Effect of a specific Escherichia coli Nissle 1917 strain on minimal/mild hepatic encephalopathy treatment
作者机构：Department of Propedeutics of Internal MedicineBogomolets National Medical UniversityKyiv 01601Ukraine Educational and Scientific Centre“Institute of Biology and Medicine”Taras Shevchenko National University of KyivKyiv 01601Ukraine Department of PediatricsBogomolets National Medical UniversityKyiv 01601Ukraine Department of ScientificMedical Laboratory CSDKyiv 01004Ukraine Department of EndocrinologyBogomolets National Medical UniversityKyiv 01601Ukraine
出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)
年 卷 期：2022年第14卷第3期
页 面：634-646页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：Hepatic encephalopathy Chronic liver disease cirrhosis Gut microbiota E.coli Nissle 1917 Cognitive functions Stroop test Rifaximin Lactulose
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 bygut-centrictherapies,such as the administration of nonabsorbable disaccharides,nonabsorbable antibiotics,probiotics and *** 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 *** From January 2017 to March 2020,a total of 45 patients with HE were enrolled in this prospective,single-centre,open-label,randomized *** 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 *** main primary outcomes of the study were changes in serum ammonia and Stroop test *** 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 *** 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 ***,the most pronounced restoration of the symbiotic microflora was associated with EcN administration and characterized by the absence of *** with altered properties and pathogenic enterobacteria in patient *** the primary outcome analysis,improvements in the Stroop test parameters in all intervention groups were ***,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 *** was more efficient than lactulose in reducing proinflammatory cytokine ***
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