PROBIOTICS: A NEW APPROACH TO CORRECT INTESTINAL PERMEABILITY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 众所周知，肝硬化患者的肠壁“渗漏”或肠道通透性受损，使细菌容易从肠道进入腹部淋巴结。 这一过程可能导致严重的并发症，如腹膜和血液感染、肝性脑病、肾衰竭和肝功能衰竭恶化。 益生菌是活的无害细菌，当摄入时，可以在肠道中增殖并减少导致这些并发症的有害细菌的数量。 益生菌已被证明可以改善其他疾病的肠道通透性和肝硬化患者肝脏疾病的临床措施。 我们假设益生菌也将改善肝硬化患者的肠道通透性，并在这样做的过程中，改善肝病的临床和生化指标。 为了验证这一假设，我们将比较给予益生菌与安慰剂45天的腹泻患者的肠道通透性、炎症、感染和肝功能的血液标志物以及神经认知功能的变化。 与安慰剂相比，益生菌给药后肠道通透性的显著改善将为进一步研究使用益生菌预防或治疗肝硬化患者的这些并发症奠定基础。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. It is well known that patients with cirrhosis have "leaky" intestinal walls or impaired intestinal permeability, allowing bacteria to easily cross from the intestine into the abdominal lymph nodes. This process can result in serious complications, such as peritoneal and blood infections, hepatic encephalopathy, kidney failure and worsening liver failure. Probiotics are live harmless bacteria that, when ingested, can proliferate in the intestine and reduce the number of harmful bacteria that cause these complications. Probiotics have been shown to improve intestinal permeability in other diseases and clinical measures of liver disease in patients with cirrhosis. We hypothesize that probiotics will also improve intestinal permeability in patients with cirrhosis and, in doing so, clinical and biochemical measures of liver disease. In order to test this hypothesis, we will compare changes in intestinal permeability, blood markers of inflammation, infection, and liver function, and neurocognitive function in cirrhotic patients given probiotics versus placebo for 45 days. A significant improvement in intestinal permeability after probiotic administration over placebo would set the stage for further study into the use of probiotics to prevent or treat these complications in patients with cirrhosis.