Probiotic combination may boost liver function: Study

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A combination of three probiotic strains with or without a postbiotic may reduce levels of liver enzymes and support liver health and function, says a new study from Glac Biotech Co. in Taiwan.

Sixty days of supplementation with Limosilactobacillus fermentum TSF331, Limosilactobacillus reuteri TSR332 and Lactiplantibacillus plantarum subsp. plantarum TSP05 led to significant reductions in aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

“The supplementation of multi-strain probiotics (L. fermentum TSF331, L. reuteri TSR332 and L. plantarum TSP05) together was able to prevent fatty liver by reducing lipid accumulation and inflammation,” wrote the researchers in PLOS One.

“This combination was also more efficient on UA [uric acid] management by promoting UA excretion in the gut. The synergy between probiotics and postbiotics has the potential to establish a harmonious environment, specifically reshaping dysbiosis in metabolic disturbances.”

Liver health

Supplements to support liver health represent a small but growing category within the wider supplements space. The category is dominated by milk thistle (Silybum marianum), which recorded about $28 million in sales in the U.S. market, according to the most recent Herb Market Report from the American Botanical Council (HerbalGram #139).

In recent years, the potential for the gut microbiota to impact metabolic health and liver function has been garnering increased attention, with some coining the term the gut-liver axis to explain the bidirectional relationship between the gut, its microbiota and the liver.

The new pilot study focused on people with abnormal levels of AST, ALT and UA in the context of metabolic-associated fatty liver disease (MAFLD, and recent alternate term for non-alcoholic fatty liver disease, NAFLD).

“There is growing evidence that NAFLD is a multisystem disease, affecting extra-hepatic organs and regulatory pathways,”  the Taiwan-based scientists explained. “NAFLD, or MAFLD, are asymptomatic, so the combination of serum ALT and AST levels, age, body mass index (BMI) and sex is an important biomarker in the diagnosis of hepatic steatosis.”

Study details

The researchers assigned 82 people with abnormal AST and ALT levels to participate in their study. The volunteers were randomly assigned to one of six groups, with all supplements prepared by Glac Biotech.:

Group 1: 6.7 billion CFUs of L. fermentum TSF331 (isolated from healthy human gut)

Group 2: 6.7 billion CFUs of L. reuteri TSR332 (isolated from healthy human gut)

Group 3: 6.7 billion CFUS of L. plantarum TSP05 (isolated from Taiwanese pickled cabbage)

Group 4: 6.7 billion CFUs of an equal mixture of all three strains

Group 5: 6.7 billion CFUs of the three strains plus 200 mg of the Totipro PE0401 postbiotic powder

Group 6: Placebo

After 60 days the results showed that AST, ALT and UA levels were significantly reduced in all the active groups (groups 1-5).

For AST, the greatest reductions in levels of this enzyme were exhibited by the mixture of the three strains (22.6% reduction) and the mixture plus the postbiotic (31.4%).

For ALT, the combination groups again displayed the greatest effects, reducing enzyme levels by 29.7% and 40.0%, respectively.

Fecal microbiota analysis showed that combination products again performed best, this time in terms of modulating changes in the microbiota. For the combination of the three strains (Group 4), the analysis showed two probiotic genera (Lactobacillus and Faecalibacterium) were significantly increased, with specific increases at the strain level noted for L. reuteri, F. prausnitzii and B. wexlerae.

On the other hand, significant decreases were recorded in two pathobiont genera (Mogibacterium and Catonella) and at the strain levels for M. neglectum and C. morbi.

For the probiotics plus the postbiotic, the researchers found significant increases for three probiotic genera (Lactobacillus, Faecalibacterium and Leuconostoc) and for five probiotic species (L. fermentum, L. plantarum, L. gasseri, B. producta and S. thermophilus).

Significant decreases were recorded for Bilophila wadsworthia, a species previously reported to aggravate high fat diet-induced metabolic dysfunctions in mice.

“The findings should be interpreted cautiously owing to the limited sample size within each group,” the researchers stated. “Nonetheless, our results indicate that further investigation into the efficacy of multi-strain and multi-strain plus postbiotics is warranted."

Source: PLOS One

Published online ahead of print, doi: 10.1371/journal.pone.0307181

“Probiotic Lactobacillus fermentum TSF331, Lactobacillus reuteri TSR332, and Lactobacillus plantarum TSP05 improved liver function and uric acid management-A pilot study”

Authors: J-H. Lin, et al.