Changes in the Intestinal Microbiome during a Multispecies Probiotic Intervention in Compensated Cirrhosis

Abstract

Probiotics have been used in trials to therapeutically modulate the gut microbiome and have shown beneficial effects in cirrhosis. However, their effect on the microbiome of cirrhosis patients is not fully understood yet. Here, we tested the effects of a multispecies probiotic on microbiome composition in compensated cirrhosis. The gut microbiome composition of 58 patients with compensated cirrhosis from a randomized controlled trial who received a daily dose of multispecies probiotics or placebo for six months was analysed by 16S rRNA gene sequencing. Microbiome composition of patients who received probiotics was enriched with probiotic strains and the abundance of Faecalibacterium prausnitzii, Syntrophococcus sucromutans, Bacteroides vulgatus, Alistipes shahii and a Prevotella species was increased in the probiotic group compared to the placebo group. Patients who had microbiome changes in response to probiotic treatment also showed a significant increase in neopterin and a significant decrease in faecal zonulin levels after intervention, which was not observed in placebo-treated patients or patients with unchanged microbiome compositions. In conclusion, multispecies probiotics may enrich the microbiome of compensated cirrhotic patients with probiotic bacteria during a six-month intervention and beneficially change the residential microbiome and gut barrier function.

The Role of Intestinal Bacteria and Gut–Brain Axis in Hepatic Encephalopathy

“…In patients with compensatory cirrhosis taking multiple probiotic strains for 6 months, their stool was found to be rich in probiotic strains, including Lactobacillus brevis , Lactobacillus salivarius and Lactococcus lactis . In addition, probiotics may boost the production of short-chain acids by increasing the abundance of multiple bacteria, including Calibacterium prausnitzii , Syntrophococcus sucromutans and Alistipes shahii ( Horvath et al, 2020 ).…”

The Gut-Liver Axis in Cholestatic Liver Diseases

“…Prebiotics, which are substrates that are selectively metabolized by beneficial gut bacteria, showed efficacy in preventing liver inflammation and development of steatosis in a mouse model of alcohol-induced hepatic injury and reduced hepatic lipogenesis in humans [ 304 , 305 , 306 ]. Probiotics as therapeutic options in liver diseases, mainly investigated for ALD, NAFLD, and cirrhosis, have been found to restore gut microbiome composition, to reduce bacterial translocation and to re-establish the gut barrier [ 27 , 307 , 308 , 309 , 310 , 311 , 312 ]. Mechanisms reducing liver inflammation include avoidance of TLR4 activation by LPS and inhibition of proinflammatory cytokines [ 313 , 314 ].…”

From intestinal dysbiosis to alcohol-associated liver disease

“…[37][38][39] However, the major drawback of routine antibiotic prophylaxis is the emergence of multidrug-resistant organisms. 34 Thus, novel therapies have been proposed based on their ability to modify the altered intestinal microbiota such as probiotics and prebiotics, 19,[40][41][42][43][44][45] fecal microbiota transplantation, 46,47 phage therapy, 31 among others. Evidence for their use in clinical practice is limited and all require further studies.…”