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Lactobacillus casei Alleviated the Abnormal Increase of Cholestasis‐Related Liver Indices During Tuberculosis Treatment: A Post Hoc Analysis of Randomized Controlled Trial
Author(s) -
Xiong Ke,
Cai Jing,
Liu Peiying,
Wang Jinyu,
Zhao Shanliang,
Xu Lei,
Yang Yang,
Liu Jiahong,
Ma Aiguo
Publication year - 2021
Publication title -
molecular nutrition and food research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.495
H-Index - 131
eISSN - 1613-4133
pISSN - 1613-4125
DOI - 10.1002/mnfr.202100108
Subject(s) - lactobacillus casei , medicine , gastroenterology , cholestasis , randomized controlled trial , gut flora , liver injury , liver function , clinical trial , immunology , biology , food science , fermentation
Scope Probiotics are promising in mitigating drug‐induced liver injury in animal experiments. However, the clinical evidence is absent. The objective is to investigate the effect of adjunctive Lactobacillus casei on tuberculosis‐drug‐induced liver injury. Methods and results A post hoc analysis is conducted for a previous randomized controlled trial. The trial is registered at the Chinese Clinical Trial Registry (No. ChiCTR‐IOR‐17013210). Four hundred twenty nine patients are allocated to receive standard tuberculosis therapy alone (control group), or together with 1 × 10 10 colony‐forming units (CFU) per day (low‐dose group), or 2 × 10 10 CFU per day of L. casei (high‐dose group) during tuberculosis treatment. The L. casei supplementation significantly reduced the incidence of the abnormal increase of cholestasis‐related liver indices including alkaline phosphatase ( p = 0.024) and bilirubin ( p = 0.013). Plasma lipopolysaccharide ( p = 0.02), intestinal permeability biomarkers including zonula occludens‐1 ( p = 0.001) and intestinal fatty acid binding protein ( p = 0.002) are significantly reduced. The gut microbiota composition is dramatically altered with a reduction of Bacteroidetes ( p < 0.001) and a corresponding increase of Actinobacteria ( p < 0.001) and Firmicutes ( p = 0.003). Conclusions L. casei supplementation is beneficial for suppressing abnormally elevated cholestasis‐related liver indices during tuberculosis treatment, which may be related to its modification on blood lipopolysaccharide, intestinal barrier function, and gut microbiota.