Lactitol Supplementation Modulates Intestinal Microbiome in Liver Cirrhotic Patients

Abstract

Background: Cirrhosis is a common chronic liver disease characterized by irreversible diffuse liver damage. Intestinal microbiome dysbiosis and metabolite dysfunction contribute to the development of cirrhosis. Lactitol (4-β-D-galactopyranosyl-D-glucitol) was previously reported to promote the growth of intestinal Bifidobacteria. However, the effect of lactitol on the intestinal microbiome and fecal short-chain fatty acids (SCFAs) and bile acids (BAs) and the interactions among these factors in cirrhotic patients pre- and post-lactitol treatment remain poorly understood.Methods: Here, using shotgun metagenomics and targeted metabolomics methods.Results: we found that health-promoting lactic acid bacteria, including Bifidobacterium longum, B.pseudocatenulatum, and Lactobacillus salivarius, were increased after lactitol intervention, and significant decrease of pathogen Klebsiella pneumonia and associated antibiotic resistant genes /virulence factors. Functionally, pathways including Pseudomonas aeruginosa biofilm formation, endotoxin biosynthesis, and horizontal transfer of pathogenic genes were decreased in cirrhotic patients after 4-week lactitol intervention compared with before treatment.Conclusion: We identified lactitol-associated metagenomic changes, and provide insight into the understanding of the roles of lactitol in modulating gut microbiome in cirrhotic patients.

CONSORT-Characteristics and metabolic phenotype of gut microbiota in NAFLD patients

“…Research findings have shown that the human gut microbiota can produce a variety of metabolites including short chain fatty acids, such as acetic acid, propionic acid, and butyric acid, which are produced by the decomposition of undigested dietary components [12] . Moreover, vitamin B and K affect the metabolism of the human body, thereby playing significant roles in pathogenesis of obesity, metabolic syndrome, diabetes, NAFLD, allergic reaction, inflammatory bowel disease and tumorigenesis in case of intestinal microecological imbalance [13] …”

“…[ 12 ] Moreover, vitamin B and K affect the metabolism of the human body, thereby playing significant roles in pathogenesis of obesity, metabolic syndrome, diabetes, NAFLD, allergic reaction, inflammatory bowel disease and tumorigenesis in case of intestinal microecological imbalance. [ 13 ]…”

“…[12] Moreover, vitamin B and K affect the metabolism of the human body, thereby playing significant roles in pathogenesis of obesity, metabolic syndrome, diabetes, NAFLD, allergic reaction, inflammatory bowel disease and tumorigenesis in case of intestinal microecological imbalance. [13] The gut microbiota, internal and external environment of the healthy human body always maintain a dynamic balance. [14] An imbalance in the intestinal microecological structure may lead to the development of obesity and related metabolic diseases, which is evident in the present study of patients with NAFLD.…”

The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases

“…Dietary cereal and yogurt intakes have been shown to be associated with high gut microbiota diversity and low hospitalization rates in patients with cirrhosis, which is possibly due to increased metabolism of short-chain fatty acids and probiotics ( 64 ). The supplementation of lactitol has been shown to reduce the load of pathogenic genes ARGs and VFGs in the intestinal flora; reduce the abundance of pathogenic bacteria associated with liver cirrhosis, such as Klebsiella ; increase the abundance of beneficial bacteria, such as Bifidobacterium ; and improve the prognosis of liver cirrhosis ( 65 ). Intestinal microbiota dysregulation is improved after transection of the hepatic branch vagus nerve in mice, which may be related to the overgrowth of potentially pathogenic bacteria enhanced by the vagus during cirrhosis ( 66 ).…”

Food Additives Associated with Gut Microbiota Alterations in Inflammatory Bowel Disease: Friends or Enemies?

“…fermentium and L . oris ) but decreased the abundance of Klebsiella pneumonia in patients with liver cirrhosis [ 119 ]. There showed an improved abundance of Bifidobacterium and the reductions of the B .…”