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Metabolic Brain Disease

, Volume 24, Issue 1, pp 223–236 | Cite as

Bio-ecological control of chronic liver disease and encephalopathy

  • Stig Bengmark
Original Paper

Abstract

Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and in one study also evidence of clinical improvement.

Keywords

Chronic liver disease Liver cirrhosis Encephalopathy Inflammation Life style Lactic acid bacteria Probiotics Prebiotics 

References

  1. Ahrné S, Nobaek S, Jeppsson B, Adlerberth I, Wold AE, Molin G (1998) The normal Lactobacillus flora of healthy human rectal and oral mucosa. J Appl Microbiol 85(1):88–94, PMID: 9721659PubMedCrossRefGoogle Scholar
  2. Almersjö O, Bengmark S, Hafström LO, Olsson R (1969) Enzyme and function changes after extensive liver resection in man. Ann Surg 169(1):111–119, PMID: 5762442PubMedCrossRefGoogle Scholar
  3. Baptista JAB, Carvalho RCB (2004) Indirect determination of Amadori compounds in milk-based products by HPLC/ELSD/UV as an index of protein detorioration. Food Research International 37:739–747CrossRefGoogle Scholar
  4. Bengmark S (2001) Nutritional modulation of acute and “chronic” phase response. Nutrition 17:489–495, PMID: 11434344PubMedCrossRefGoogle Scholar
  5. Bengmark S (2004) Acute and “chronic” phase response—a mother of disease. Clin Nutr 23:1256–1266, PMID: 15556248PubMedCrossRefGoogle Scholar
  6. Bengmark S (2006) Curcumin, an atoxic antioxidant and natural NFkappaB, cyclooxygenase-2, lipooxygenase, and inducible nitric oxide synthase inhibitor: a shield against acute and chronic diseases. JPEN J Parenter Enteral Nutr 30(1):45–51, PMID: 16387899PubMedCrossRefGoogle Scholar
  7. Bengmark S (2007) Advanced glycation and lipoxidation end products—amplifiers of inflammation: the role of food. JPEN J Parenter Enteral Nutr 31(5):430–440, PMID: 17712153PubMedCrossRefGoogle Scholar
  8. Bengmark S (2008) Control of systemic inflammation and chronic diseases—the use of turmeric and curcuminoids. In: Mine, Miyashita, Shahidi (Ed) Nutrigenomics and proteogenomics in health and disease: Impact of food factors-gene interactions. Under publicationGoogle Scholar
  9. Bengmark S, Olsson R (1962a) Effect of vitamin B12 on liver regeneration after carbon tetrachloride injury. Lab Invest 11:235–239, PMID: 13867203PubMedGoogle Scholar
  10. Bengmark S, Olsson R (1962b) The effect of sex and of testosterone on toxic liver damage. J Endocrinol 25:293–297, PMID: 13967433PubMedCrossRefGoogle Scholar
  11. Bengmark S, Olsson R (1963a) Effect of vitamin B12 on liver regeneration after partial hepatectomy. Gastroenterologia 100:75–86, PMID: 14062564PubMedCrossRefGoogle Scholar
  12. Bengmark S, Olsson R (1963b) Experimental study of liver healing after partial hepatectomy. Special regard to changes in content of liver glutamic pyruvic transaminase. Acta Hepatosplenol 10:283–293, PMID: 14089254PubMedGoogle Scholar
  13. Bengmark S, Olsson R (1963c) Effect of testosterone upon liver regeneration. Bull Soc Int Chir 22:451–457, PMID: 14108493PubMedGoogle Scholar
  14. Bengmark S, Olsson R (1964a) The effect of testosterone on liver healing after partial hepatectomy. Acta Chir Scand 127:93–100, PMID: 14104711PubMedGoogle Scholar
  15. Bengmark S, Olsson R (1964b) The effect of castration and testosterone treatment on liver healing in male rats after carbon tetrachloride injury. Pathol Microbiol (Basel) 27:167–174, PMID: 14122870CrossRefGoogle Scholar
  16. Bengmark S, Ekdahl PH, Olsson R (1964a) Effect of taurine and glycine treatment on the conjugation of bile acids in partially hepatectomized rats. Acta Chir Scand 128:180–185, PMID: 14196495PubMedGoogle Scholar
  17. Bengmark S, Olsson R, Svanborg A (1964b) Fat infiltration after partial hepatectomy. Changes in glycerides, cholesterol and phospholipids in the residual liver of the rat. Acta Hepatosplenol 11:276–285, PMID: 14325227PubMedGoogle Scholar
  18. Bengmark S, Ekman B, Olsson R, Rehnström B (1966a) Further studies on the effect of testosterone on liver healing after partial hepatectomy in male rats. Scand J Gastroenterol 1(2):106–110, PMID: 5963565PubMedGoogle Scholar
  19. Bengmark S, Edlund Y, Olsson R (1966b) Serum, liver and bile transaminases during extrahepatic biliary obstruction in the rat. Acta Hepatosplenol 13(2):84–88, PMID: 5992181PubMedGoogle Scholar
  20. Bengmark S, Ekdahl PH, Gottfries A, Mobacken H, Olsson R, Rehnström B, Scherstén T (1966c) Influence of testosterone treatment in experimental nutritional hepatic cirrhosis in the rat. Gastroenterologia 105(5):301–315, PMID: 5958907PubMedCrossRefGoogle Scholar
  21. Brandtzaeg P, Halstensen TS, Kett K, Krajci P, Kvale D, Rognum TO et al (1989) Immunobiology and immunopathology of human gut mucosa: humoral immunity and intraepithelial lymphocytes. Gastroenterology 97(6):1562–1584, PMID: 2684725PubMedGoogle Scholar
  22. Candore G, Balistreri CR, Colonna-Romano G, Grimaldi MP, Lio D, Listi’ F et al (2008) Immunosenescence and anti-immunosenescence therapies: the case of probiotics. Rejuvenation Res 11(2):425–432, PMID: 18442326PubMedCrossRefGoogle Scholar
  23. Chen H, O’Reilly E, McCullough ML, Rodriguez C, Schwarzschild MA, Calle EE et al (2007) Consumption of dairy products and risk of Parkinson’s disease. Am J Epidemiol 165(9):998–1006, PMID: 17272289PubMedCrossRefGoogle Scholar
  24. Debarry J, Garn H, Hanuszkiewicz A, Dickgreber N, Blümer N, von Mutius E et al (2007) Acinetobacter lwoffii and Lactococcus lactis strains isolated from farm cowsheds possess strong allergy-protective properties. J Allergy Clin Immunol 119(6):1514–1521, PMID: 17481709PubMedCrossRefGoogle Scholar
  25. Eutamene H, Bueno L (2007) Role of probiotics in correcting abnormalities of colonic flora induced by stress. Gut 56(11):1495–1497, PMID: 17938427PubMedCrossRefGoogle Scholar
  26. Eutamene H, Lamine F, Chabo C, Theodorou V, Rochat F, Bergonzelli GE (2007) Synergy between Lactobacillus paracasei and its bacterial products to counteract stress-induced gut permeability and sensitivity increase in rats. J Nutr 137(8):1901–1907, PMID: 17634262PubMedGoogle Scholar
  27. Finegold SM et al (1983) Human intestinal microflora in health and disease. Academic, London, pp 3–31Google Scholar
  28. Fujiwara D, Inoue S, Wakabayashi H, Fujii T (2004) The anti-allergic effects of lactic acid bacteria are strain dependent and mediated by effects on both Th1/Th2 cytokine expression and balance. Int Arch Allergy Immunol 135(3):205–215, PMID: 15467373PubMedCrossRefGoogle Scholar
  29. Ganmaa D, Li XM, Wang J, Qin LQ, Wang PY, Sato A (2002) Incidence and mortality of testicular and prostatic cancers in relation to world dietary practices. Int J Cancer 98(2):262–267 10, PMID: 11857417PubMedCrossRefGoogle Scholar
  30. Gareau MG, Jury J, MacQueen G, Sherman PM, Perdue MH (2007) Probiotic treatment of rat pups normalises corticosterone release and ameliorates colonic dysfunction induced by maternal separation. Gut 56(11):1522–1528, PMID: 17339238 (Erratum in: Gut. 2008 Apr;57(4):560)PubMedCrossRefGoogle Scholar
  31. Goldberg T, Cai W, Peppa M, Dardaine V, Baliga BS, Uribarri J et al (2004) Advanced glycoxidation end products in commonly consumed foods. J Am Diet Assoc 104(8):1287–91, PMID: 15281050PubMedCrossRefGoogle Scholar
  32. Hein G, Franke S (2002) Are advanced glycation end-product-modified proteins of pathogenetic importance in fibromyalgia? Rheumatology (Oxford) 41(10):1163–1167, PMID: 12364637CrossRefGoogle Scholar
  33. Holmes MD, Pollak MN, Willett WC, Hankinson SE (2002a) Dietary correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomarkers Prev 11(9):852–861, PMID: 12223429PubMedGoogle Scholar
  34. Holmes MD, Pollak MN, Hankinson SE (2002b) Lifestyle correlates of plasma insulin-like growth factor I and insulin-like growth factor binding protein 3 concentrations. Cancer Epidemiol Biomarkers Prev 11(9):862–867, PMID: 12223430PubMedGoogle Scholar
  35. Hyogo H, Yamagishi S, Iwamoto K, Arihiro K, Takeuchi M, Sato T et al (2007) Elevated levels of serum advanced glycation end products in patients with non-alcoholic steatohepatitis. J Gastroenterol Hepatol 22(7):1112–1119, PMID: 17559366PubMedCrossRefGoogle Scholar
  36. Ibnou-Zekri N, Blum S, Schiffrin EJ, von der Weid T (2003) Divergent patterns of colonization and immune response elicited from two intestinal Lactobacillus strains that display similar properties in vitro. Infect Immun 71(1):428–436, PMID: 12496193PubMedCrossRefGoogle Scholar
  37. Jiang R, Camargo CA Jr, Varraso R, Paik DC, Willett WC, Barr RG (2008) Consumption of cured meats and prospective risk of chronic obstructive pulmonary disease in women. Am J Clin Nutr 87(4):1002–1008, PMID: 18400725PubMedGoogle Scholar
  38. Kiraly MA, Kiraly SJ (2005) The effect of exercise on hippocampal integrity: review of recent research. Int J Psychiatry Med 35(1):75–89, PMID: 15977946PubMedCrossRefGoogle Scholar
  39. Kohut ML, Senchina DS (2004) Reversing age-associated immunosenescence via exercise. Exerc Immunol Rev 10:6–41, PMID: 15633584PubMedGoogle Scholar
  40. Kop WJ, Weissman NJ, Zhu J, Bonsall RW, Doyle M, Stretch MR, Glaes SB, Krantz DS, Gottdiener JS, Tracy RP (2008) Effects of acute mental stress and exercise on inflammatory markers in patients with coronary artery disease and healthy controls. Am J Cardiol 101:767–773, Mar 15, PMID: 18328837PubMedGoogle Scholar
  41. Kuhad A, Chopra K (2007) Curcumin attenuates diabetic encephalopathy in rats: behavioral and iochemical evidences. Eur J Pharmacol 576(1–3):34–42, PMID: 17822693PubMedCrossRefGoogle Scholar
  42. Laso FJ, Vaquero JM, Almeida J, Marcos M, Orfao A (2007) Chronic alcohol consumption is associated with changes in the distribution, immunophenotype, and the inflammatory cytokine secretion profile of circulating dendritic cells. Alcohol Clin Exp Res 31(5):846–854, Epub ahead of print Mar 26 PMID: 17386065PubMedCrossRefGoogle Scholar
  43. Lata J, Novotný I, Príbramská V, Juránková J, Fric P, Kroupa R et al (2007) The effect of probiotics on gut flora, level of endotoxin and Child-Pugh score in cirrhotic patients: results of a double-blind randomized study. Eur J Gastroenterol Hepatol 19(12):1111–1113, PMID: 17998837PubMedCrossRefGoogle Scholar
  44. Levitzky YS, Guo CY, Rong J, Larson MG, Walter RE, Keaney JF Jr, et al (2008) Relation of smoking status to a panel of inflammatory markers: The Framingham offspring. Atherosclerosis Epub ahead of print Feb 18 PMID: 18289552Google Scholar
  45. Liu Q, Duan ZP, Ha DK, Bengmark S, Kurtovic J, Riordan SM (2004) Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology 39(5):1441–1449, PMID: 15122774PubMedCrossRefGoogle Scholar
  46. Loguercio C, Federico A, Tuccillo C, Terracciano F, D’Auria MV, De Simone C et al (2005) Beneficial effects of a probiotic VSL#3 on parameters of liver dysfunction in chronic liver diseases. J Clin Gastroenterol 39(6):540–543, PMID: 15942443PubMedCrossRefGoogle Scholar
  47. Malaguarnera M, Greco F, Barone G, Gargante MP, Malaguarnera M, Toscano MA (2007) Bifidobacterium longum with fructo-oligosaccharide (FOS) treatment in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled study. Dig Dis Sci 52(11):3259–3565, PMID: 17393330PubMedCrossRefGoogle Scholar
  48. Malekinejad H, Scherpenisse P, Bergwerff AA (2006) Naturally occurring estrogens in processed milk and in raw milk (from gestated cows). J Agric Food Chem 54(26):9785–9791, PMID: 17177502PubMedCrossRefGoogle Scholar
  49. Müller M, Lier D (1994) Fermentation of fructans by epiphytic lactic acid bacteria. J Appl Bacteriol 76(4):406–411, PMID: 8200866PubMedGoogle Scholar
  50. Naaber P, Smidt I, Stsepetova J, Brilene T, Annuk H, Mikelsaar M (2004) Inhibition of Clostridium difficile strains by intestinal Lactobacillus species. J Med Microbiol 53(Pt 6):551–554, PMID: 15150337PubMedCrossRefGoogle Scholar
  51. Nagler-Anderson C (2000) Tolerance and immunity in the intestinal immune system. Crit Rev Immunol 20(2):103–20, PMID: 10872893PubMedGoogle Scholar
  52. Outwater JL, Nicholson A, Barnard N (1997) Dairy products and breast cancer: the IGF-I, estrogen, and bGH hypothesis. Med Hypotheses 48(6):453–461, PMID: 9247884PubMedCrossRefGoogle Scholar
  53. Ouwehand AC, Salminen S, Isolauri E (2002) Probiotics: an overview of beneficial effects. Antonie Van Leeuwenhoek 82(1–4):279–289, PMID: 12369194PubMedCrossRefGoogle Scholar
  54. Pancer Z, Cooper MD (2006) The evolution of adaptive immunity. Annu Rev Immunol 24:497–518, PMID: 16551257PubMedCrossRefGoogle Scholar
  55. Prioult G, Fliss I, Pecquet S (2003) Effect of probiotic bacteria on induction and maintenance of oral tolerance to beta-lactoglobulin in gnotobiotic mice. Clin Diagn Lab Immunol 10(5):787–792, PMID: 12965905PubMedCrossRefGoogle Scholar
  56. Rayes N, Seehofer D, Theruvath T, Schiller RA, Langrehr JM, Jonas S et al (2005) Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant 5(1):125–130, PMID: 15636620PubMedCrossRefGoogle Scholar
  57. Reddy GK (2004) Cross-linking in collagen by nonenzymatic glycation increases the matrix stiffness in rabbit achilles tendon. Exp Diabesity Res 5(2):143–53, PMID: 15203885PubMedCrossRefGoogle Scholar
  58. Riordan SM, Skinner NA, McIver CJ, Liu Q, Bengmark S, Bihari D, Visvanathan K (2007) Synbiotic-associated improvement in liver function in cirrhotic patients: Relation to changes in circulating cytokine messenger RNA and protein levels. Microb Ecol Health Dis 19:7–16CrossRefGoogle Scholar
  59. Sebeková K, Krajcoviová-Kudlácková M, Schinzel R, Faist V, Klvanová J, Heidland A (2001) Plasma levels of advanced glycation end products in healthy, long-term vegetarians and subjects on a western mixed diet. 240(6):275–81, PMID: 11876491Google Scholar
  60. Sebeková K, Kupcová V, Schinzel R, Heidland A (2002) Markedly elevated levels of plasma advanced glycation end products in patients with liver cirrhosis—amelioration by liver transplantation. J Hepatol 36(1):66–71, PMID: 11804666PubMedCrossRefGoogle Scholar
  61. Stadlbauer V, Mookerjee RP, Hodges S, Wright GA, Davies NA, Jalan R (2007) Effect of probiotic treatment on deranged neutrophil function and cytokine responses in patients with compensated alcoholic cirrhosis. J Hepatol 48(6):945–951, PMID: 18433921CrossRefGoogle Scholar
  62. Solga SF, Diehl AM (2004) Gut flora-based therapy in liver disease? The liver cares about the gut. Hepatology 39(5):1197–1200, PMID: 15122746PubMedCrossRefGoogle Scholar
  63. Suzuki C, Kimoto-Nira H, Kobayashi M, Nomura M, Sasaki K, Mizumachi K (2008) Immunomodulatory and cytotoxic effects of various Lactococcus strains on the murine macrophage cell line J774.1. Int J Food Microbiol 123(1–2):159–165, PMID: 18258324PubMedCrossRefGoogle Scholar
  64. Tabak C, Arts IC, Smit HA, Heederik D, Kromhout D (2001) Chronic obstructive pulmonary disease and intake of catechins, flavonols, and flavones: the MORGEN Study. Am J Respir Crit Care Med 164(1):61–64, PMID: 11435239PubMedGoogle Scholar
  65. Taneja R, Parodo J, Jia SH, Kapus A, Rotstein OD, Marshall JC (2004) Delayed neutrophil apoptosis in sepsis is associated with maintenance of mitochondrial transmembrane potential and reduced caspase-9 activity. Crit Care Med 32(7):1460–1469, PMID: 15241089PubMedCrossRefGoogle Scholar
  66. Tlaskalová-Hogenová H, Stepánková R, Hudcovic T, Tucková L, Cukrowska B, Lodinová-Zádníková R et al (2004) Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases. Immunol Lett 93(2–3):97–108, PMID: 15158604PubMedCrossRefGoogle Scholar
  67. Tok D, Ilkgul O, Bengmark S, Aydede H, Erhan Y, Taneli F et al (2007) Pretreatment with pro- and synbiotics reduces peritonitis-induced acute lung injury in rats. J Trauma 62(4):880–885, PMID: 17426542PubMedCrossRefGoogle Scholar
  68. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP (2006) Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr 84(4):936–942, PMID: 17023723PubMedGoogle Scholar
  69. van Tongeren SP, Slaets JP, Harmsen HJ, Welling GW (2005) Fecal microbiota composition and frailty. Appl Environ Microbiol 71(10):6438–6442, PMID: 16204576PubMedCrossRefGoogle Scholar
  70. Vasto S, Malavolta M, Pawelec G (2006) Age and immunity. Immun Ageing 3:2, Feb 24, PMID: 16504129PubMedCrossRefGoogle Scholar
  71. Verdú EF, Bercík P, Bergonzelli GE, Huang XX, Blennerhasset P, Rochat F et al (2004) Lactobacillus paracasei normalizes muscle hypercontractility in a murine model of postinfective gut dysfunction. Gastroenterology 127(3):826–837, PMID: 15362038PubMedCrossRefGoogle Scholar
  72. von der Weid T, Bulliard C, Schiffrin EJ (2001) Induction by a lactic acid bacterium of a population of CD4(+) T cells with low proliferative capacity that produce transforming growth factor beta and interleukin-10. Clin Diagn Lab Immunol 8(4):695–701, PMID: 11427413CrossRefGoogle Scholar
  73. Wolford ST, Argoudelis CJ (1979) Measurement of estrogens in cow’s milk, human milk, and dairy products. J Dairy Sci 62(9):1458–1463, PMID: 512140PubMedCrossRefGoogle Scholar
  74. Woodmansey EJ (2007) Intestinal bacteria and ageing. J Appl Microbiol 102(5):1178–1186, PMID: 17448153PubMedCrossRefGoogle Scholar
  75. Yagmur E, Tacke F, Weiss C, Lahme B, Manns MP, Kiefer P et al (2006) Elevation of Nepsilon-(carboxymethyl)lysine-modified advanced glycation end products in chronic liver disease is an indicator of liver cirrhosis. Clin Biochem 39(1):39–45, PMID: 16321365PubMedCrossRefGoogle Scholar
  76. Zittermann A, Schleithoff SS, Koerfer R (2005) Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 94(4):483–92, PMID: 16197570PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Lund UniversityLundSweden
  2. 2.Department of HepatologyUniversity College, London Medical SchoolsLondonUK
  3. 3.LondonUK

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