title: The effect of short term treatment with probiotic VSL#3 on various clinical and biochemical parameters in patients with liver cirrhosis.
abstract: The evidence is mounting that alterations of innate immunity and gut microbiota contribute to chronic liver disease and its complications. Modulation of intestinal microbiota is an emerging therapeutic strategy in hepatology. Probiotics through modulation of intestinal milieu have the potential to affect the course of liver disease. The data concerning the influence of probiotics on various plasma molecules and compounds involved in the pathogenesis of hyperdynamic circulatory state in liver cirrhosis is still not confluent and require further evaluation. In our study twenty patients with compensated and decompensated liver cirrhosis and ten healthy controls received probiotic VSL#3 daily for 28 days. Plasma levels of interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), plasminogen activator inhibitor (PAI), macrophage inflammatory protein 3/α (MIP-3 α/CCL20), monocyte chemotactic protein-1α (MCP-1/CCL2), human myeloperoxidase (MPO), nitric oxide (NO), prostaglandins, thromboxane (TXB2) and big-endothelin were measured at baseline, day 14 and 28 of probiotic administration. The incidence of hepatic encephalopathy was assessed with critical flicker frequency. Changes in clinical, biochemical and microbiological parameters were evaluated. The stage of liver cirrhosis correlated with an increase in plasma levels of pro-inflammatory cytokines (IL-6) and chemotactic chemokines involved in immune cell trafficking (MIP-3α/CCL20). Probiotic administration in patients with liver cirrhosis led to modulation of plasma levels of several molecules and compounds measured (MIP-3α/CCL20, NO, big-endothelin, TXB2and MPO). The grade of encephalopathy during the course of probiotic supplementation remained unaffected in both groups of patients. VSL#3 treatment was well tolerated and safe in patients with liver disease. In patients with compensated and decompensated liver cirrhosis, VSL#3 manipulates selected plasma molecules and compounds involved in hyperdynamic circulatory dysfunction. Short term VSL#3 administration affects several clinical and biochemical parameters commonly altered in liver cirrhosis.
authors.affiliation: Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland. marlicz@hotmail.com.
authors.forename: W
authors.initials: W
authors.lastname: Marlicz
authors.affiliation: Translational Medicine Group Pomeranian Medical University, Szczecin, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Wunsch
authors.affiliation: Translational Medicine Group Pomeranian Medical University, Szczecin, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Mydlowska
authors.affiliation: Department of Medical Biology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Milkiewicz
authors.affiliation: Department of Physiology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Serwin
authors.affiliation: Department of Human Anatomy, Pomeranian Medical University, Szczecin, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Mularczyk
authors.affiliation: Translational Medicine Group Pomeranian Medical University, Szczecin, Poland.|Liver and Internal Medicine Unit, Medical University of Warsaw, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Milkiewicz
authors.affiliation: Liver and Internal Medicine Unit, Medical University of Warsaw, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Raszeja-Wyszomirska
mesh_terms: D000328:Adult; D018932:Chemokine CCL2 / Q000378:metabolism; D054418:Chemokine CCL20 / Q000378:metabolism; D018925:Chemokines / Q000378:metabolism; D016232:Endothelins / Q000378:metabolism; D005260:Female; D000069196:Gastrointestinal Microbiome / Q000187:drug effects*; D006501:Hepatic Encephalopathy / Q000473:pathology; D006801:Humans; D007113:Immunity, Innate / Q000187:drug effects; D015850:Interleukin-6 / Q000378:metabolism; D007422:Intestines / Q000382:microbiology; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D009195:Peroxidase / Q000378:metabolism; D015849:Plasminogen Inactivators / Q000378:metabolism; D019936:Probiotics / Q000008:administration & dosage*; D011453:Prostaglandins / Q000378:metabolism; D013931:Thromboxanes / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: C108355:CCL20 protein, human; D018932:Chemokine CCL2; D054418:Chemokine CCL20; D018925:Chemokines; D016232:Endothelins; C508600:IL6 protein, human; D015850:Interleukin-6; D015849:Plasminogen Inactivators; D011453:Prostaglandins; D013931:Thromboxanes; D042461:Vascular Endothelial Growth Factor A; D009569:Nitric Oxide; D009195:Peroxidase