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Selected Publication:

Horvath, A.
Probiotic modulation of gut microflora in cirrhosis: Influence on immune function and infection
PhD-Studium (Doctor of Philosophy); Humanmedizin; [ Dissertation ] Graz Medical University; 2016. pp. [OPEN ACCESS]


Authors Med Uni Graz:
Horvath Angela
Gorkiewicz Gregor
Leber Bettina
Marsche Gunther
Stadlbauer-Köllner Vanessa

Cirrhosis is associated with dysbiosis and bacterial translocation. Pro-inflammatory conditions and the overflow of endotoxin into the systemic circulation are major factors in the acquired immunodeficiency common in cirrhosis. Probiotics have beneficial effects on the gut barrier and inflammation. Therefore we hypothesized that the administration of a multispecies probiotic would restore the gut barrier of cirrhotic patients and thereby ameliorate bacterial translocation and innate immune dysfunction. To test this hypothesis a randomized, double-blind, placebo controlled study was conducted. Patients either received Ecologic® BARRIER (Winclove, Amsterdam, The Netherlands) for six months (n=44) or a placebo (n=36). After six months of intervention patients were observed for another six months. During the intervention the abundance of Lactobacillus was significantly increased and the invasion of Veillonella from the oral cavity into the intestine tended to decrease. We found that the administration of the probiotic increased neutrophil resting burst and serum neopterin levels in the probiotic group and boosted serum killing capacity of alcoholic cirrhotics. Furthermore, probiotics increased the conversion of phenylalanine to tyrosine which was reflected in an increase in quality of life and therefore in a better adherence to the study protocol in the probiotic group. Probiotics tended to improve liver function. Placebo did not show any affects. Probiotics did not influence gut permeability, endotoxemia, neutrophil phagocytosis, or cytokine levels. In conclusion, probiotic administration was well tolerated and increased innate immune responses. It improved the general well-being of the patients and had a beneficial effect on liver function, although their influence on gut permeability, endotoxemia and cytokine expression was not detectable.

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