The Effect of Probiotics on Non Alcoholic Fatty Liver Disease

Probiotics and Non Alcoholic Steatohepatitis (NASH)

Nonalcoholic Fatty Liver Disease (NAFLD) has been suggested to be the most common cause of chronic liver disease in the general population in the Western World. In advanced stages of NAFLD, steatohepatitis (NASH) develops characterized by: steatosis, inflammation, and fibrosis progressing to cirrhosis in some patients. The knowledge of the role of small intestinal bacterial overgrowth (SIBO) in the pathogenesis of NASH has led to the proposal of probiotics as a therapeutic strategy for this disorder.

Probiotics may interfere with the development of NASH by several mechanisms. Data from an uncontrolled clinical trial in NASH patients show promising results, with improvement of liver enzymes in treated patients.

RESEARCH GOALS:

A. To assess the degree of SIBO in NAFLD patients vs. healthy controls. B. To evaluate the effect of probiotics vs. placebo on SIBO in NAFLD patients. C. To evaluate the effect of probiotics vs. placebo on disease severity (inflammation, steatosis, and fibrosis) in NAFLD patients.

Inclusion Criteria:

• Controls- healthy volunteers, male and female, above 18 years.
• NAFLD group - patients with histological proven NAFLD, male and female, above 18 years.

Exclusion Criteria:

• Controls

  • those who will be found to have fatty liver in abdominal ultra sound
  • any participant who will take antibiotics for any indication for more than 1 week during the study period or before recruitment to the study
  • any participant who had lost more than 10% of baseline body weight during the study period.

• NAFLD group

  • those who will be found to have any concomitant liver disease (i.e., HBV/HCV/HIV/EBV/CMV infection
  • autoimmune hepatitis
  • metabolic liver disease: Wilson's disease, cholestatic liver disease: PBC/PSC, etc.)
  • any participant who will take antibiotics for any indication for more than 1 week during the study period or before recruitment to the study
  • any participant who had lost more than 10% of baseline body weight during the study period