Liver alterations are not improved by inulin supplementation in alcohol use disorder patients during alcohol withdrawal: A pilot randomized, double-blind, placebo-controlled study
eBioMedicine. 2022-06-01; 80: 104033
DOI: 10.1016/j.ebiom.2022.104033
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Amadieu C(1), Maccioni L(2), Leclercq S(1), Neyrinck AM(3), Delzenne NM(3), de Timary P(4), Stärkel P(5).
Author information:
(1)Metabolism and Nutrition Research Group, Louvain Drug Research Institute,
Université catholique de Louvain, UCLouvain, Brussels, Belgium; Institute of
Neuroscience, Université catholique de Louvain, UCLouvain, Brussels, Belgium.
(2)Institute of Experimental and Clinical Research, Laboratory of
Hepato-Gastroenterology, Université catholique de Louvain, UCLouvain, Brussels,
Belgium.
(3)Metabolism and Nutrition Research Group, Louvain Drug Research Institute,
Université catholique de Louvain, UCLouvain, Brussels, Belgium.
(4)Institute of Neuroscience, Université catholique de Louvain, UCLouvain,
Brussels, Belgium; Department of Adult Psychiatry, Cliniques universitaires Saint
Luc, Brussels, Belgium.
(5)Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc,
Brussels, Belgium; Institute of Experimental and Clinical Research, Laboratory of
Hepato-Gastroenterology, Université catholique de Louvain, UCLouvain, Brussels,
Belgium. Electronic address: .
BACKGROUND: Emerging evidence highlights that targeting the gut microbiota could
be an interesting approach to improve alcohol liver disease due to its important
plasticity. This study aimed to evaluate the effects of inulin supplementation on
liver parameters in alcohol use disorder (AUD) patients (whole sample) and in a
subpopulation with early alcohol-associated liver disease (eALD).
METHODS: Fifty AUD patients, hospitalized for a 3-week detoxification program,
were enrolled in a randomized, double-blind, placebo-controlled study and
assigned to prebiotic (inulin) versus placebo for 17 days. Liver damage,
microbial translocation, inflammatory markers and 16S rDNA sequencing were
measured at the beginning (T1) and at the end of the study (T2).
FINDINGS: Compared to placebo, AST (β = 8.55, 95% CI [2.33:14.77]), ALT
(β = 6.01, 95% CI [2.02:10.00]) and IL-18 (β = 113.86, 95% CI [23.02:204.71])
were statistically significantly higher in the inulin group in the whole sample
at T2. In the eALD subgroup, inulin supplementation leads to specific changes in
the gut microbiota, including an increase in Bifidobacterium and a decrease of
Bacteroides. Despite those changes, AST (β = 14.63, 95% CI [0.91:28.35]) and ALT
(β = 10.40, 95% CI [1.93:18.88]) at T2 were higher in the inulin group compared
to placebo. Treatment was well tolerated without important adverse events or side
effects.
INTERPRETATION: This pilot study shows that 17 days of inulin supplementation
versus placebo, even though it induces specific changes in the gut microbiota,
did not alleviate liver damage in AUD patients. Further studies with a larger
sample size and duration of supplementation with adequate monitoring of liver
parameters are needed to confirm these results. Gut2Brain study:
https://clinicaltrials.gov/ct2/show/NCT03803709 FUNDING: Fédération
Wallonie-Bruxelles, FRS-FNRS, Fondation Saint-Luc.
Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.