
DSF modulates serum metabolites in patients with cirrhosis
Thirty-two patients with cirrhosis and cognitive dysfunction or a history of falls were enrolled in a recent study by Soriano, Laghi, and colleagues. The scope of the trial was to explore new approaches to improve cirrhotic patients’ outcomes and health-related quality of life. Seventeen patients were supplemented with the multistrain probiotic De Simone Formulation (the DSF, Vivomixx®, 450 billion live bacteria daily) for 12 weeks, and 15 received a placebo. Blood and fecal samples were collected to analyze the serum metabolome and microbiota composition. Among the 54 blood metabolites identified using proton nuclear magnetic resonance (1H-NMR) spectroscopy, the probiotic group showed an increase in glutamine, a decrease in glutamate, and an increase in the glutamine/glutamate ratio. The placebo group showed increased glutamate and decreased glutamine/glutamate ratio. The increase in the serum glutamine/glutamate ratio could reflect a higher capacity of ammonia clearance that, together with a decrease in the pro-inflammatory state, would explain the improvement in cognitive function and risk of falls observed in patients supplemented with Vivomixx®. Interestingly, authors found that higher glutamine/glutamate ratio values in blood were associated with a lower abundance of Paraprevotella and Oscillospira in feces. The quantity of these bacteria has been associated with sedentarism, physical frailty, and sarcopenia.
This finding contributes to the understanding of the mechanisms involved in the effects of the DSF in cirrhotic patients, suggesting a role in influencing glutamine/glutamate metabolism, thereby increasing the capacity of ammonia detoxification.
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Laghi L, Román E, Lan Q, Nieto JC, Canalda-Baltrons A, Poca M, Sánchez-Rodríguez MB, Clària J, Alvarado E, Cuyàs B, Sánchez E, Vidal S, Guarner C, Escorsell A, Manichanh C, Soriano G. A multistrain probiotic increases the serum glutamine/glutamate ratio in patients with cirrhosis: a metabolomic analysis, Epatol Commun. 2023 Apr 4;7(4):e0072.
doi: 10.1097/HC9.0000000000000072
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