Histological improvement of non-alcoholic steatohepatitis with a prebiotic: a pilot clinical trial

Purpose In obesity and diabetes the liver is highly susceptible to abnormal uptake and storage of fat. In certain individuals hepatic steatosis predisposes to the development of non-alcoholic steatohepatitis (NASH), a disease marked by hepatic inflammation and fibrosis. Although the precise pathophy...

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Bibliographic Details
Published in:European journal of nutrition 2019-06, Vol.58 (4), p.1735-1745
Main Authors: Bomhof, Marc R., Parnell, Jill A., Ramay, Hena R., Crotty, Pam, Rioux, Kevin P., Probert, Chris S., Jayakumar, Saumya, Raman, Maitreyi, Reimer, Raylene A.
Format: Article
Language:English
Subjects:
Biopsy
Body composition
Body weight
Body weight loss
Chemistry
Chemistry and Materials Science
Clinical trials
Diabetes mellitus
Fatty liver
Female
Fibrosis
Glucose tolerance
Humans
Inflammation
Intestinal microflora
Liver
Liver diseases
Male
Microbiota
Middle Aged
Non-alcoholic Fatty Liver Disease - drug therapy
Nutrition
Oligosaccharides - therapeutic use
Original Contribution
Pathophysiology
Pilot Projects
Prebiotics
Prebiotics - administration & dosage
Steatosis
Supplements
Treatment Outcome
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Summary:Purpose In obesity and diabetes the liver is highly susceptible to abnormal uptake and storage of fat. In certain individuals hepatic steatosis predisposes to the development of non-alcoholic steatohepatitis (NASH), a disease marked by hepatic inflammation and fibrosis. Although the precise pathophysiology of NASH is unknown, it is believed that the gut microbiota-liver axis influences the development of this disease. With few treatment strategies available for NASH, exploration of gut microbiota-targeted interventions is warranted. We investigated the therapeutic potential of a prebiotic supplement to improve histological parameters of NASH. Methods In a placebo-controlled, randomized pilot trial, 14 individuals with liver-biopsy-confirmed NASH [non-alcoholic fatty liver activity score (NAS) ≥ 5] were randomized to receive oligofructose (8 g/day for 12 weeks followed by 16 g/day for 24 weeks) or isocaloric placebo for 9 months. The primary outcome measure was the change in liver biopsy NAS score and the secondary outcomes included changes in body weight, body composition, glucose tolerance, inflammatory markers, and gut microbiota. Results Independent of weight loss, oligofructose improved liver steatosis relative to placebo and improved overall NAS score ( P  = 0.016). Bifidobacterium was enhanced by oligofructose, whereas bacteria within Clostridium cluster XI and I were reduced with oligofructose ( P  
ISSN:1436-6207
1436-6215
DOI:10.1007/s00394-018-1721-2