Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure

Abstract

Objective To assess the effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 101 patients with HBV-ACLF treated in our hospital between January, 2017 and June, 2018 were enrolled in this study, including 56 without secondary infections (HBV-ACLF group) and 45 with secondary infections to HBV-ACLF (secondary infection group), with 67 healthy participants as controls. All the patients with HBV-ACLF were treated with bifidobacterium quadruple live bacteria tablets in addition to the routine treatments for 1 month. From all the participants, fecal specimens were collected before and after the treatment to analyze the changes in Lactobacillus, Bifidobacterium, Escherichia coli, Enterococcus, yeast, Staphylococcus, Bacteroides and Streptococcus mutans; peripheral blood samples were also obtained for testing the serum levels of immunoglobulin A (IgA), IgG and IgM using ELISA; the changes in T lymphocyte subsets CD3+, CD4+ and CD8+ were detected using immunofluorescence flow cytometry, and the levels of C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and interleukin-8(IL-8) were determined using ELISA. Results Compared with the control group, the patients with HBV-ACLF in both groups before the treatment showed significantly reduced abundance of intestinal Lactobacilli and Bifidobacteria and increased abundance of Escherichia coli, Enterococcus, yeast, Staphylococcus, Bacteroides, and Streptococcus pneumoniae (P 0.05). Conclusion The patients with secondary infections to HBV-ACLF have abnormal changes in intestinal flora and immune status, which can be improved by probiotic intervention