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The power of probiotics to support liver function and modulate gut microbiome
There is a rapidly growing interest in the power of probiotics to promote overall health and counter specific illnesses.
Research has found that the number of search results and the number of articles containing the words probiotic has significantly increased over the last decade.1 As more research is conducted into the area, the benefits that are provided by improving the health of the gut microbiota have been shown to allow for the improvement of digestive health conditions, such as IBS and inflammatory bowel disease. Research has also shown the potential for probiotics to improve illnesses ranging from obesity to osteoporosis.2
Probiotics can support the immune system by stimulating the production of antibodies and immune cells, reducing the risk of infections. They also have anti-inflammatory properties, which help lower the risk of chronic diseases. In addition, by enhancing gut-barrier function, probiotics can support liver health. They can help prevent harmful substances from entering the bloodstream and reaching the liver, which reduces liver stress and damage.
Probiotics also modulate gut bacteria, reducing the overgrowth of harmful bacteria that can contribute to liver diseases. Additionally, probiotics can help regulate lipid metabolism, reducing fat accumulation in the liver and lowering oxidative stress. By balancing the gut microbiota, probiotics can also support liver detoxification and may help slow the progression of liver disease.
The importance of the gut microbiome
The capacity of probiotics to enhance gut health in this way is increasingly important as populations globally shift to living in urban areas. Associated with this is a corresponding higher rate of metabolic disorders due to changes in diet, reduced physical activity, and increased levels of stress.3 The metabolic disturbances can result in obesity, insulin resistance, and dyslipidaemia, which can in turn lead to fatty liver disease (FLD). There are two types of FLD: non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). As referenced in the name, ALD is primarily driven by excessive alcohol intake, whereas NALFD is associated with the overconsumption of food.
NAFLD is a leading cause of liver disease worldwide, with an estimated global incidence of 47 cases per 1,000 population.4 Recently, the term ‘metabolic-associated fatty liver disease’ (MAFLD) has been proposed to replace NAFLD to better reflect the metabolism-related aetiology of the condition.
Hyperuricemia (high uric acid levels) is a risk factor for metabolic syndrome and is closely linked to lipid metabolism, inflammation, and oxidative stress. The condition is associated with NAFLD in human and animal studies, regardless of obesity status.5 High uric acid (UA) can signal early metabolic dysregulation.
Recent studies highlight the gut microbiome's role in metabolic conditions.6 Dysbiosis in the gut has been linked to FLD, and changes in specific gut bacteria have been observed in conditions like obesity, NAFLD, and hyperuricemia. As a result, probiotics and prebiotics are gaining attention for their potential to promote microbial balance, reduce serum UA levels, and support liver health. However, their effects are strain-specific and not all probiotics are able to effectively influence gut bacteria.
Biotics: Mono-strains vs multi-strains
Glac Biotech carried out a placebo-controlled, double-blinded, randomised clinical study to better understand the impact of daily supplementation with various combinations of probiotics on liver function and serum UA levels for individuals with a potential risk for MAFLD.7 To monitor outcomes, blood samples were collected to monitor the biochemistry profiles, and faecal samples were collected to investigate the gut microbiome modulation.
In addition, lipid accumulation and gene expressions of inflammatory factors were examined to understand the liver-protective mechanisms in HepG2 cells, as well as UA transporter activity being analysed to assess UA excretion.
The trial contained 120 participants who were recruited according to their latest physical examination report, with 82 final participants randomised into six groups to be tested over a 60-day period. The study aimed to compare the supplementation of multi-strain probiotics (Lactobacillus fermentum TSF331, Lactobacillus reuteri TSR332, and Lactobacillus plantarum TSP05), a mono-strain probiotic (one of the noted probiotics), and multi-strain probiotics with the addition of postbiotics (Totipro1 PE0401 postbiotic powder).
Among the participants, the study demonstrated the benefits of multi-strain probiotics and postbiotics on liver health, UA levels, energy metabolism, and gut microbiota. Serum AST and ALT levels, key indicators of liver function, were notably reduced in all treatment groups after 60 days, with the multi-strain probiotics plus postbiotics group showing the most significant decreases (31.43% for AST and 40.00% for ALT), indicating enhanced liver protection compared to the control group.
In UA management, gender-specific analyses revealed that serum UA levels significantly declined in both male and female subjects receiving probiotic treatments. In males, the multi-strain probiotics plus postbiotics group saw the largest UA reduction (19.93%), while females in the same group experienced a 15.76% reduction.
Gut microbiota composition analysis revealed that while alpha and beta diversity remained stable, the intervention led to notable changes in the abundance of specific bacterial genera. The multi-strain and multi-strain plus postbiotic groups displayed the best efficiency in modulating gut flora, with significant increases in beneficial genera such as Lactobacillus, Faecalibacterium, and Leuconostoc. Additionally, harmful pathobionts like Mogibacterium and Bilophila wadsworthia decreased in abundance, particularly in the multi-strain probiotics plus postbiotics group.
In cell models, treatment with Lactobacillus strains also significantly reduced fat build-up and lowered the expression of inflammatory genes in all probiotic groups. In further models, the probiotics were also able to enhance UA excretion to lower serum UA levels. With the results of these trials, Glac Biotech fully understood the potential for the effective combination of probiotic products to help the treatment of MALFD and improve the health of people living with the condition.
Probiotic potential
The research demands further investigation into the efficacy of multi-strain and multi-strain with postbiotics, and highlights the potential that these products have to become part of a toolkit to treat conditions related to the gut microbiome. This could be especially important as other treatment options, such as urate-lowering drugs, are associated with safety and tolerability concerns. This could make the intestine a safer and more effective target organ for a variety of conditions, with the results showing potential in liver health, uric acid reduction, modulation of gut microbiota, and reducing harmful bacteria.
The research conducted by Glac Biotech is part of its commitment to advance the science of probiotic and postbiotic ingredients and products. Continual R&D forms the backbone of the company’s work, with over 50 PhD and Master’s degree holders making up the research team. This allows Glac Biotech the expertise and research capacity to produce the highest quality probiotic and postbiotic products. By doing so, it is possible to deliver functional biotics to support health and wellbeing for people everywhere.
References
1. ResearchGate. Number of search results containing probiotic or prebiotics over the years.
2. Gul, S.; Durante-Mangoni, E.; (2024). Unraveling the Puzzle: Health Benefits of Probiotics-A Comprehensive Review. J Clin Med. 13(5):1436.
3. Kurniawan, F.; Manurung, M.D.; Harbuwono, D.S.; et al. (2022). Urbanization and Unfavorable Changes in Metabolic Profiles: A Prospective Cohort Study of Indonesian Young Adults. Nutrients. 14(16):3326.
4. Teng, M.L.; Ng, C.H.; Huang, D.Q.; et al. (2023). Global incidence and prevalence of nonalcoholic fatty liver disease. Clin Mol Hepatol. 29(Suppl):S32-S42.
5. Yang, X.; Lin, Y.; Huang, J.; et al. (2024). Serum uric acid levels and prognosis of patients with non-alcoholic fatty liver disease. Scientific reports.
6. Hur, K.Y.; Lee, M.S. Gut Microbiota and Metabolic Disorders. Diabetes Metab J. 2015 Jun;39(3):198-203.
7. Lin, J-H.; Lin, C-H.; Kuo, Y-W.; et al. (2024). Probiotic Lactobacillus fermentum TSF331, Lactobacillus reuteri TSR332, and Lactobacillus plantarum TSP05 improved liver function and uric acid management-A pilot study. Plus One.