title: Probiotic as a novel treatment strategy against liver disease.
abstract: BACKGROUND
  A symbiotic relationship between the liver and intestinal tract enables the healthy status of both organs. Microflora resident in intestinal lumen plays a significant role in hepatocytes function. Alterations to the type and amount of microorganisms that live in the intestinal tract can result in serious and harmful liver dysfunctions such as cirrhosis, nonalcoholic fatty liver disease, alcoholic liver disease, and hepatic encephalopathy. An increased number of pathogens, especially enterobacteriaceae, enterococci, and streptococci species causes the elevation of intestinal permeability and bacterial translocation. The presence of high levels of lipopolysaccharide (LPS) and bacterial substances in the blood result in a portal hypertension and ensuing hepatocytes damage. Several methods including the usage of antibiotics, prebiotics, and probiotics can be used to prevent the overgrowth of pathogens. Compared to prebiotic and antibiotic therapy, probiotics strains are a safer and less expensive therapy. Probiotics are "live microorganisms (according to the FAO/WHO) which when administered in adequate amounts confer a health benefit on the host".
  
  
  METHODS
  Data from numerous preclinical and clinical trials allows for control of the flora bacteria quantity, decreases in compounds derived from bacteria, and lowers proinflammatory production such as TNF-α, IL-6 and IFN-γ via down-regulation of the nuclear factor kappa B (NF-κ B).
  
  
  RESULTS
  On the other hand, probiotic can reduce the urease activity of bacterial microflora. Furthermore, probiotic decreases fecal pH value and reduces ammonia adsorption. In addition, the serum level of liver enzymes and other substances synthesized by the liver are modulated subsequent to probiotic consumption.
  
  
  CONCLUSIONS
  According to our knowledge, Probiotic therapy as a safe, inexpensive and a noninvasive strategy can reduce pathophysiological symptoms and improve different types of liver diseases without side effects.
authors.affiliation: Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Imani Fooladi
authors.forename: Hamideh
authors.initials: H
authors.lastname: Mahmoodzadeh Hosseini
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Nourani
authors.forename: Soghra
authors.initials: S
authors.lastname: Khani
authors.forename: Seyed Moayed
authors.initials: SM
authors.lastname: Alavian
keywords: Carcinoma, Hepatocellular; Hepatic Encephalopathy; Hepatitis; Liver Cirrhosis, Nonalcoholic Fatty Liver Disease; Liver Diseases, Alcoholic; Probiotics