Clinical

Probiotics improve liver enzymes in alcoholic hepatitis

Last Updated: 2011-11-11 13:03:18 -0400 (Reuters Health)

By Rob Goodier

NEW YORK (Reuters Health) - Probiotics may improve liver function in patients with alcoholic hepatitis, a randomized control trial has shown.

Patients who took cultured Lactobacillus subtilis and Streptococcus faecium for seven days had improvements in their liver enzymes, researchers reported November 5th at the annual meeting of the American Association for the Study of Liver Disease in San Francisco.

Probiotics might work by helping to restore the gut's microbial environment, Dr. Ki-Tae Suk, who led the study at Sacred Heart Hospital and Hallym University in Chuncheon, South Korea, told Reuters Health by email.

Dr. Suk's team studied 40 patients, randomizing 23 to receive 1500 mg/day of probiotics and 17 to placebo. After seven days, the probiotics group had improvements in Maddrey's Discriminant Function, a prognostic indicator for alcoholic hepatitis; the mean score went from 39 at baseline to 22 (a score above 32 indicates a poor prognosis).

In addition, albumin went from 3.1 to 3.4 g/dL, bilirubin from 28.8 to 16.2 mg/dL, aspartate aminotransferase from 432 to 57 IU/L, alanine aminotransferase from 150 to 63 IU/L, alkaline phosphatase from 137 to 122 IU/L, and gamma glutamyl-transferase from 383 to 189 IU/L. All of these improvements were statistically significant.

There were only two significant improvements in the placebo group. Aspartate aminotransferase fell from 157 to 76 IU/L, and alkaline phosphatase fell from 123 to 108 IU/L.

Dr. Suk and colleagues have now begun a larger study of 120 patients. Data from that trial should be available next year.

Even if probiotics prove effective, treatment should also include an abstinence program and psychological support, Dr. Suk believes.

"Alcoholic hepatitis is not a personal problem but a social problem," Dr. Suk said.