Probiotics may offer benefits for alcoholic livers

Supplements of friendly bacteria may restore the immune function of white blood cells in alcoholics, suggests new research from the UK.

The small study by researchers at University College London assigned patients with alcoholic cirrhosis to receive Lactobacillus casei Shirota supplements, and report that neutrophil (white blood cell) function was restored after four weeks.

"Our results provide novel data to suggest that Lactobacillus casei Shirota may restore neutrophil dysfunction in alcoholic cirrhotic patients," wrote lead author Vanessa Stadlbauer in the Journal of Hepatology .

The new study adds to the body of science by reporting that the 'friendly' bacteria may boost immune function in alcoholics.

Previous studies have already reported benefits from probiotics for the immune response, but no research has ever studied their potential benefits in immune function of people with alcoholic cirrhosis, stated the researchers.

"Patients with alcoholic cirrhosis are susceptible to infections and once infected, they have increased in-hospital mortality," explained Stadlbauer and co-workers.

"This may relate to a defective innate immune response in conjunction with an inappropriate inflammatory response."

Study details The researchers recruited 20 people with alcoholic cirrhosis, 12 of whom were assigned to consume L. casei Shirota supplements three times a day for four weeks.

The other eight were used as control subjects, as were a further 13 healthy people, and received no probiotics.

As expected, the neutrophil phagocyte capacity was 25 per cent lower in the people with alcoholic cirrhosis compared to the healthy controls.

At the end of the study, however, this capacity was normalized in the people receiving the probiotics.

No improvements were observed in the alcoholic cirrhosis controls.

"Although our study was not randomised, the data from the contemporaneous disease controls, who had similar clinical and biochemical characteristics as the study group and showed no significant changes in phagocytic function over the four-week study period, lends weight to the suggestion that the observed normalization in phagocytic capacity was likely to be due to an effect of administration of Lactobacillus casei Shirota," wrote the researchers.

The researchers suggest that the mechanism may be due to changes in the secretion in interleukin 10 (IL-10), and also by affecting the expression of the toll-like receptor (TLR4), which play a role in activating the immune response.

"Further understanding of how Lactobacillus casei Shirota achieves improved phagocytosis would provide novel insights into the dysfunction of the innate immune system associated with alcoholic cirrhosis and warrants an appropriately randomised, controlled and powered clinical trial," concluded the researchers.

The researchers note that some of the analytical costs and the probiotic Yakult were provided by Yakult UK.

Market stats Consumers are increasingly aware of the health benefits associated with probiotics, including improved intestinal health and immune system stimulation.

Indeed, probiotics remains a major growth market.

The European sector is set to more than triple in value over the next few years, according to Frost & Sullivan, to reach $137.9 million (€118.5m) in 2010.

Source: Journal of Hepatology (Elsevier) Published online ahead of print 25 March 2008, doi: 10.1016/j.jhep.2008.02.015 "Effect of probiotic treatment on deranged neutrophil function and cytokine responses in patients with compensated alcoholic cirrhosis" Authors: V. Stadlbauer, R.P. Mookerjee, S. Hodges, G.A.K. Wright, N.A. Davies, R. Jalan