Guerrero HI, Torre DA, Vargas VF, Uribe M

Language: English
References: 40
Page: 120-124
PDF size: 137.93 Kb.

Text Extraction

Intestinal microflora constitutes a symbiotic ecosystem in permanent equilibrium, composed mainly of anaerobic bacteria. However, such equilibrium may be altered by daily conditions as drug use or pathologies interfering with intestinal physiology, generating an unfavorable environment for the organism. Besides, there are factors which may cause alterations in the intestinal wall, creating the conditions for translocation or permeation of substances or bacteria. In cirrhotic patients, there are many conditions that combine to alter the amount and populations of intestinal bacteria, as well as the functional capacity of the intestinal wall to prevent the permeation of substances and bacteria. Nowadays, numerous complications associated with cirrhosis have been identified, where such mechanisms could play an important role. There is evidence that some probiotic microorganisms could restore the microbiologic and immunologic equilibrium in the intestinal wall in cirrhotic patients and help in the treatment of complications due to cirrhosis. This article has the objective to review the interactions between intestinal flora, gut permeability, and the actual role of probiotics in the field of cirrhotic patients.

REFERENCES

1. Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgrad Med J 2004; 80: 516-526.

2. Stephen M. Riordan, Roger Williams. The intestinal flora and bacterial infection in cirrhosis. J Hepatol 2006; 45: 744-57.

3. Elmer GW, McFarland LV. Biotherapeutic agents in the treatment of infectious diarrhea. Gastroenterol Clin N Am 2001; 30: 837-52.

4. Marteau P, Seksik P. Tolerance of probiotics and prebiotics. J Clin Gastroenterol 2004; 38: S67-S69.

5. Berg RD. Inhibition of E. coli translocation from the gastrointestinal tract by the normal cecal flora in gnotobiotic or antibiotic decontaminated mice. Infect Immun 1980; 29: 1073-81.

6. Runyon BA, Squier S, Bporzio M. Translocation of gut bacteria in rats with cirrhosis to mesenteric lymph nodes partially explains the pathogenesis of spontaneuos bacterial peritonitis. J Hepatol 1994; 21: 792-796.

7. Chesta J, Defilippi C. Abnormalities in proximal small bowel motility in patients with cirrhosis. Hepatology 1993; 17: 828-32.

8. Pérez Páramo M, Muñoz J, Albillos A, et al. Effect of propranolol on the factors promoting bacterial translocation in cirrhotic rats with ascites. Hepatology 2000; 31: 43-8.

9. Ramachandran A, Prabhu R, Thomas S, et al. Intestinal mucosa alterations in experimental cirrhosis in the rat. Role of oxygen free radicals. Hepatology 2002; 35: 622-9.

10. Cirera I, Bauer T, Navasa M, et al. Bacterial translocation of entric organisms in patients with cirrhosis. J Hepatol 2001; 34: 32-7.

11. Steffen EK, Berg RD, Deitch EA. Comparison of translocation rates of various indigenous bacteria from the gastrointestinal tract to the mesenteric lymph node. J Infect Dis 1988; 157: 1032-8.

12. Johansson ML, Mollin G, Jeppsson B, et al. Administration of different Lactobacillus strains in fermented oatmeal soup: in vivo colonization of human intestinal mucosa and effect on the indigenous flora. Appl Environ Microbiol 1993; 59: 15-20.

13. Salminen S, Isolauri E, Salminen E. Clinical uses of probiotics for stabilizing the gut mucosal barrier successful strains and future challenges. Antonie Van Leeuwenhoel 1996; 70: 347-58.

14. Gómez F, Ruiz P, Schreiber AD. Impaired function of macrophage Fcy receptor and bacterial infection in alcoholic cirrhosis. N Engl J Med 1994; 331: 1122-28.

15. Panés J, Pérez del Pulgar S, Casadevall M, et al. Impaired mesenteric leukocyte recruitment in experimental portal hypertension in the rat. Hepatology 1999; 30: 445-53.

16. Wiest R, Das S, Cadelina G, et al. Bacterial translocation in cirrhotic rat stimulates eNOS derived NO production and impairs mesenteric vascular contractility. J Clin Invest 1999; 104: 1223-33.

17. Llovet JM, Bartoli R, Planas R, et al. Selective intestinal decontamination with norfloxacin reduces bacterial translocation in ascitic cirrhotic rats exposed to hemorrhagic shock. Hepatology 1996; 23: 781-7.

18. Pardo A, Bartoli R, Lorenzo-Zuñiga V, et al. Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrosis. Hepatology 2000; 31: 858-63.

19. Chiva M, Soriano G, Rochat I, et al. Effect of Lactobacillus johnsonii La1 and antioxidants on intestinal flora and bacterial translocation in rats with experimental cirrhosis. J Hepatol 2002; 37: 456-62.

20. Loguercio C, Federico A, Tuccillo C, Terracciano F. Beneficial effects of a probiotic VSL#3 on parameters of liver dysfunction in chronic liver diseases. J Clin Gastroenterol 2005; 39:540-3.

21. Aldo Torre, Florencia Vargas-Vorackova, Varenka Barbero. Effect of short-term administration of a Lactobacillus casei beverage (Yakult) on intestinal flora and permeability, endotoxins, cytokines, nitric oxide, and blood ammonia levels of patients with chronic liver disease. A before-after clinical trial. Gastroenterology 2002; 122: T 829.

22. Rimola A, Soto R, Bory F, et al. Reticuloendothelial system phagocytic activity in cirrhosis and its relation to bacterial infections and prognosis. Hepatology 1984; 4: 53-8.

23. Holdstock G, Leslie B, Hill S, et al. Monocyte function in cirrhosis. J Clin Pathol 1982; 35: 972-9.

24. Conn HO. Spontaneous peritonitis and bacterial in Laennec´s cirrhosis caused by enteric organisms: a relatively common but rarely recognized syndrome. Ann Intern Med 1964; 60: 568-80.

25. Pinzello G, Simonetti RG, Craxi A, et al. Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients. Hepatology 1983; 3: 545-9.

26. Runyon BA. Bacterial infections in patients with cirrhosis. J Hepatol 1993; 18: 271-2.

27. Meyer J, Traber LD, Nelson S, et al. Reversal of hyperdynamic response to continuous entotoxin administration by inhibition of NO synthesis. J Appl Physiol 1992; 73: 324-28.

28. Schumann RR, Latz E. Lipopolysaccharide binding protein. Chem Immunol 2000; 74: 42-60.

29. Albillos A, de la Hera A, González M, et al. Increased lipopolysaccharide binding protein in cirrhotic patients with marked immune and hemodynamic derangement. Hepatology 2003; 37: 1: 208-17.

30. Weist R, Groszmann RJ. The paradox of nitric oxide in cirrhosis and portal hypertension: Too much, not enough. Hepatology 2002; 35: 478-87.

31. Sessa W. The nitric oxide synthase family of proteins. J Vasc Res 1994; 31: 131-143.

32. Cadelina G, Shah V, Choo K, et al. Elevated portal pressure in mice with targeted disruption of the gene for endothelial nitric oxide sythase. Hepatology 2000; 32: A1202.

33. Perdigon G, de Macías ME, Alvarez S, et al. Systemic augmentation of the immune response in mice by feeding frmented milks with Lactobacillus casei and Lactobacillus acidophilus. Immunology 1988; 63: 17-23.

34. Sato K, Saito H, Tomioka H, et al. Enhancement of host resistance against Listeria infection by Lactobacillus casei: efficacy of cell wall preparation of Lactobacillus casei. Micriobiol Immunol 1988; 32: 1189-1200.

35. Oakey HJ, Harty DW, Knox KW. Enzyme production by lactobacilli and the potential link with infective endocarditis. J Appl Bacteriol 1995; 78: 142-8.

36. Mackay AD, Taylor MB, Kibbler CC, et al. Lactobacillus endocarditis caused by a probiotic organism. Clin Microbiol Infect 1999; 5: 290-2.

37. Clark JM, Brancati FL. The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol 2003; 98: 960-7.

38. Madsen K. DNA from probitic bacteria exerts anti-inflammatory actions on intestinal epithelial cells by inhibition of NK-k. Abstract DDW 2002.

39. Uysal KT, Wiesbrock SM, Marino MW. Protection from obesity-induced insulin resistance in mice lacking TNF alpha function. Nature 1997; 389: 610-4.

40. De Santis A, Famularo G, De Simone C. Probiotics for the hemodynamic alterations of patients with liver cirrhosis. Am J Gastroenterol 2000; 95: 323-4.