Lactobacillus casei alleviated the abnormal increase of cholestasis-related liver indices during tuberculosis treatment: a post hoc analysis of randomized controlled trial.
- 2021-07-19
- Molecular Nutrition & Food Research 65(16)
- Ke Xiong
- Jing Cai
- Peiying Liu
- Jinyu Wang
- Shanliang Zhao
- Lei Xu
- Yang Yang
- Jiahong Liu
- A. Ma
- PubMed: 33864432
- DOI: 10.1002/mnfr.202100108
Abstract
Scope: Probiotics are promising in mitigating drug-induced liver injury in animal experiments. However, the clinical evidence is absent. The objective is to investigate the effect of adjunctive Lactobacillus casei on tuberculosis-drug-induced liver injury.
Methods and results: A post hoc analysis is conducted for a previous randomized controlled trial. The trial is registered at the Chinese Clinical Trial Registry (No. ChiCTR-IOR-17013210). Four hundred twenty nine patients are allocated to receive standard tuberculosis therapy alone (control group), or together with 1 × 1010 colony-forming units (CFU) per day (low-dose group), or 2 × 1010 CFU per day of L. casei (high-dose group) during tuberculosis treatment. The L. casei supplementation significantly reduced the incidence of the abnormal increase of cholestasis-related liver indices including alkaline phosphatase (p = 0.024) and bilirubin (p = 0.013). Plasma lipopolysaccharide (p = 0.02), intestinal permeability biomarkers including zonula occludens-1 (p = 0.001) and intestinal fatty acid binding protein (p = 0.002) are significantly reduced. The gut microbiota composition is dramatically altered with a reduction of Bacteroidetes (p < 0.001) and a corresponding increase of Actinobacteria (p < 0.001) and Firmicutes (p = 0.003).
Conclusions: L. casei supplementation is beneficial for suppressing abnormally elevated cholestasis-related liver indices during tuberculosis treatment, which may be related to its modification on blood lipopolysaccharide, intestinal barrier function, and gut microbiota.
Keywords: drug-induced liver injury; gut microbiota; intestinal barrier function; probiotics; randomized controlled trial; tuberculosis.
Research Insights
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lacticaseibacillus casei | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lacticaseibacillus casei | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lacticaseibacillus casei | Reduced Abnormally Elevated Cholestasis-Related Liver Indices | Beneficial | Moderate |
| Lacticaseibacillus casei | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lacticaseibacillus casei R0215 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lacticaseibacillus casei R0215 | Improved Gut Permeability | Beneficial | Large |
| Lacticaseibacillus casei R0215 | Reduced Incidence of Cholestasis | Beneficial | Moderate |
| Lacticaseibacillus casei R0215 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei | Improved Gut Permeability | Beneficial | Large |
| Lactobacillus casei | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei HA-108 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei HA-108 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei HA-108 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei PXN 37 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei PXN 37 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei PXN 37 | Reduced Alkaline Phosphatase Levels | Beneficial | Moderate |
| Lactobacillus casei PXN 37 | Reduced Incidence of Hyperbilirubinemia | Beneficial | Moderate |
| Lactobacillus casei PXN 37 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei R0215 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei R0215 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei R0215 | Reduced Abnormally Elevated Cholestasis-Related Liver Indices | Beneficial | Moderate |
| Lactobacillus casei R0215 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei SD-5213 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei SD-5213 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei SD-5213 | Reduced Incidence of Cholestasis | Beneficial | Moderate |
| Lactobacillus casei SD-5213 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei SD-5842 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei SD-5842 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei SD-5842 | Reduced Incidence of Cholestasis | Beneficial | Moderate |
| Lactobacillus casei SD-5842 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei subsp. casei | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei subsp. casei | Increased Gut Microbiota Diversity | Beneficial | Large |
| Lactobacillus casei subsp. casei | Reduced Abnormal Cholestasis-Related Liver Indices | Beneficial | Moderate |
| Lactobacillus casei subsp. casei | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei UALc-03 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei UALc-03 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei UALc-03 | Reduced Incidence of Cholestasis | Beneficial | Moderate |
| Lactobacillus casei UALc-03 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |
| Lactobacillus casei VK4 | Altered Gut Microbiota Composition | Beneficial | Moderate |
| Lactobacillus casei VK4 | Improved Intestinal Barrier Function | Beneficial | Moderate |
| Lactobacillus casei VK4 | Reduced Abnormal Cholestasis-Related Liver Indices | Beneficial | Moderate |
| Lactobacillus casei VK4 | Reduced Plasma Lipopolysaccharide Levels | Beneficial | Moderate |