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Abstract

Gut microbiota performs indispensable functions in the pathophysiology of alcoholic hepatitis (AH). We investigated the effects of Lacticaseibacillus rhamnosus R0011 and Lactobacillus helveticus for gut microbial restoration toward eubiosis in patients with AH. A multicenter, double-blind, and randomized trial was conducted. Probiotics (n = 44) and placebo (n = 45) groups received, during 7 days, L. rhamnosus R0011/L. helveticus R0052 at 120 mg/day and placebo. All patients were hospitalized to ensure abstinence. Liver function, lipopolysaccharide level, and stool analysis were evaluated in patients before and after 7 days of treatment. At baseline, the dominant bacteria were Gram-negative in both groups which decreased after the probiotics treatment and exhibited a significant reduction in lipopolysaccharide level (p < 0.001). The probiotics ameliorated the Child−Pugh scores (p < 0.001). Furthermore, the probiotics group showed a decline in the levels of alanine aminotransferase and gamma-glutamyltranspeptidase (p < 0.05). The probiotics changed the gut microbial composition at various taxonomical levels. The proportion of Bacteroidetes (147%) was increased after 7 days of probiotics supplementation while Proteobacteria (30%) and Fusobacteria (0%) were decreased. Administration of L. rhamnosus R0011 and L. helveticus R0052 conceivably associated with restoration of gut microbiome in AH patients and improved AH by modulating the gut−liver axis.

Keywords: alcoholic hepatitis; lipopolysaccharides; microbiota; probiotics.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lacticaseibacillus rhamnosusImproved Child-Pugh ScoresBeneficial
Large
Lacticaseibacillus rhamnosusIncreased Bacteroidetes ProportionBeneficial
Large
Lacticaseibacillus rhamnosusReduced Alanine Aminotransferase LevelsBeneficial
Moderate
Lacticaseibacillus rhamnosusReduced Gamma-Glutamyl Transferase LevelsBeneficial
Moderate
Lacticaseibacillus rhamnosusReduced Gram-Negative Bacteria LevelsBeneficial
Large
Lacticaseibacillus rhamnosusReduced Plasma Lipopolysaccharide LevelsBeneficial
Large
Lacticaseibacillus rhamnosusReduced Proportion of FusobacteriaBeneficial
Large
Lacticaseibacillus rhamnosusReduced Proportion of ProteobacteriaBeneficial
Large
Lacticaseibacillus rhamnosusRestored Normal MicrobiotaBeneficial
Large
Lacticaseibacillus rhamnosus R0011Improved Child-Pugh ScoresBeneficial
Large
Lacticaseibacillus rhamnosus R0011Increased Bacteroidetes ProportionBeneficial
Large
Lacticaseibacillus rhamnosus R0011Reduced Plasma Lipopolysaccharide LevelsBeneficial
Large
Lactobacillus helveticus R0052Improved Child-Pugh ScoreBeneficial
Large
Lactobacillus helveticus R0052Increased Bacteroidetes ProportionBeneficial
Large
Lactobacillus helveticus R0052Reduced Aminotransferase LevelsBeneficial
Moderate
Lactobacillus helveticus R0052Reduced Gamma-Glutamyl Transferase LevelsBeneficial
Moderate
Lactobacillus helveticus R0052Reduced Gram-Negative Bacteria CountBeneficial
Large
Lactobacillus helveticus R0052Reduced Proportion of FusobacteriaBeneficial
Large
Lactobacillus helveticus R0052Reduced Proportion of ProteobacteriaBeneficial
Large
Lactobacillus rhamnosus R0011Improved Child-Pugh ScoreBeneficial
Large
Lactobacillus rhamnosus R0011Reduced Gamma-Glutamyl Transferase LevelsBeneficial
Moderate
Lactobacillus rhamnosus R0011Reduced Plasma Lipopolysaccharide LevelsBeneficial
Large
Lactobacillus rhamnosus R0011Reduced Serum Alanine Aminotransferase LevelsBeneficial
Moderate
Lactobacillus rhamnosus R0011Restored Gut Microbiota CompositionBeneficial
Large

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