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.
Similar content being viewed by others
References
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: 9721659
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: 5762442
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 37:739–747
Bengmark S (2001) Nutritional modulation of acute and “chronic” phase response. Nutrition 17:489–495, PMID: 11434344
Bengmark S (2004) Acute and “chronic” phase response—a mother of disease. Clin Nutr 23:1256–1266, PMID: 15556248
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: 16387899
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: 17712153
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 publication
Bengmark S, Olsson R (1962a) Effect of vitamin B12 on liver regeneration after carbon tetrachloride injury. Lab Invest 11:235–239, PMID: 13867203
Bengmark S, Olsson R (1962b) The effect of sex and of testosterone on toxic liver damage. J Endocrinol 25:293–297, PMID: 13967433
Bengmark S, Olsson R (1963a) Effect of vitamin B12 on liver regeneration after partial hepatectomy. Gastroenterologia 100:75–86, PMID: 14062564
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: 14089254
Bengmark S, Olsson R (1963c) Effect of testosterone upon liver regeneration. Bull Soc Int Chir 22:451–457, PMID: 14108493
Bengmark S, Olsson R (1964a) The effect of testosterone on liver healing after partial hepatectomy. Acta Chir Scand 127:93–100, PMID: 14104711
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: 14122870
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: 14196495
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: 14325227
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: 5963565
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: 5992181
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: 5958907
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: 2684725
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: 18442326
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: 17272289
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: 17481709
Eutamene H, Bueno L (2007) Role of probiotics in correcting abnormalities of colonic flora induced by stress. Gut 56(11):1495–1497, PMID: 17938427
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: 17634262
Finegold SM et al (1983) Human intestinal microflora in health and disease. Academic, London, pp 3–31
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: 15467373
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: 11857417
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)
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: 15281050
Hein G, Franke S (2002) Are advanced glycation end-product-modified proteins of pathogenetic importance in fibromyalgia? Rheumatology (Oxford) 41(10):1163–1167, PMID: 12364637
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: 12223429
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: 12223430
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: 17559366
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: 12496193
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: 18400725
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: 15977946
Kohut ML, Senchina DS (2004) Reversing age-associated immunosenescence via exercise. Exerc Immunol Rev 10:6–41, PMID: 15633584
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: 18328837
Kuhad A, Chopra K (2007) Curcumin attenuates diabetic encephalopathy in rats: behavioral and iochemical evidences. Eur J Pharmacol 576(1–3):34–42, PMID: 17822693
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: 17386065
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: 17998837
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: 18289552
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: 15122774
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: 15942443
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: 17393330
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: 17177502
Müller M, Lier D (1994) Fermentation of fructans by epiphytic lactic acid bacteria. J Appl Bacteriol 76(4):406–411, PMID: 8200866
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: 15150337
Nagler-Anderson C (2000) Tolerance and immunity in the intestinal immune system. Crit Rev Immunol 20(2):103–20, PMID: 10872893
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: 9247884
Ouwehand AC, Salminen S, Isolauri E (2002) Probiotics: an overview of beneficial effects. Antonie Van Leeuwenhoek 82(1–4):279–289, PMID: 12369194
Pancer Z, Cooper MD (2006) The evolution of adaptive immunity. Annu Rev Immunol 24:497–518, PMID: 16551257
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: 12965905
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: 15636620
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: 15203885
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 19:7–16
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: 11876491
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: 11804666
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: 18433921
Solga SF, Diehl AM (2004) Gut flora-based therapy in liver disease? The liver cares about the gut. Hepatology 39(5):1197–1200, PMID: 15122746
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: 18258324
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: 11435239
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: 15241089
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: 15158604
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: 17426542
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: 17023723
van Tongeren SP, Slaets JP, Harmsen HJ, Welling GW (2005) Fecal microbiota composition and frailty. Appl Environ Microbiol 71(10):6438–6442, PMID: 16204576
Vasto S, Malavolta M, Pawelec G (2006) Age and immunity. Immun Ageing 3:2, Feb 24, PMID: 16504129
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: 15362038
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: 11427413
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: 512140
Woodmansey EJ (2007) Intestinal bacteria and ageing. J Appl Microbiol 102(5):1178–1186, PMID: 17448153
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: 16321365
Zittermann A, Schleithoff SS, Koerfer R (2005) Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr 94(4):483–92, PMID: 16197570
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bengmark, S. Bio-ecological control of chronic liver disease and encephalopathy. Metab Brain Dis 24, 223–236 (2009). https://doi.org/10.1007/s11011-008-9128-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11011-008-9128-z