title: Effects of Cassia tora fiber supplement on serum lipids in Korean diabetic patients. Effect of Daily Consumption of Probiotic Yoghurt on Serum Levels of Calcium, Iron and Liver Enzymes in Pregnant Women Supplementation with probiotics modifies gut flora and attenuates liver fat accumulation in rat nonalcoholic fatty liver disease model Effect of microbial cell preparation on renal profile and liver function among type 2 diabetics: a randomized controlled trial Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. The effect of enriched chicory inulin on liver enzymes, calcium homeostasis and hematological parameters in patients with type 2 diabetes mellitus: A randomized placebo-controlled trial. Effects of symbiotic and vitamin E supplementation on blood pressure, nitric oxide and inflammatory factors in non-alcoholic fatty liver disease Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis Effects of Synbiotic Food Consumption on Serum Minerals, Liver Enzymes, and Blood Pressure in Patients with Type 2 Diabetes: A Double-blind Randomized Cross-over Controlled Clinical Trial Effects of xylooligosaccharides in type 2 diabetes mellitus. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Altered Fecal Microbiota Correlates with Liver Biochemistry in Nonobese Patients with Non-alcoholic Fatty Liver Disease Treatment of nonalcoholic steatohepatitis with probiotics. A proof-of-concept study. The Effect of Chlorella vulgaris Supplementation on Liver En-zymes, Serum Glucose and Lipid Profile in Patients with Non-Alcoholic Fatty Liver Disease. Oat Prevents Obesity and Abdominal Fat Distribution, and Improves Liver Function in Humans Fecal Microbiota Transplantation: From Clostridium difficile to Inflammatory Bowel Disease. Probiotics restore bowel flora and improve liver enzymes in human alcohol-induced liver injury: a pilot study. Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial. 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 [Non alcoholic fatty liver disease: treatment with soluble fibres]. Effects of Probiotics on Nonalcoholic Fatty Liver Disease in Obese Children and Adolescents Randomised clinical trial: the beneficial effects of VSL#3 in obese children with non‐alcoholic steatohepatitis Bifidobacterium combined with fructo-oligosaccharide versus lactulose in the treatment of patients with hepatic encephalopathy Effects of traditional homemade koumiss on some hematological and biochemical characteristics in sedentary men exposed to exercise Probiotics reduce the inflammatory response induced by a high-fat diet in the liver of young rats.
abstract: Cassia tora fiber supplement consisting of 2 g of soluble fiber extracted from Cassia semen ( C. tora L. ) , 200 mg of alpha-tocopherol , 500 mg of ascorbic acid , and 300 mg of maltodextrin was formulated in a pack , and given to 15 type II diabetic subjects ( seven men and eight women 57.1 + /- 2.9 years old ) with instructions to take two packs per day for 2 months . Placebo contained maltodextrin only with a little brown caramel color . Lifestyle factors and dietary intakes of the subjects were not altered during the 2-month period . Serum total cholesterol was moderately ( P < .1 ) decreased in the C. tora group compared with the age- and gender-matched placebo group , as was the ratio of apolipoprotein B to apolipoprotein A1 ( P < .1 ) . Levels of serum triglycerides and low-density lipoprotein-cholesterol tended to decrease more in the C. tora-supplemented group than in the placebo group . Serum alpha-tocopherol was increased ( P < .01 ) but lipid peroxides were not significantly lower in the C. tora group . Fasting blood glucose , hemoglobin A1c , blood urea nitrogen , creatinine , and activities of serum aspartate aminotransferase and alanine aminotransferase were not changed by the fiber supplement . We concluded that C. tora supplements can help improve serum lipid status in type II diabetic subjects without serious adverse effects Background : To reach fetal appropriate growth during the third trimester , the requirements for dietary calcium and iron intakes during the pregnancy increases . This study was carried out to determine the effects of daily consumption of probiotic yoghurt on serum calcium and iron levels and liver enzymes among Iranian healthy pregnant women . Methods : In this controlled clinical trial , 70 primigravida pregnant women carrying singleton pregnancy at their third trimester were participated . Participants were r and omly divided into two groups of consuming 200 g/d of conventional ( n = 33 ) or probiotic yogurts ( n = 37 ) for 9 weeks . The probiotic yogurt contained Lactobacillus acidophilus and Bifidobacterium lactis with a total of min 1 × 107 CFU . To measure serum calcium , iron , aspartate aminotransferase ( AST ) and alanine aminotransferase ( ALT ) levels , blood sample s were drawn in a fasting state at baseline and after 9 weeks intervention . Results : Consumption of probiotic yogurt result ed in maintaining serum calcium levels compared with the conventional yogurt ( P = 0.01 ) . Within-group differences in the conventional yogurt group revealed a significant reduction of serum calcium levels ( −1.7 mg/dL , P < 0.0001 ) . No significant differences were found between the two yogurts in terms of their effects on serum iron , AST and ALT levels . Conclusions : Consumption of probiotic yogurt among pregnant women result ed in maintaining serum calcium levels compared with the conventional yogurt ; however , it could not affect serum iron , ALT and AST levels This study aim ed to evaluate the relationship between gut probiotic flora and nonalcoholic fatty liver disease in a diet-induced rat model , and to compare the effects of two different probiotic strains on nonalcoholic fatty liver disease . Forty male Sprague-Dawley rats were r and omized into 4 groups for 12 weeks : control ( st and ard rat chow ) , model ( fat-rich diet ) , Lactobacillus ( fat-rich diet plus Lactobacillus acidophilus ) , and Bifidobacterium ( fat-rich diet plus Bifidobacterium longum ) groups . Probiotics were provided to rats in drinking water ( 1010/ml ) . Gut bifidobacteria and lactobacilli were obviously lower at weeks 8 and 10 , respectively , in the model group compared with the control group . Supplementation with Bifidobacterium significantly attenuated hepatic fat accumulation ( 0.10 ± 0.03 g/g liver tissue ) compared with the model group ( 0.16 ± 0.03 g/g liver tissue ) . However , there was no improvement in intestinal permeability in either the Lactobacillus or the Bifidobacterium group compared with the model group . In all 40 rats  , the hepatic total lipid content was negatively correlated with gut Lactobacillus ( r = −0.623 , p = 0.004 ) and Bifidobacterium ( r = −0.591 , p = 0.008 ) . Oral supplementation with probiotics attenuates hepatic fat accumulation . Further , Bifidobacterium longum is superior in terms of attenuating liver fat accumulation than is Lactobacillus acidophilus Background The beneficial effect of probiotics on renal profile and liver function has been reported among patients with chronic kidney disease and fatty liver respectively . However , its effect on renal profile and liver function among type 2 diabetic individuals has not been fully understood . To investigate the effect of microbial cell preparation on renal profile and liver function tests among type 2 diabetic individuals . Methods A r and omized , double-blind , parallel-group , controlled clinical trial was conducted on a total of 136 type 2 diabetics age 30 - 70 years old in a teaching hospital in Kuala Lumpur , Malaysia . Subjects were r and omly assigned to receive microbial cell preparation ( N = 68 ) or a placebo ( N = 68 ) for 12 weeks . The outcomes measured at baseline , week 6 , and week 12 and included changes in renal profile ( Sodium , Potassium , Urea , Creatinine , Glomerular Filtration Rate ) , and liver function tests ( Albumin , Total Protein , Alkaline Phosphatase , Alanine Aminotransferase , Aspartate Aminotransferase ) . Intention to treat ( ITT ) analysis was performed on all the recruited subjects , while per protocol ( PP ) analysis was conducted on those who completed the trial with good compliance . Result The urea levels significantly declined in the probiotic group . Serum urea levels reduced from 4.26 mmol/L to 4.04 mmol/L in Probiotic Group while it increased in Placebo Group from 4.03 mmol/L to 4.24 mmol/L. These changes were significant between groups in ITT analysis ( p = 0.018 ) . Other parameters did not change significantly between groups . Conclusion 12 weeks supplementation with daily dosage of 6 × 1010 Colony Forming Units of multi-strain microbial cell preparation significantly improved urea levels . Trial registration ( Clinical trials : # NCT01752803 BACKGROUND Nonalcoholic fatty liver disease ( NAFLD ) is the most common chronic liver disease in the world . Oral administration of synbiotic has been proposed as an effective treatment of NAFLD because of its modulating effect on the gut flora , which can influence the gut-liver axis . OBJECTIVE The objective was to evaluate the effects of supplementation with synbiotic on hepatic fibrosis , liver enzymes , and inflammatory markers in patients with NAFLD . DESIGN In a r and omized , double-blind , placebo-controlled clinical trial conducted as a pilot study , 52 patients with NAFLD were supplemented twice daily for 28 wk with either a synbiotic or a placebo capsule . Both groups were advised to follow an energy-balanced diet and physical activity recommendations . RESULTS At the end of the study , the alanine aminotransferase ( ALT ) concentration decreased in both groups ; this reduction was significantly greater in the synbiotic group . At the end of the study , the following significant differences [ means ( 95 % CIs ) ] were seen between the synbiotic and placebo groups , respectively : ALT [ -25.1 ( -26.2 , -24 ) compared with -7.29 ( -9.5 , -5.1 ) IU/L ; P < 0.001 ] , aspartate aminotransferase [ -31.33 ( -32.1 , -30.5 ) compared with -7.94 ( -11.1 , -4.8 ) IU/L ; P < 0.001 ] , γ-glutamyltransferase [ -15.08 ( -15.5 , -14.7 ) compared with -5.21 ( -6.6 , -3.9 ) IU/L ; P < 0.001 ] , high-sensitivity C-reactive protein [ -2.3 ( -3 , -1.5 ) compared with -1.04 ( -1.5 , -0.6 ) mmol/L ; P < 0.05 ] , tumor necrosis factor-α [ -1.4 ( -1.7 , -1.1 ) compared with -0.59 ( -0.8 , -0.3 ) mmol/L ; P < 0.001 ] , total nuclear factor κ-B p65 [ -0.016 ( -0.022 , -0.011 ) compared with 0.001 ( -0.004 , -0.007 ) mmol/L ; P < 0.001 ] , and fibrosis score as determined by transient elastography [ - 2.98 ( -3.6 , -2.37 ) compared with -0.77 ( -1.32 , -0.22 ) kPa ; P < 0.001 ] . CONCLUSIONS Synbiotic supplementation in addition to lifestyle modification is superior to lifestyle modification alone for the treatment of NAFLD , at least partially through attenuation of inflammatory markers in the body . Whether these effects will be sustained with longer treatment duration s remains to be determined BACKGROUND S AND AIMS Type 2 diabetic mellitus ( T2DM ) as one of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities . In the current study we aim ed to evaluate the effects of enriched chicory inulin supplementation on liver enzymes , serum calcium and phosphorous concentrations and hematological parameters in patients with T2DM . METHODS Forty-six diabetic females patients were r and omly allocated into intervention ( n=27 ) and control ( n=22 ) groups . Subjects in the intervention group received a daily dose of 10 g of chicory and subjects in control group received a placebo for two months . Anthropometric variables , glucose homeostasis , hematological parameters and metabolic indices including serum alanine aminotransfersae ( ALT ) , aspartate aminotransferase ( AST ) , alkaline phosphatase ( ALP ) , calcium and phosphorous as well as creatinine concentrations , glomerular filtration rate ( GFR ) and blood pressure were assessed at the beginning and end of the trial . RESULTS Significant reductions in fasting serum glucose ( FSG ) , Hb A1C , AST and ALP concentrations were observed in chicory-treated group . Systolic and diastolic blood pressures were also reduced in chicory-treated group . Serum calcium significantly increased after chicory supplementation but no change in placebo treated group has been occurred ( P=0.014 ) . Supplementation with enriched chicory for two months significantly reduced hematocrit and mean corpuscular volume ( MCV ) values ( P<0.05 ) . Changes in serum insulin , creatinine and GFR were not significant . CONCLUSION The present study showed beneficial effects of oligofructose-enriched chicory on the improvement of the glucose and calcium homeostasis , liver function tests , blood pressure and reduction in hematologic risk factors of diabetes in female patients with T2DM . Further studies in both genders are needed to generalize these findings to total population Non-alcoholic fatty liver disease ( NAFLD ) has been suggested to be well correlated with altered blood pressure . This study was conducted to determine the effects of symbiotic and vitamin E supplementation on blood pressure and inflammatory indices of patients with NAFLD . This r and omized , double-blind , placebo-controlled trial was performed among 60 NAFLD patients aged 25 to 64 years old . Participants were r and omly divided into four groups to receive a 400 IU alpha-tocopherol and 2 × 108 CFU/g symbiotic supplement for 8 weeks . The anthropometric parameters , systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) , serum malondialdehyde ( MDA ) , nitric oxide ( NO ) and tumor necrosis factor α ( TNFα ) were assessed at baseline and after 8 weeks of intervention . After 8 weeks of intervention , combined symbiotic and alpha-tocopherol , symbiotic and alpha-tocopherol alone administration , compared with the placebo , result ed in significant decreases in SBP ( -17.07±2.1 , -16.07±3.56 , -1.73±2.25 and -1.55±3.01 mmHg , P=0.01 ) , serum MDA ( -1.19±0.5 , -0.12±0.65 , 0.14 ± 0.64 and 0.16±0.34 nmol/mL , P<0.001 ) , serum TNFα ( -15.62±13.93 , -9.24±7.12 , -11.44 ± 15.47 and 3.01±1.71 pg/ml , P<0.001 ) concentrations . A significant decrease in serum AST ( -11.36±4.52 , -7.43±8.58 , -5.93±6.61 and 2.5±5.75 μmol/L , P < 0.001 ) , ALT ( -12.79±3.65 , -3.66±6.81 , -6.54±7.66 and 4.16±3.43 μmol/L , P < 0.001 ) and ALP ( -26.8±11.1 , -4.56±9.22 , -14.48±12.22 and 5.19±2.64 μmol/L , P < 0.001 ) was seen . Variations in DBP and serum NO concentration were not significant . Alpha-tocopherol and symbiotic supplementation among patients with NAFLD result ed in decreased SBP , serum MDA , TNFα levels and enzymes liver ; however , they did not affect DBP and serum NO concentration Nonalcoholic fatty liver disease is the most prevalent chronic liver disease in Western countries ; it can progress to nonalcoholic steatohepatitis ( NASH ) , cirrhosis and hepatocarcinoma . The importance of gut-liver-adipose tissue axis has become evident and treatments targeting gut microbiota may improve inflammatory and metabolic parameters in NASH patients . In a r and omized , controlled clinical trial , involving 50 biopsy-proven NASH patients , we investigated the effects of synbiotic supplementation on metabolic parameters , hepatic steatosis , intestinal permeability , small intestinal bacterial overgrowth ( SIBO ) and lipopolysaccharide ( LPS ) serum levels . Patients were separated into two groups receiving Lactobacillus reuteri with guar gum and inulin for three months and healthy balanced nutritional counseling versus nutritional counseling alone . Before and after the intervention we assessed steatosis by magnetic resonance imaging , intestinal permeability by lactulose/mannitol urinary excretion and SIBO by glucose breath testing .  NASH patients presented high gut permeability , but low prevalence of SIBO . After the intervention , only the synbiotic group presented a reduction in steatosis , lost weight , diminished BMI and waist circumference measurement . Synbiotic did not improve intestinal permeability or LPS levels . We concluded that synbiotic supplementation associated with nutritional counseling seems superior to nutritional counseling alone for NASH treatment as it attenuates steatosis and may help to achieve weight loss Background : This research was to examine the effects of synbiotic intake on minerals , liver enzymes , and blood pressure in patients with type 2 diabetes ( T2D ) . Methods : This r and omized , cross-over clinical trial was performed among 62 diabetic patients . Persons were r and omly assigned to intake either a synbiotic ( n = 62 ) or a control food ( n = 62 ) for 6 weeks . A 3-week washout period was applied following which persons were crossed over to the alternate intervention arm for an additional 6 weeks . The synbiotic was consisted of Lactobacillus sporogenes ( 1 × 107 CFU ) , 0.04 g inulin ( HPX ) as prebiotic . Persons were asked to consume the synbiotic and control foods 27 g a day . Blood pressure was measured , and blood sample s were taken at baseline and after 6-week intervention to assess calcium , magnesium , iron , alkaline phosphatase , aspartate aminotransferase , alanine aminotransferase , and total bilirubin . Results : The consumption of a synbiotic food , compared to the control food , result ed in a significant rise of calcium ( 0.66 vs. −0.14 mg/dL , P = 0.03 ) and iron ( 5.06 vs. −9.98 mg/dL , P = 0.03 ) . The decrease of total bilirubin ( 0.08 vs. −0.04 mg/dL ; P = 0.009 ) was also seen in the synbiotic group compared with the control group . Conclusions : Overall , synbiotic in T2D patients had beneficial effects on calcium , iron , and total bilirubin concentrations The purpose of this study was to evaluate the effect of xylooligosaccharide ( XOS ) on the blood sugar , lipids and oxidative status in type 2 diabetes mellitus ( DM ) . A total of 26 outpatient subjects of Taichung Veterans General Hospital , Taiwan , with HbA1c levels between 7.0 and 10.0 % and triglyceride < 400 mg/dL were enrolled in the present study . Subjects were supplemented with 4 g/d XOS ( n=12 ) or a placebo ( n=14 ) for 8 wk in a r and omized double-blind clinical design . The results showed that the anthropometric values and nutrient intakes did not change during the experimental period . XOS supplementation not only reduced the glucose , HbA1c and fructosamine concentrations , but also decreased the levels of total cholesterol , low density lipoprotein ( LDL ) cholesterol , oxidized low density lipoprotein ( ox-LDL ) and apolipoprotein B. The activity of catalase of the erythrocyte sample decreased in the XOS group , but not the activities of superoxide dismutase and glutathione peroxidase . In conclusion , the dietary supplementation with XOS for 8 wk was effective in improving the blood sugar and lipids in type 2 diabetes , indicating that XOS-containing diets might be beneficial to DM subjects Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Increasing evidence suggests a role of intestinal dysbiosis in obesity and non-alcoholic fatty liver disease ( NAFLD ) . But it remains unknown in nonobese NAFLD . This prospect i ve , cross-sectional study sought to characterize differences in fecal microbiota between nonobese adult individuals with and without NAFLD and their potential association with metabolic markers of disease progression . A total of 126 nonobese subjects were enrolled : 43 NAFLD and 83 healthy controls ( HC ) . The microbial community was profiled by denaturing gradient gel electrophoresis and examined by 454 pyrosequencing of the 16S ribosomal RNA V3 region . Lower diversity and a phylum-level change in the fecal microbiome were found in NAFLD . Compared with HC , patients had 20 % more phylum Bacteroidetes ( p = 0.005 ) and 24 % less Firmicutes ( p = 0.002 ) . Within Firmicutes , four families and their 8 genera , which were short-chain fatty acids-producing and 7α-dehydroxylating bacteria , were significantly decreased . Moreover , Gram-negative ( G− ) bacteria were prevalent in NAFLD ( p = 0.008 ) . Furthermore , a significant correlation with metabolic markers was revealed for disturbed microbiota in NAFLD . This novel study indicated that intestinal dysbiosis was associated with nonobese NAFLD and might increase the risk of NAFLD progression BACKGROUND Probiotics have profound effect on nonalcoholic steatohepatitis ( NASH ) in animal models . We aim ed to test the hypothesis that probiotics treatment was superior to usual care in reducing liver fat in NASH patients . MATERIAL AND METHODS Patients with histology-proven NASH were r and omized to receive probiotics ( n = 10 ) or usual care ( n = 10 ) for 6 months . The Lepicol probiotic formula contained Lactobacillus plantarum , Lactobacillus deslbrueckii , Lactobacillus acidophilus , Lactobacillus rhamnosus and Bifidobacterium bifidum . The primary endpoint was change in intrahepatic triglyceride content ( IHTG ) , as measured by proton-magnetic resonance spectroscopy , from baseline to month 6 . Secondary endpoints included changes in liver biochemistry and metabolic profile . RESULTS IHTG decreased from 22.6 ± 8.2 % to 14.9 ± 7.0 % in the probiotic group ( P = 0.034 ) but remained static in the usual care group ( 16.9 ± 6.1 % to 16.0 ± 6.6 % ; P = 0.55 ) . Six subjects in the probiotic group had IHTG reduced by more than 30 % from baseline , compared to 2 subjects in the usual care group ( P = 0.17 ) . The probiotic group also had greater reduction in serum aspartate aminotransferase level ( P = 0.008 ) . On the other h and , the use of probiotics was not associated with changes in body mass index , waist circumference , glucose and lipid levels . CONCLUSIONS Probiotics treatment may reduce liver fat and AST level in NASH patients . The therapeutic potential of probiotics in NASH should be tested in larger studies BACKGROUND Non-alcoholic fatty liver disease ( NAFLD ) is becoming a public health problem worldwide and using microalgae is a new approach on its treatment . The aim of this study was to investigate the effect of Chlorella vulgaris supplementation on liver enzymes , serum glucose and lipid profile in patients with NAFLD . METHODS This double-blind r and omized placebo-controlled clinical trial was conducted on 60 NAFLD patients from specialized clinics of Tabriz University of Medical Sciences from December 2011 to July 2012 . The subjects were r and omly allocated into 2 groups : 1 ) " intervention " ( n=30 ) received 400 mg/day vitamin E plus four 300 mg tablets of Chlorella vulgaris and , 2 ) " placebo " ( n=30 ) received 400 mg/day vitamin E and four placebo tablets per day for 8 weeks . Weight , liver enzymes and metabolic factors were assessed in fasting serum and dietary data was collected at baseline and end of the study . RESULTS Weight , liver enzymes , fasting blood sugar ( FBS ) and lipid profile decreased significantly in both groups ( P<0.05 ) . The differences in weight , ALP and FBS between the two groups were statistically significant ( P=0.01 , P=0.04 and P=0.02 , respectively ) . CONCLUSION C. vulgaris seems to improve FBS and lipid profile and therefore could be considered as an effective complementary treatment in NAFLD Obesity is associated with a great diversity of diseases including non-alcoholic fatty liver disease . Our recent report suggested that oat , rich in beta-glucan , had a metabolic-regulating and liver-protecting effect in an animal model . In this study , we performed a clinical trial to further confirm the effect of oat .  Subjects with BMI ≧27 and aged 18–65 , were r and omly divided into a  control ( n = 18 ) and an  oat-treated ( n = 16 ) group , taking a placebo or beta glucan-containing oat cereal , respectively , for 12 weeks . Our data showed that consumption of oat reduced body weight , BMI , body fat and the waist-to-hip ratio . Profiles of hepatic function , including AST , but especially ALT , were useful re sources to help in the evaluation of the liver , since both showed decrements in patients with oat consumption . Nevertheless , anatomic changes were still not observed by ultrasonic image analysis . Ingestion of oat was well tolerated and there was no adverse effect during the trial . In conclusion , consumption of oat reduced obesity , abdominal fat , and improved lipid profiles and liver functions . Taken as a daily supplement , oat could act as an adjuvant therapy for metabolic disorders Fecal microbiota transplantation ( FMT ) has evolved from a case report in the medical literature to the basis of major innovations in the treatment of Clostridium difficile infection ( CDI ) and , potentially , inflammatory bowel disease ( IBD ) . In the clinical setting , FMT was noted to significantly lower the risk of recurrent CDI , likely by increasing microbial diversity and altering the metabolic environment in the intestinal tract of recipients . In parallel , advances in the ability to quantify and characterize microbial communities in fecal sample s led to the association of IBD with a state of intestinal dysbiosis . Consequently , a number of case series and r and omized , controlled trials have evaluated FMT in treating active ulcerative colitis or Crohn 's disease . Unlike in CDI , the efficacy of  FMT  in the treatment of IBD appears to be influenced by a number of factors , including donor microbial profiles , inflammatory burden , and the microbial diversity of the recipient . The therapeutic potential of the microbiome has led to a number of biotechnology and pharmaceutical companies isolating specific strains from healthy stool for use as targeted therapies for IBD in clinical trials . Ongoing studies are likely to determine the missing link between the efficacy of FMT  and its impact on microbial communities and mucosal inflammation The effects of chronic alcohol consumption on the bowel flora and the potential therapeutic role of probiotics in alcohol-induced liver injury have not previously been evaluated . In this study , 66 adult Russian males admitted to a psychiatric hospital with a diagnosis of alcoholic psychosis were enrolled in a prospect i ve , r and omized , clinical trial to study the effects of alcohol and probiotics on the bowel flora and alcohol-induced liver injury . Patients were r and omized to receive 5 days of Bifidobacterium bifidum and Lactobacillus plantarum 8PA3 versus st and ard therapy alone ( abstinence plus vitamins ) . Stool cultures and liver enzymes were performed at baseline and again after therapy . Results were compared between groups and with 24 healthy , matched controls who did not consume alcohol . Compared to healthy controls , alcoholic patients had significantly reduced numbers of bifidobacteria ( 6.3 vs. 7.5 log colony-forming unit [CFU]/g ) , lactobacilli ( 3.15 vs. 4.59 log CFU/g ) , and enterococci ( 4.43 vs. 5.5 log CFU/g ) . The mean baseline alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , and gamma-glutamyl transpeptidase ( GGT ) activities were significantly elevated in the alcoholic group compared to the healthy control group ( AST : 104.1 vs. 29.15 U/L ; ALT : 50.49 vs. 22.96 U/L ; GGT 161.5 vs. 51.88 U/L ) , indicating that these patients did have mild alcohol-induced liver injury . After 5 days of probiotic therapy , alcoholic patients had significantly increased numbers of both bifidobacteria ( 7.9 vs. 6.81 log CFU/g ) and lactobacilli ( 4.2 vs. 3.2 log CFU/g ) compared to the st and ard therapy arm . Despite similar values at study initiation , patients treated with probiotics had significantly lower AST and ALT activity at the end of treatment than those treated with st and ard therapy alone ( AST : 54.67 vs. 76.43 U/L ; ALT 36.69 vs. 51.26 U/L ) . In a subgroup of 26 subjects with well-characterized mild alcoholic hepatitis ( defined as AST and ALT greater than 30 U/L with AST-to-ALT ratio greater than one ) , probiotic therapy was associated with a significant end of treatment reduction in ALT , AST , GGT , lactate dehydrogenase , and total bilirubin . In this subgroup , there was a significant end of treatment mean ALT reduction in the probiotic arm versus the st and ard therapy arm . In conclusion , patients with alcohol-induced liver injury have altered bowel flora compared to healthy controls . Short-term oral supplementation with B. bifidum and L. plantarum 8PA3 was associated with restoration of the bowel flora and greater improvement in alcohol-induced liver injury than st and ard therapy alone OBJECTIVE The present pilot trial was carried out to evaluate the effects of an acute treatment with a mixture containing 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus per day in patients with non alcoholic fatty liver disease ( NAFLD ) . RESEARCH METHODS A sample of 30 patients with NAFLD ( diagnosed by liver biopsy ) was enrolled and 28 patients were analyzed in a double blind r and omized clinical trial . Patients were r and omized to one of the following treatments during 3 months : group I , treated with one tablet per day with 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus and group II , treated with one placebo tablet ( 120 mg of starch ) . RESULTS In group I , alanine amino transferase ( ALT : 67.7 + /- 25.1 vs. 60.4 + /- 30.4 UI/L ; p < 0.05 ) , aspartate aminotransferase activity ( AST : 41.3 + /- 15.5 vs. 35.6 + /- 10.4 UI/L ; p < 0.05 ) and gammaglutamine transferase levels ( gammaGT : 118.2 + /- 63.1 vs. 107.7 + /- 60.8 UI/L ; p < 0.05 ) decreased . In group II , all liver function parameters remained unchanged ( ALT : 60.7 + /- 32.1 vs. 64.8 + /- 35.5 UI/L ; p < 0.05 ) , aspartate aminotransferase activity ( AST : 31.7 + /- 13.1 vs. 36.4 + /- 13.8 UI/L ; ns ) and gammaglutamine transferase levels ( gammaGT : 82.1 + /- 55.1 vs. 83.6 + /- 65.3 UI/L ; ns ) . Anthropometric parameters and cardiovascular risk factors remained unchanged after treatment in both groups . CONCLUSION A tablet of 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus , with a r and omized clinical design , improved liver aminotransferases levels in patients with NAFLD Background : Regarding to the growing prevalence of nonalcoholic fatty liver disease ( NAFLD ) , concentrating on various strategies to its prevention and management seems necessary . The aim of this study was to determine the effects of symbiotic on C-reactive protein ( CRP ) , liver enzymes , and ultrasound findings in patients with NAFLD . Methods : Eighty NAFLD patients were enrolled in this r and omized , double-blind , placebo-controlled clinical trial . Participants received symbiotic in form of a 500 mg capsule ( containing seven species of probiotic bacteria and fructooligosaccharides ) or a placebo capsule daily for 8 weeks . Ultrasound grading , CRP , and liver enzymes were evaluated at the baseline and the end of the study . Results : In the symbiotic group , ultrasound grade decreased significantly compared to baseline ( P < 0.005 ) but symbiotic supplementation was not associated with changes in alanine aminotransferase ( ALT ) and aspartate transaminase ( AST ) levels . In the placebo group , there was no significant change in steatosis grade whereas ALT and AST levels were significantly increased ( P = 0.002 , P = 0.02 , respectively ) . CRP values remained static in either group . Conclusions : Symbiotic supplementation improved steatosis  in NAFLD patients and might be useful in the management of NAFLD or protective against its progression The pilot study evaluated the efficiency of oral soluble fibers to treat patients with nonalcoholic fatty liver disease . Twelve patients received 10 g/day of soluble fibers during 3 months . After the treatment 100 % of patients presented reduction in body mass index , waist circumference and insulin resistance index . In 66.7 % of the patients were observed reduction of the cholesterol levels and 75 % presented normal liver enzymes ( AST , ALT , and GGT ) . The present study suggests that oral soluble fibers may be useful to control risk factors and liver enzymes in patients with nonalcoholic fatty liver disease . However , future studies with histological controls are considered necessary Objectives : This study aims to evaluate the effects of some probiotics on sonographic and biochemical nonalcoholic fatty liver disease ( NAFLD ) . Methods : This r and omized triple-blind trial was conducted among 64 obese children with sonographic NAFLD . They were r and omly allocated to receive probiotic capsule ( containing Lactobacillus acidophilus ATCC B3208 , 3 × 109 colony forming units [ CFU ] ; Bifidobacterium lactis DSMZ 32269 , 6 × 109 CFU ; Bifidobacterium bifidum ATCC SD6576 , 2 × 109 CFU ; Lactobacillus rhamnosus DSMZ 21690 , 2 × 109 CFU ) or placebo for 12 weeks . Results : After intervention , in the probiotic group the mean levels of alanine aminotransferase decreased from 32.8 ( 19.6 ) to 23.1 ( 9.9 ) U/L ( P = 0.02 ) and mean aspartate aminotransferase decreased from 32.2 ( 15.7 ) to 24.3 ( 7.7 ) U/L ( P = 0.02 ) . Likewise the mean cholesterol , low-density lipoprotein-C , and triglycerides as well as waist circumference decreased in the intervention group , without significant change in weight , body mass index , and body mass index z score . After the trial , normal liver sonography was reported in 17 ( 53.1 % ) and 5 ( 16.5 % ) of patients in the intervention and placebo groups , respectively . Conclusions : The present findings suggest that a course of the abovementioned probiotic compound can be effective in improving pediatric NAFLD Gut microbiota modifiers may have beneficial effects of non‐alcoholic fatty liver disease ( NAFLD ) but r and omised controlled trials ( RCT ) are lacking in children Background Hepatic encephalopathy ( HE ) is a reversible neuropsychiatric syndrome in patients with liver disease . It was suggested that Bifidobacterium+fructo-oligosaccharides ( FOS ) may decrease blood and brain ammonia levels . Aim The study was conducted to compare the efficacy of Bifidobacterium+FOS and lactulose in patients with HE . Methods One hundred and twenty-five patients ( 35 hepatitis B virus infected , 70 hepatitis C virus infected and 20 cryptogenetic cirrhosis ) were enrolled in the study . Patients were r and omized either to a treatment for 60 days with Bifidobacterium and FOS ( group A ) or into-group receiving lactulose ( group B ) in double-blind . Results After 30 days of the study period , the Bifidobacterium+FOS-treated patients compared with lactulose-treated patients showed a significant decrease of Trail Making Test B ( TMT B ) ( P<0.005 ) , and a significant increase of Symbol Digit Modalities Test ( P<0.001 ) and Block Design Test ( P<0.001 ) . After 60 days of the study period , the Bifidobacterium+FOS-treated patients compared with lactulose-treated patients showed a significant decrease of NH4 fasting HE1 ( P<0.001 ) , TMT A ( P<0.05 ) , TMT B ( P<0.001 ) , and a significant increase of Symbol Digit Modalities Test ( P<0.001 ) and Block Design Test ( P<0.001 ) . Conclusion The treatment with Bifidobacterium+FOS is an alternative to the use of lactulose in patients with cirrhosis , for its usefulness in reducing blood ammonia levels and improvement of psychometric tests Abstract We evaluated the effects of koumiss on some hematological and biochemical characteristics of persons who exercise . Eighteen sedentary males were assigned to three equal groups : koumiss ( K ) , koumiss + exercise ( KE ) and exercise alone ( E ) . Leukocytes ( WBC ) , differential leucocyte count , erythrocytes ( RBC ) , hemoglobin ( HGB ) , hematocrit ( HCT ) , platelet ( PLT ) , glucose , total cholesterol , triglycerides , high density lipoprotein ( HDL ) , aspartate aminotransferase ( AST ) and alanine aminotransferase ( ALT ) were assessed In blood sample s. By the end of the study , triglycerides ( TG ) and cholesterol levels tended to decrease in all groups , but the decrease was significant only at day 15 for the KE group . HDL tended to be increased in all groups at day 15 , but the increase was significant only in the KE group . We found that koumiss had beneficial effects on some hematological and biochemical characteristics Nonalcoholic fatty liver disease ( NAFLD ) is the most common form of chronic liver disease in the pediatric population . Preliminary evidence suggests a potential therapeutic utility of probiotics for this condition . Here , we tested the potential effect of the probiotic VSL#3 ( a multistrain preparation composed of Streptococcus thermophilus and several species of Lactobacillus and Bifidobacteria ) on oxidative and inflammatory damage induced by a high-fat diet in the liver of young rats . At weaning , young male Sprague-Dawley rats were r and omly divided into 3 groups ( n = 6 ) fed a st and ard , nonpurified diet ( Std ; 5.5 % of energy from fat ) or a high-fat liquid diet ( HFD ; 71 % of energy from fat ) . One of the HFD groups received by gavage VSL#3 ( 13 x 10(9 ) bacteria x kg(-1 ) x d(-1 ) ) . After 4 wk , the HFD rats had greater body weight gain , fat mass , serum aminotransferase , and liver weight than rats fed the Std diet . The HFD induced liver lipid peroxidation , tumor necrosis factor ( TNFalpha ) production , protein S-nitrosylation , inducible nitric oxide synthase ( iNOS ) , cyclooxygenase (COX)-2 expression , and metalloproteinase ( MMP ) activity . Moreover , in the HFD group , PPARalpha expression was less than in rats fed the Std diet . In rats fed the HFD diet and treated with VSL#3 , liver TNFalpha levels , MMP-2 and MMP-9 activities , and expression of iNOS and COX-2 were significantly lower than in the HFD group . In VSL#3-treated rats , PPARalpha expression was greater than in the HFD group . A modulation of the nuclear factor-kappaB pathway by VSL#3 was also demonstrated . Our data suggest that VSL#3 administration could limit oxidative and inflammatory liver damage in patients with NAFLD
target: Conclusion This meta- analysis supports the potential use of microbial therapies in the treatment of NAFLD and sheds light on their potential mode of action .
background: Context Nonalcoholic fatty liver disease ( NAFLD ) is a highly prevalent and underdiagnosed comorbidity of many chronic diseases that is associated with altered intestinal bacterial communities .
  This association has prompted research into alternative treatments aim ed at modulating intestinal microbiota .
  Given the novelty of these treatments , scarce evidence regarding their effectiveness in clinical population s exists .
  Objective This meta- analysis sought to systemically review and quantitatively synthesize evidence on prebiotic , probiotic , and synbiotic therapies for patients with NAFLD in r and omized controlled trials .