Evaluation of the Immunological Role of Human Intestinal Microflora (Lactobacillus Acidophillus) in Chronic Hepatitis C Patients

Abstract

A n estimated 170 million people worldwide have HCV infection as recorded by world health organization (WHO) in2011.Egypt has the highest countrywide prevalence of HCV in the world with an estimated 10 million patients. Our intestinal microbial flora includes a variety of microorganisms, predominantly bacteria, which colonize the gut of all living organisms. The gut microflora is essential for the development of both the digestive tract itself as well as our immune system required for the development of tissues such as Peyer‘s patches and the production of immunoglobulin A. The gut microflora is physically separated from the host by a thin intestinal epithelial barrier. As noted throughout this supplement, the gut microbiota have significant effects on human health and disease, particularly nutrient uptake. The effects of the gut microbiota, however, are not limited to the intestine. The gut and the liver are intimately associated, and there is continuous bidirectional communication between these organs through the bile, hormones, inflammatory mediators, and products of digestion and absorption. Thus, the quantity, quality, and composition of the intestinal microbiota can be expected to have both direct and indirect effects on liver function and physiology and possibly liver disease progression. A symbiotic relationship between the liver and intestinal tract enables the healthy status of both organs. Microflora resident in intestinal lumen plays a significant role in hepatocytes function. In the present study we aimed to evaluate the immunological role of human intestinal microflora (lactobacillus acidophilus) in chronic hepatitis c patients. This study included 50 subjects divided into 40 patients and 10 healthy subjects. All studied subjects were submitted to: 1- Clinical evaluation. 2- Abdominal sonography. 3- Laboratory investigations (liver functions,CBC, PCR for HCV, stool analysis& culture) 4- SerumImmunological markers: -IL2 (Th1 cytokine) by ELISA. -IL4 (Th2 cytokine) by ELISA. -IL10 (Th3, T- regulatory anti-inflammatory cytokines) by ELISA technique. 5- Liver biopsy (for patients only). We observed from this study that: -In this study we observed no relation between HCVRNA viral load and fobrosis score in HCV patients. - Both IL-2 and IL-10 were significantly increased in HCV infected patients while there was reduction of IL4 in same patients in comparison to healthy control. - In this study we found statistically significant decline in both total lactic acid bacteria and lactobacillus acidophillus in patient group than the healthy control group. - Furthermore, no relation was detected between either total lactic acid bacteria nor L. Acidophillus and the variuos cytokine profile (IL-2, IL-4 and IL-10).