Clinical study of probiotics combined with lactulose for minimal hepatic encephalopathy treatment

Area of Science:

• Gastroenterology and Hepatology
• Microbiology
• Clinical Medicine

Background:

• Minimal hepatic encephalopathy (MHE) is a complication of liver dysfunction affecting cognitive function.
• Current treatments for MHE, such as lactulose, aim to reduce ammonia levels but can be further optimized.
• The gut microbiome's role in MHE pathogenesis is increasingly recognized, suggesting potential therapeutic targets.

Purpose of the Study:

• To evaluate the clinical efficacy of combining probiotics with lactulose for treating MHE.
• To compare the effects of combination therapy versus lactulose alone on biochemical markers and cognitive tests in MHE patients.

Main Methods:

• A randomized controlled trial involving 88 MHE patients divided into a control group (lactulose) and a combined group (probiotics + lactulose).
• Measurements included serum ammonia, liver function tests (ALT, AST), intestinal mucosal barrier markers (FABP2, AGEs), and cognitive tests (NCT-A, DST).
• Data were analyzed to compare pre- and post-treatment outcomes between the two groups.

Main Results:

• Both groups showed significant improvements in serum ammonia, liver enzymes, intestinal barrier markers, and cognitive scores post-treatment.
• The combined group demonstrated significantly greater reductions in ammonia, ALT, AST, FABP2, AGEs, and NCT-A scores compared to the control group.
• The combined group also showed a significantly greater increase in DST scores, indicating enhanced cognitive improvement.

Conclusions:

• Probiotics significantly potentiate the therapeutic effects of lactulose in treating minimal hepatic encephalopathy.
• Combination therapy offers a superior approach to managing MHE by improving both biochemical parameters and cognitive function.
• This study supports the use of probiotics as an adjunct therapy for MHE, highlighting the interplay between gut health and liver disease.