ABSTRACT
BACKGROUND: Probiotics may correct intestinal dysbiosis and proinflammatory conditions in patients with liver cirrhosis. AIM: To test the effects of a multispecies probiotic on innate immune function, bacterial translocation and gut permeability. METHODS: In a randomised, double blind, placebo-controlled study, stable cirrhotic out-patients either received a daily dose of a probiotic powder containing eight different bacterial strains (Ecologic Barrier, Winclove, Amsterdam, The Netherlands) (n = 44) or a placebo (n = 36) for 6 months and were followed up for another 6 months. RESULTS: We found a significant but subclinical increase in neutrophil resting burst (2.6-3.2%, P = 0.0134) and neopterin levels (7.7-8.4 nmol/L, P = 0.001) with probiotics but not with placebo. Probiotic supplementation did not have a significant influence on neutrophil phagocytosis, endotoxin load, gut permeability or inflammatory markers. Ten severe infections occurred in total; one during intervention in the placebo group, and five and four after the intervention has ended in the probiotic and placebo group, respectively. Liver function showed some improvement with probiotics but not with placebo. CONCLUSIONS: Probiotic supplementation significantly increased serum neopterin levels and the production of reactive oxygen species by neutrophils. These findings might explain the beneficial effects of probiotics on immune function. Furthermore, probiotic supplementation may be a well-tolerated method to maintain or even improve liver function in stable cirrhosis. However, its influence on gut barrier function and bacterial translocation in cirrhotic patients is minimal.
Subject(s)
Bacterial Translocation/physiology , Gastrointestinal Absorption/physiology , Immunity, Innate/physiology , Liver Cirrhosis/drug therapy , Liver Cirrhosis/immunology , Probiotics/administration & dosage , Adult , Bacterial Translocation/drug effects , Dietary Supplements , Double-Blind Method , Female , Gastrointestinal Absorption/drug effects , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/physiology , Humans , Immunity, Innate/drug effects , Liver Cirrhosis/microbiology , Male , Middle Aged , Permeability/drug effects , Treatment OutcomeSubject(s)
Esophageal Diseases/virology , Herpes Zoster/complications , Herpesvirus 3, Human/isolation & purification , Ulcer/virology , Acyclovir/therapeutic use , Aged, 80 and over , Antiviral Agents/therapeutic use , DNA, Viral/isolation & purification , Duodenal Ulcer/pathology , Duodenal Ulcer/virology , Esophageal Diseases/pathology , Herpes Zoster/drug therapy , Herpesvirus 3, Human/genetics , Humans , Male , Stomach Ulcer/pathology , Stomach Ulcer/virology , Ulcer/pathologyABSTRACT
Continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) via PEJ tubes is increasingly used in patients with advanced stages of Parkinson's disease. Tube-related complications such as kinking or coiling have been frequently reported. We herein describe two cases of tube dysfunction in patients with Parkinson's disease and continuous Duodopa® treatment due to knotting of the distal end of the tube. The mechanisms of knotting are unclear although a causative role of impaired gastrointestinal motility either by Parkinson's disease itself or Duodopa® treatment might be suspected.
