbrueckii, Lactobacillus acidophilus, Lactobacillus rhamnosus and Bifidobacterium bifidum. The primary endpoint was change in intrahepatic triglyceride content (IHTG), as measured by proton-magnetic resonance spectroscopy, from baseline to month 6. Secondary endpoints included changes in liver biochemistry and metabolic profile.
  
  
  RESULTS
  IHTG decreased from 22.6 ± 8.2% to 14.9 ± 7.0% in the probiotic group (P = 0.034) but remained static in the usual care group (16.9 ± 6.1% to 16.0 ± 6.6%; P = 0.55). Six subjects in the probiotic group had IHTG reduced by more than 30% from baseline, compared to 2 subjects in the usual care group (P = 0.17). The probiotic group also had greater reduction in serum aspartate aminotransferase level (P = 0.008). On the other hand, the use of probiotics was not associated with changes in body mass index, waist circumference, glucose and lipid levels.
  
  
  CONCLUSIONS
  Probiotics treatment may reduce liver fat and AST level in NASH patients. The therapeutic potential of probiotics in NASH should be tested in larger studies.
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
authors: Vincent Wai-Sun
authors: VW
authors: Wong
authors: Grace Lai-Hung
authors: GL
authors: Won
authors: Angel Mei-Ling
authors: AM
authors: Chim
authors: Winnie Chiu-Wing
authors: WC
authors: Chu
authors: David Ka-Wai
authors: DK
authors: Yeung
authors: Kevin Chi-To
authors: KC
authors: Li
authors: Henry Lik-Yuen
authors: HL
authors: Chan
mesh_terms: D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005234:Fatty Liver / Q000097:blood / Q000473:pathology / Q000628:therapy*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010865:Pilot Projects; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014280:Triglycerides; D001219:Aspartate Aminotransferases