Effect of a specific Escherichia coli Nissle 1917 strain on minimal/mild hepatic encephalopathy treatment  

作　　者：Elina Manzhalii Valentyna Moyseyenko Vitalii Kondratiuk Nataliia Molochek Tetyana Falalyeyeva Nazarii Kobyliak 

机构地区：[1]Department of Propedeutics of Internal Medicine,Bogomolets National Medical University,Kyiv 01601,Ukraine [2]Educational and Scientific Centre“Institute of Biology and Medicine”,Taras Shevchenko National University of Kyiv,Kyiv 01601,Ukraine [3]Department of Pediatrics,Bogomolets National Medical University,Kyiv 01601,Ukraine [4]Department of Scientific,Medical Laboratory CSD,Kyiv 01004,Ukraine [5]Department of Endocrinology,Bogomolets National Medical University,Kyiv 01601,Ukraine

出　　处：《World Journal of Hepatology》2022年第3期634-646,共13页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Hepatic encephalopathy(HE)can be considered a result of dysregulated gutliver-brain axis function,where cognitive impairment can be reversed or prevented by the beneficial effects induced by"gut-centric"therapies,such as the administration of nonabsorbable disaccharides,nonabsorbable antibiotics,probiotics and prebiotics.AIM To assess the short-term efficacy and safety of the probiotic Escherichia coli Nissle(EcN)1917 strain compared to lactulose and rifaximin in patients with minimal/mild HE.METHODS From January 2017 to March 2020,a total of 45 patients with HE were enrolled in this prospective,single-centre,open-label,randomized study.Participants were randomly assigned at a ratio of 1:1:1 to one of the treatment groups:The EcN group(n=15),lactulose group(n=15)or rifaximin group(n=15)for a 1 mo intervention period.The main primary outcomes of the study were changes in serum ammonia and Stroop test score.The secondary outcomes were markers of a chronic systemic inflammatory response(ІL-6,ІL-8,and IFN-γ)and bacteriology of the stool flora evaluated by specialized nonculture techniques after a 1 mo intervention period.RESULTS Patients who were given rifaximin or EcN showed a more significant reduction in serum ammonia and normalization of Bifidobacteria and Lactobacilli abundance compared to the lactulose group.However,the most pronounced restoration of the symbiotic microflora was associated with EcN administration and characterized by the absence of E.coli with altered properties and pathogenic enterobacteria in patient faeces.In the primary outcome analysis,improvements in the Stroop test parameters in all intervention groups were observed.Moreover,EcN-treated patients performed 15%faster on the Stroop test than the lactulose group patients(P=0.017).Both EcN and rifaximin produced similar significant reductions in the proinflammatory cytokines INF-γ,IL-6 and IL-8.EcN was more efficient than lactulose in reducing proinflammatory cytokine levels.CONCLUSION The use of the probiotic EcN strain was sa

关 键 词：Hepatic encephalopathy Chronic liver disease CIRRHOSIS Gut microbiota E.coli Nissle 1917 Cognitive functions Stroop test RIFAXIMIN LACTULOSE 

分 类 号：R575.3[医药卫生—消化系统]