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World J Gastroenterol. Jun 28, 2011; 17(24): 2890-2896
Published online Jun 28, 2011. doi: 10.3748/wjg.v17.i24.2890
Probiotics in hepatology
Jan Lata, Jana Jurankova, Marcela Kopacova, Petr Vitek
Jan Lata, Petr Vitek, Department of Internal Medicine, Faculty of Medicine and University Hospital, Ostrava University, 708 52 Ostrava-Poruba, Czech Republic
Jana Jurankova, Department of Clinical Microbiology, University Hospital Brno, 637 00 Brno, Czech Republic
Marcela Kopacova, 2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Kralove, University Teaching Hospital, 500 05 Hradec Králove, Czech Republic
Author contributions: All authors contributed equally to this work.
Supported by Research Grant MSM 6198959223, Ministry of Education, Czech Republic
Correspondence to: Jan Lata, MD, PhD, Professor, Department of Internal Medicine, Faculty of Medicine and University Hospital, Ostrava University, Syllabova 19, 703 00 Ostrava, Czech Republic.
Telephone: +420-597091013 Fax: +420-596113146
Received: December 13, 2010
Revised: February 18, 2011
Accepted: February 25, 2011
Published online: June 28, 2011

The paper provides a basic review of intestinal microflora and its importance in liver diseases. The intestinal microflora has many important functions, above all to maintain the microbial barrier against established as well as potential pathogens. Furthermore, it influences the motility and perfusion of the intestinal wall, stimulates the intestinal immune system and therefore also the so-called common mucosal immune system, reducing bacterial translocation and producing vitamins. Immune homeostasis at mucosal level results from a controlled response to intestinal luminal antigens. In liver cirrhosis, there are many changes in its function, mostly an increase in bacterial overgrowth and translocation. In this review, probiotics and their indications in hepatology are generally discussed. According to recent knowledge, these preparations are indicated in clinical practice only for cases of hepatic encephalopathy. Probiotics are able to decrease the permeability of the intestinal wall, and decrease bacterial translocation and endotoxemia in animal models as well as in clinical studies, which is extremely important in the prevention of complications of liver cirrhosis and infection after liver transplantation. Probiotics could limit oxidative and inflammatory liver damage and, in some situations, improve the histological state, and thus non-alcoholic steatohepatitis could be considered as another possible indication.

Keywords: Intestinal microflora, Probiotics, Liver encephalopathy, Non-alcoholic steatohepatitis, Liver cirrhosis