Effect of the use of probiotics, prebiotics and symbiotics in Non-Alcoholic Fatty Liver Disease
DOI:
https://doi.org/10.33448/rsd-v9i8.2594Keywords:
Non-alcoholic fatty liver disease; Microbiome; Clinical trial.Abstract
Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is a spectrum of chronic liver diseases, being the more common due to obesity prevalence around the world. In this context, there are studies in the literature that ratify the potential effects of microorganisms against the complications of NAFLD. Objective: This review is designed as a check on probiotics, prebiotics and symbiotics in non-alcoholic fatty liver disease. Methodology: a search of articles published in the database Science Direct, PubMed and Cochrane, using a combination of descriptors registered in the Descriptors in Health Sciences (DeCS): non-alcoholic fatty liver disease; microbiome; nutritional intervention; clinical trial. Fifteen original articles were chosen between the years of 2012 and 2018. Results: Studies that used probiotics, prebiotics and symbiotics in NAFLD showed improvement in some parameters that contribute to disease progression, such as: pro-oxidant enzyme action, reduction of adiposity, inflammation and fibrosis in the liver, regulation of intestinal bacterial flora, among others. If they are probiotic bacteria, studies report that they prevent liver damage, improve visceral fat accumulation and insulin sensitivity. Among the effects of prebiotics, the attenuation of the extension of NAFLD, restoring the intestinal microbiota homeostasis and the function of the intestinal epithelial barrier are outstanding. Symbiotics, in turn, significantly decreased levels of alanine aminotransferase, a marker of liver damage, and serum levels of TNFα and PCR. Final considerations: Therapies directed to the intestinal microbiota have become important tools for the treatment of NAFLD, since there are in the literature experimental reports that highlight a series of benefits through the use of probiotics, prebiotics and symbiotics. However, further studies are needed on this topic.
References
Asgharian, A. (2016). The Effect of Symbiotic Supplementation on Liver Enzymes, C- reactive Protein and Ultrasound Findings in Patients with Non-alcoholic Fatty Liver Disease: A Clinical Trial. International Journal of Preventive Medicine, 7(59).
Bäckhed, F., Fraser, C. M., Ringel, Y., Sanders, M. E., Sartor, R. B., Sherman, P. M., Versalovic, J., Young, V., & Finlay, B. B. (2012). Defining a healthy human gut microbiome: current concepts, future directions, and clinical applications. Cell Host & Microbe, 12(5), 611-622.
BRASIL. (2002). Resolução RDC nº 2, de 7 de janeiro de 2002. Aprova o Regulamento Técnico de Substâncias Bioativas e Probióticos Isolados com Alegação de Propriedades Funcionais e ou de Saúde. Diário Oficial da República Federativa do Brasil. Brasília, 9 jan. 2002. Recuperado em 27 junho, 2018, de <https://www.saude.rj.gov.br/comum/code/MostrarArquivo.php?C=MjI1Mw%2C%2C.>
Camargo, K. F. (2014). Estudo da inflamação e da autoimunidade na Doença Hepática gordurosa Não Alcoólica. Dissertação de Mestrado, Faculdade de Medicina, Universidade Estadual Paulista “Julio de Mesquita Filho”, Botucatu, SP, Brasil.
Cani, P. D., Possemiers, S., Wiele, T. V., Guiot, Y., Everard, A., Rottier, O., Geurts, L., Naslain, D., Neyrinck, A., Lambert, D. M., Muccioli, G. G., & Delzenne, N. M. (2009). Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut. 58, 1091–1103.
Cano, P. G., Santacruz, A., Trejo, F. M., & Sanz, Y. (2013). Bifidobacterium CECT 7765 improves metabolic and immunological alterations associated with obesity in high-fat diet-fed mice. Obesity, 21, 2310–2321.
Chen, J., Wang, R., LI, X., & Wang, R. (2012). Bifidobacterium adolescentis supplementation ameliorates visceral fat accumulation and insulin sensitivity in an experimental model of the metabolic syndrome. British Journal of Nutrition, 107, 1429–1434.
Corbin, K. D. & Zeisel, S. H. (2012). Choline Metabolism Provides Novel Insights into Non-alcoholic Fatty Liver Disease and its Progression. Current Opinion in Gastroenterology, 28, 159-165.
Cotrim, H. P. (2009). Doença hepática gordurosa não alcoólica: história natural. Gazeta Médica da Bahia, 79, 46-47.
Ekhlasi, G., Zarrati, M., Agah, S., Hosseini, A. F., Hosseini, S. Shidfar, S., Soltani Aarbshahi, S. S., Razmpoosh, E., & Shidfar, F. (2017). Effects of symbiotic and vitamin E supplemantation on blood pressure, nitric oxide and inflammatory factors in non-alcoholic fatty liver disease. EXCLI Journal, 16, 278-290.
Eslamparast, T., Poustchi, H., Zamani, F., Sharafkah, M., Malekzadeh, R., & Hekmatdoost, A. (2014). Synbiotic supplementation in nonalcoholic fatty liver disease: A randomized, double-blind, placebo-controlled pilot study. The American. Journal of Clinical Nutrition, 99, 535–542.
Ferolla, S. M., Couto, C. A., Costa Silva, L., Armiliato, G. N., Pereira, C. A., Martins, F. S., Ferrari, M. D. E. L., Vilela, E. G., Torres, H. O., Cunha, A. S., & Ferrari, T. C. (2016). Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis. Nutrients, 8, 7.
Flesh, A. G. T., Poziomyck, A. K., & Damin, D. C. (2014). O uso terapêutico dos simbióticos. Arquivos Brasileiros de Ciurgia Digestiva, 27 (3), 206-209.
Giovannini, M., Agostoni, C., Riva, E., Salvini, F., Ruscitto, A., Zuccotti, G. V. & Radaelli, G. (2007). A randomized prospective double blind controlled trial on effects of long term consumption of fermented milk containing Lactobacillus casei in preschool children with allergic asthma and/or rhinitis. Pediatric Research, 62, 215- 220.
Harryson, S. A. & Day, C. P. Benefits of lifestyle modification in NAFLD. Gut, 56 (12), 1760-1769.
Holscher, H. D., Faust, K. L, Czerkies, L. A., Litov, R., Zieglerm, E. E., Lessin, H., Hatch, T., Sun. S., & Tappenden, K. A. (2012). Effects of prebiotic-containing infant formula on gastrointestinal tolerance and fecal microbiota in a randomized controlled trial. Journal Parenteral and Enteral Nutrition, 36, 95-105.
Kim, Y., Edwards, N., & Fenselau, C. (2016). Extracellular vesicle proteomes reflect developmental phases of Bacillus subtilis, Clinical Proteomics, 13 (6).
Kobyliak, N., Abenavoli, L., Mykhalchyshyn, G., Kononenko, L., Boccuto, L., KYRIIENKO, D., & Dynnyk, O. (2018). A Multi-strain Probiotic Reduces the Fatty Liver Index, Cytokines and Aminotransferase levels in NAFLD Patients: Evidence from a Randomized Clinical Trial. Journal of Gastrointestinal and Liver Diseases, 27 (1), 41-49.
Lambert, J. E., Parnell, J. A., Eksteen, B., Raman, M., Bomhof, M. R., Rioux, K. P., Madsen, K. L., & Reimer, R. A. (2015). Gut microbiota manipulation with prebiotics in patients with non-alcoholic fatty liver disease: A randomized controlled trial protocol. BMC Gastroenterology, 15 (169).
LI, C., Nie, S. P., Zhu, K. X., Ding, Q., LI, C., Xiong, T. & Xie, M. Y. (2014). Lactobacillus plantarum NCU116 improves liver function, oxidative stress and lipid metabolism in rats with high fat diet induced non-alcoholic fatty liver disease. Journal of Functional Foods, 5, 3216-3223.
Lirussi, F., Mastropasqua, E., Orando, S., & Orlando, R. (2008). Probiotics for non-alcoholic fatty liver disease and/or steatohepatitis. Cochrane Database of Systematic Reviews. 2.
Ma, J., Zhou, Q., & LI, H. (2017) Gut Microbiota and Nonalcoholic Fatty Liver Disease: Insights on Mecanisms and Therapy. Nutrientes, 9 (10).
Malaguarnera, M., Vacante, M., Antic, T., Giordano, M., Chisari, G., Acquaviva, R., Mastrojeni, S., Malaguarnera, G., Mistretta, A., LI Volti, G., & Galvano, F. (2012). Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Digestive Diseases and Sciences, 57, 545–553.
Manzhalii, E., Virchenko, O., Falalyeyeva, T., Beregova, T., & Stremmel, W. (2017). Treatment efficacy of a probiotic preparation for non-alcoholic steatohepatitis: A pilot trial. Journal of Digestive Diseases, 18 (12), 698-703.
Matsumoto, K., Ichimura, M., Tsuneyama, K., Moritoki, Y., Tsunashima, H., Omagari, K., Hara, M., Yasuda, I., Miyakawa, H., & Kikuchi, K. (2017). Fructo-oligosaccharides and intestinal barrier function in a methionine-choline-deficient mouse model of nonalcoholic steatohepatitis. PLoS ONE, 12.
Minemura, M., & Shimizu, Y. (2015). Gut microbiota and liver diseases. World Journal of Gastroenterology, 21, 1691-1702.
Mofidi, F. (2017). Synbiotic supplementation in lean patients with non-alcoholic fatty liver disease: A pilot, randomised, double-blind, placebo-controlled, clinical trial. British Journal of Nutrition, 117, 662–668.
Mouzaki, M., & Bandsma, R. (2015). Targeting the Gut Microbiota for the Treatment of Non- Alcoholic Fatty Liver Disease. Current Drug Targets, 16, 1324-1331.
Moraes, A. C., F., Silva, I. T., Almeida-Pititto, B., & Ferreira, S. R. G. (2014). Microbiota intestinal e risco cardiometabólico: mecanismos e modulação dietética. Arquivos Brasileiros de Endocrinologia Metabólica, 58 (4).
Moschen, A. R., Kaser, S., & Tilg, H. (2013). Non-alcoholic steatohepatitis: a microbiota-driven disease. Trends in Endocrinology & Metabolism, 24(11), 537-545.
Odamaki, T., Xiao, J. Z., Iwabuchi, N., Sakamoto, M., Takahashi, M., Kondo, S., Iwatsuki, K., Kokubo, S., Togashi, H., Enomoto, T., & Benno, Y. (2009). Fluctuation of fecal microbiota in individuals with Japanese cedar pollinosis during the pollen season and influence of probiotic intake. Journal of Investigational Allergology and Clinical Immunology, 17, 92-100.
Okubo, H., Sakoda, H., Kushiyama, A., Fujishiro, M., Nakatsu, Y., Fukushima, T., Matsunaga, Y., Kamata, H., Asahara, T., Yoshida, Y., Chonan, O., Iwashita, M., Nishimura, F., & Asano, T. (2013). Lactobacillus casei strain Shirota protects against nonalcoholic steatohepatitis development in a rodent model. American Journal of Physiology-Gastrointestinal and Liver Physiology, 305, 911-918.
Oliveira, A., & Aarestrup, F. M. (2012). Avaliação nutricional e atividade inflamatória sistêmica de pacientes com câncer colorretal submetidos à suplementação com simbiótico. Arquivos Brasileiros de Cirurgia Digestiva, 25 (3), 147-153.
Pacífico, L., Nobili, V., Anania, C., Verdecchia, P., & Chiesa, C. (2011). Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk. World Journal of Gastroenterology, 17, 3082-3091.
Pachikian, B. D., Essaghir, A., Demoulin, J. B., Catry, E., Neyrinck, A. M., Dewulf, E. M., Sohet, F. M., Portois, L., Clerbaux, L. A., Carpentier, Y. A., Possemiers, S., Bommer, G. T., Cani, P. D., & Delzenne, N. M. (2013). Prebiotic approach alleviates hepatic steatosis: Implication of fatty acid oxidative and cholesterol synthesis pathways. Molecular Nutrition & Food Research, 57, 347-359.
Pineiro, M., & Stanton, C. (2007). Probiotic bacteria: legislative framework - requirements to evidence basis. Journal of Nutrition, 137, 850-853.
Polakowski, C. B. (2015). Impacto do uso de simbióticos no pré-operatório de cirurgia por câncer colorretal. 2015. Dissertação DE Mestrado, Universidade Federal do Paraná, Curitiba, Brasil.
Portela, C. L. M., Melo, M. L. P., & Sampaio, H. A. C. (2013). Aspectos fisiopatológicos e nutricionais da doença hepática gordurosa não-alcóolica (DHGNA). Revista Brasileira de Nutrição Clínica, 28 (1), 54-60.
Raso, G. M., Simeoli, R., Iacono, A., Santoro, A., Amero, P., Paciello, O., Russo, R., D’agostino, G., DI Costanzo, M., Canani, R. B., Calignano, A., & Meli, R. (2014). Effects of a Lactobacillus paracasei B21060 based synbiotic on steatosis, insulin signaling and toll-like receptor expression in rats fed a high-fat diet. The Journal of Nutritional Biochemistry, 25, 81-90.
Ren, T., Huang, C., & Cheng, M. Dietary blueberry and bifidobacteria attenuate nonalcoholic fatty liver disease in rats by affecting SIRT1-mediated signaling pathway. Oxidative Medicine and Cellular Longevity.
Salgado Júnior, W., Santos, J. S., Sankarakutty, A. K., & Silva, E. C. (2006). Nonalcoholic fatty liver disease and obesity. Acta Cirúrgica Brasileira, 21, 72-78.
Santos, A. C. A. L. (2010). Uso de probióticos na recuperação intestinal. Curso de especialização em terapia nutricional. Rio de janeiro, Brasil. Recuperado em 17 janeiro, 2019, de http://doczz.com.br/doc/205720/uso-de-probi%C3%B3ticos-na-recupera%C3%A7%C3%A3o-da-flora-intestinal.
Shen, J., Obin, M. S., & Zhao, L. (2013). The gut microbiota, obesity and insulin resistance. Molecular Aspects of Medicine, 34, 39-58.
Singh, D. P., Khare, P., Zhu, J., Kondepudi, K. K., Singh, J., Baboota, R. K., Boparai, R. K., Khardori, R., Chopra, K., & Bishnoi, M. (2016). A novel cobiotic-based preventive approach against high-fat diet- induced adiposity, nonalcoholic fatty liver and gut derangement in mice. International Journal of Obesity, 40, 487-496.
Sohn, W. (2015). Lactobacillus paracaseiInduces M2-Dominant Kupffer Cell Polarization in a Mouse Model of Nonalcoholic Steatohepatitis. Digestive Diseases and Sciences, 60, 3340–3350.
Souza, F. S. (2010) Prebióticos, probióticos e simbióticos na prevenção e tratamento das doenças alérgicas. Revista Paulista de Pediatria, 28 (1).
Sepideh, A.M., Karim, P., Hossein, A., Leila, R., Hamdollah, M., Mohammad, E. G., Mojtaba, S., Mohammad, S., Ghader, G., & Seyed Moayed, A. (2016). Effects of Multistrain Probiotic Supplementation on Glycemic and Inflammatory Indices in Patients with Nonalcoholic Fatty Liver Disease: A Double-Blind Randomized Clinical Trial. Journal of the American College of Nutrition, 35 (6), 500-505.
Stefe, C. A., Ribeiro, R. L., & Ribeiro-Alves, M. A. (2008). Probióticos, prebióticos e simbióticos- artigo de revisão. Saúde e Ambiente em Revista, 3 (1), 16-33.
Tagliari, E. et al. Impacto do uso de simbiótico na doença hepática gordurosa não alcoólica em modelo de ratos. Arquivos Brasileiros de Cirurgia Digestiva, v.30, n.3, p:211-215, 2017.
Tamura, M., Shikina, T., Morihana, T., Hayama, M., Kajimoto, O., Sakamoto, A., Kajimoto, Y., Watanabe, O., Nonaka, C., Shida, K., & Nanno, M. (2007). Effects of probiotics on allergic rhinitis induced by Japanese cedar pollen: randomized double-blind, placebo-controlled clinical trial. Internatinal Archives of Allergy and Immunology, 143, 75-82.
Theophilo, I. P. P., & Guimarães, N. G. (2008). Tratamento com probióticos na síndrome do intestino irritável. Comumicação em Ciências da Saúde, 19 (3), 271-281.
Varavalho, M. A., Thomé, J. N., & Teshima, E. (2008). Aplicação de bactérias probióticas para profilaxia e tratamento de doenças gastrointestinais. Semina: Ciências Biológicas e da Saúde, 29 (1), 83-104.
Wree, A., Broderick, L., Canbay, A., Hoffman, H. M., & Feldstein, A. E. (2013). From Nafld to NASH to cirrhosis-new insights into disease mechanisms. Nature Reviews Gastroenterology & Hepatology, 10, 627-636.
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