Chronic liver disease is often caused by the hepatitis C virus and accompanied by neuropsychiatric complications called hepatic encephalopathy (HE). It can be a temporary or permanent condition and current treatments have some limitations in their efficacy and tolerability emphasizing the need for alternative therapies. There is increasing evidence that chronic liver disease is accompanied by qualitative and quantitative changes in the intestinal flora. Dysbiosis and bacterial overgrowth can lead to raised production of endotoxins entering the circulation, and increase the intestinal permeability which aggravates the inflammation. In this contest, the study published by Cristina Cudalbu in Scientific Reports (1) aimed to analyze whether a long-term treatment with a multistrain probiotic mixture (De Simone Formulation) in a rat model of type C HE attenuated the behavioral and neurometabolic changes typically observed in this model. Results showed that the prophylactic administration of this probiotic formulation reduced or delayed disease progression, probably by decreasing plasma ammonium which may be related to the increase of Bifidobacteria observed in the gut, and slowing down the progression of the precipitating factors. Both the performance in behavioral tests and the neurometabolic profile of rats supplemented with probiotics were improved compared to the untreated animals. They displayed a significantly lesser increase in brain glutamine, a milder decrease in brain myo-inositol and a smaller decrease in neurotransmitter glutamate than untreated animals. These are positive findings as some of these metabolic changes in the brain reflect disease severity.
These results have great clinical potential as they demonstrate that the administration of a specific probiotic formulation (De Simone Formulation) had a beneficial effect on the development of HE in a rat model of type C HE, both when analyzing locomotor activity and neurometabolic profile.
Pr De Simone, About
Rackayova V. et al. Probiotics improve the neurometabolic profile of rats with chronic cholestatic liver disease. Scientific reports (2021) 11:2269 https://doi.org/10.1038/s41598-021-81871-8