Maslennikov R, Efremova I, Ivashkin V, Zharkova M, Poluektova E, Shirokova E, Ivashkin K. Effect of probiotics on hemodynamic changes and complications associated with cirrhosis: A pilot randomized controlled trial. World J Hepatol 2022; 14(8): 1667-1677 [PMID: 36157871 DOI: 10.4254/wjh.v14.i8.1667]
Corresponding Author of This Article
Roman Maslennikov, MD, PhD, Assistant Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya Street 1, Moscow 119435, Russia. mmmm00@yandex.ru
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2022; 14(8): 1667-1677 Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1667
Effect of probiotics on hemodynamic changes and complications associated with cirrhosis: A pilot randomized controlled trial
Roman Maslennikov, Irina Efremova, Vladimir Ivashkin, Maria Zharkova, Elena Poluektova, Elena Shirokova, Konstantin Ivashkin
Roman Maslennikov, Irina Efremova, Vladimir Ivashkin, Maria Zharkova, Elena Poluektova, Elena Shirokova, Konstantin Ivashkin, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia
Roman Maslennikov, Vladimir Ivashkin, Elena Poluektova, The Scientific Community for Human Microbiome Research, Moscow 119435, Russia
Roman Maslennikov, Consultative and Diagnostic Center No. 2 of Moscow Health Department , Moscow 107764, Russia
Author contributions: Ivashkin V provided the research idea; Ivashkin V, Efremova I, and Roman Maslennikov R designed the study; Efremova I and Maslennikov R wrote the draft; Maslennikov R was the guarantor; All authors edited the draft and contributed to the research and data analysis.
Supported byBiocodex Microbiota Foundation: National Research Grant Russia 2019.
Institutional review board statement: The study was approved by the Ethics Committee of Sechenov University.
Clinical trial registration statement: The study was registered at https://clinicaltrials.gov (NCT05231772).
Informed consent statement: The study procedures were explained to potential participants, and written informed consent was obtained before enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: Data can be provided upon request to the corresponding author.
CONSORT 2010 statement: The authors have read the CONSORT Statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roman Maslennikov, MD, PhD, Assistant Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya Street 1, Moscow 119435, Russia. mmmm00@yandex.ru
Received: February 15, 2022 Peer-review started: February 15, 2022 First decision: March 9, 2022 Revised: April 12, 2022 Accepted: July 26, 2022 Article in press: July 26, 2022 Published online: August 27, 2022 Processing time: 191 Days and 11 Hours
ARTICLE HIGHLIGHTS
Research background
Bacterial translocation exacerbates the hyperdynamic circulation observed in cirrhosis and contributes to a more severe disease course.
Research motivation
Probiotics may reduce bacterial translocation and may therefore be useful to redress the circulatory imbalance.
Research objectives
To investigate the effect of probiotics on hemodynamic parameters, systemic inflammation, and complications of cirrhosis in this randomized placebo-controlled trial.
Research methods
This single-blind randomized placebo-controlled study included patients with Child-Pugh class B and C cirrhosis that received probiotics (Saccharomyces boulardii) or a placebo for 3 mo. Liver function and the systemic hemodynamic status were evaluated pre- and post-intervention. Echocardiography and simultaneous blood pressure and heart rate monitoring were performed to evaluate systemic hemodynamic indicators. Cardiac output and systemic vascular resistance were calculated.
Research results
Following a 3-mo course of probiotics in comparison to the control group, we observed amelioration of hyperdynamic circulation and systemic inflammation with improved liver function, reduction in the severity of ascites, hepatic encephalopathy, and cholestasis, and an increase in platelet counts.
Research conclusions
Probiotic administration was associated with amelioration of hyperdynamic circulation and the associated complications of cirrhosis.
Research perspectives
To study the changes in the levels of the biomarkers of bacterial translocation, intestinal permeability, and in indicators of intrahepatic hemodynamics after the use of the probiotic in decompensated cirrhosis.
