Bacterial intestinal microflora and diseases of the liver
Abstract
The aim of review. To analyze the literature data on application of prebiotics in treatment of metabolic disorders at diseases of the liver.
Original positions. As it is known, diverse functions of gastro-intestinal tract are related to vital activity of intestinal microflora. The normal microflora sustains colonization resistance of the body, prevents development of pathogenic and opportunistic flora. In the case of disorders of this major function the number of potentially pathogenic microorganism is increased and the spectrum extends, their translocation through intestinal wall may occur that can be accompanied by development of endogenous infection or superinfection. Recently the role of bacterial overgrowth in pathogenesis of non-alcoholic steatohepatitis is widely discussed. At obesity entry of free fatty acids in the liver is increased and steatosis of the liver develops that is considered to be «the first blow». The oxydative stress («the second blow») which takes place at bacterial overgrowth syndrome as well due to increased endogenous secretion of ethanol and lipopolysaccharides, stimulating excessive production of proinflammatory cytokines by Kupffer’s cells, educes consequtively or simultaneously. Bacterial overgrowth syndrome along with immunodepression, change of permeability of intestinal wall also participates in pathogenesis of bacterial translocation, and then — in development of infections at liver cirrhosis (LC).
Conclusion. Scientific studies showed efficacy of prebiotics (alimentary fibers) as the drugs providing normal activity of intestinal microflora that promotes prophylaxis and treatment of liver diseases, including at patients with the LC, bacterial overgrowth, minimal hepatic encephalopathy, non-alcoholic steatohepatitis.
About the Authors
Ye. A. FedosyinaRussian Federation
M. S. Zharkova
Russian Federation
M. V. Maevskaya
Russian Federation
References
1. Болезни печени и желчевыводящих путей: Руководство для врачей / Под ред. В.Т. Ивашкина. – 2-е изд., испр. и доп. – М.: Изд. Дом «М-Вести», 2005. – 536 с.
2. Буеверов А.О., Богомолов П.О., Маевская М.В. Патогенетическое лечение неалкогольного стеатогепатита: обоснование, эффективность, безопасность // Тер. арх. – 2007. – Т. 79, № 8. – С. 88–92.
3. Bartoli R., Maсй J., Cabrй E. et al. Effect of the administration of fermentable and non-fermentable dietary fibre on intestinal bacterial translocation in ascitic cirrhotic rats // Clin. Nutr. – 2007. – Vol. 26, N 3. – P. 383–387.
4. Deng G., Jiang Z., Liu Y. et al. Dietary fiber protects intestinal structure and barrier function // Zhonghua Wai Ke Za Zhi. – 1998. – Vol. 36, N 12. – P. 759–762.
5. Fischer M.H., Yu N., Gray G.R. et al. The gel-forming polysaccharide of psyllium husk (Plantago ovata Forsk) // Carbohydr. Res. – 2004. – Vol. 2; 339 (11). – P. 2009–2017.
6. Iwasa M., Nakao M., Kato Y. et al. Dietary fiber decreases ammonia levels in patients with cirrhosis // Hepatology. – 2005. – Vol. 41, N 1. – P. 217–218.
7. Liu Q., Duan Z.P., Ha D.K. et al. Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis// Hepatology. – 2004. – N 39. – P. 1441–1449.
8. Marlett J.A., Fischer M.H. The active fraction of psyllium seed husk // Proc. Nutr. Soc. – 2003. – Vol. 62, N 1. – P. 207–209.
9. Medina J., Fernбndez-Salazar L.I., Garcнa-Buey L., Moreno-Otero R. Approach to the pathogenesis and treatment of non-alcoholic steatohepatitis // Diabetes Care. – 2004. – N 27. – P. 2057–2066.
10. Oneta C.M., Dufour J.F. Non-alcoholic fatty liver disease: treatment options based on pathogenic considerations // Swiss Med. Wkly. – 2002. – Vol. 132. – Р. 493–505.
11. Rayes N., Seehofer D., Hansen S. et al. Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients // Transplantation. – 2002. – Vol. 15; 74, N 1. – P. 123–12.
12. Riordan S.M., Williams R. The intestinal flora and bacterial infection in cirrhosis // J. Hepatol. – 2006. – Vol. 45, N 5. – P. 744–757.
13. Solga S.F., Diehl A. Non-alcoholic fatty liver disease: lumen-liver interactions and possible role for probiotics // J. Hepatol. – 2003. – Vol. 38. – P. 681–687.
14. Talbot J.M. Role of dietary fiber in diverticular disease and colon cancer // Fed. Proc. – 1981. – N 40 (9). – P. 2337–2342.
15. Wiest R., Garcia-Tsao G. Bacterial translocation in cirrhosis // Hepatology. – 2005. – Vol. 41, N 3. – P. 422–433.
16. Wu W.C., Zhao W., Li S. Small intestinal bacteria overgrowth decreases small intestinal motility in the NASH rats // World J. Gastroenterol. – 2008. – N 14 (2). – P. 313–317.
Review
For citations:
Fedosyina Ye.A., Zharkova M.S., Maevskaya M.V. Bacterial intestinal microflora and diseases of the liver. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(6):73-81. (In Russ.)
Views:
45
Email this article 
