Eficacia del uso de probióticos como profilaxis en pacientes con encefalopatía hepática de cambios mínimos
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Publicado:
Oct 5, 2023
Palabras clave:
Alcoholic, Cirrhosis; Encephalopathy; Hepatic; Liver; Probiotics.
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Resumen
Introducción. la encefalopatía hepática de cambios mínimos es la presentación más leve que se caracteriza por alteraciones subclínicas inespecíficas que no son evidentes mediante la exploración física, la cual se debe a la incapacidad del hígado de eliminar las toxinas originadas en el intestino siendo el amoniaco la principal toxina , en la actualidad se considera que los probióticos representan un gran avance en esta patología, la misma que va actuar disminuyendo la cantidad de microorganismos patógenos facilitando el exceso de amoniaco a nivel cerebral. Objetivo. describir la eficacia de los probióticos como profilaxis secundaria en pacientes con encefalopatía hepática de cambios mínimos. Metodología. es un estudio de revisión bibliográfica tipo narrativa, una revisión amplia de la literatura, sobre la eficacia del uso de probióticos como profilaxis en pacientes con encefalopatía hepática de cambios minimos en bases de datos científicas, como Pub Med, Scielo, Biblioteca Cochrane, y Science Direct, mediante parte de la estrategia PRISMA. Resultados. se revisaron 51 estudios, que recopilaron las principales recomendaciones sobre la importancia del diagnóstico del streptococo b hemolitico en el embarazo en bases de datos científicas, como Pub Med, Scielo, Biblioteca Cochrane, y Science Direct, mediante parte de la estrategia PRISMA. Conclusión. el empleo de probióticos ha demostrado tener efectos positivos en el manejo y prevencion de la encefalopatia hepatica de cambios minimos, principalmente cuando se emplean en diferentes combinaciones de varias cepas bacterianas y otros farmacos coadyucantes. Ademas se debe destacar que son economicos y de facil acceso, los estudios planteadoos exponen su eficiacia en el tratamiento de diferentes hepatopatías, así como en la prevención de las complicaciones de la cirrosis, debido a su capacidad para modular la flora intestinal, la permeabilidad intestinal y la respuesta inmune. Área de estudio general: medicina. Área de estudio específica: medicina general.
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Toaza Gutama, D. C., & Orellana Bernal, P. V. (2023). Eficacia del uso de probióticos como profilaxis en pacientes con encefalopatía hepática de cambios mínimos. ConcienciaDigital, 6(4), 6-32. https://doi.org/10.33262/concienciadigital.v6i4.2695
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Ahmadi, S., Wang, S., Nagpal, R., Wang, B., Jain, S., Razazan, A., & Wang, T. D. (2019). A human-origin probiotic cocktail ameliorates aging-related leaky gut and inflammation via modulating the microbiota/taurine/tight junction axis. JCI Insight, 5(9), e132055.
Bellafante, D., Gioia, S., Faccioli, J., Riggio, O., Ridola, L., & Nardelli, S. (2023). Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution. Journal of Clinical Medicine, 12(3), 1187.
Butterworth, R. F. (2019). Hepatic Encephalopathy in Cirrhosis: Pathology and Pathophysiology. Drugs, 79(Suppl 1), 17-21.
Coronel-Castillo, C. E., Contreras-Carmona, J., Frati-Munari, A. C., Uribe, M., & Méndez-Sánchez, N. (2020). Efficacy of rifaximin in the different clinical scenarios of hepatic encephalopathy. Revista de Gastroenterología de México, 85(1), 56-68.
Di Marco, L., La Mantia, C., & Di Marco, V. (2022). Hepatitis C: Standard of Treatment and What to Do for Global Elimination. Viruses, 14(3), 505.
Enomoto, H., Ueno, Y., Hiasa, Y., Nishikawa, H., Hige, S., Takikawa, Y., ... & Nishiguchi, S. (2020). Transition in the etiology of liver cirrhosis in Japan: a nationwide survey. Journal of Gastroenterology, 55(3), 353-362.
Faccioli, J., Nardelli, S., Gioia, S., Riggio, O., & Ridola, L. (2022). Minimal Hepatic Encephalopathy Affects Daily Life of Cirrhotic Patients: A Viewpoint on Clinical Consequences and Therapeutic Opportunities. *Journal of Clinical Medicine*, 11(23), 7246.
González-Regueiro, J. A., Higuera-de la Tijera, M. F., Moreno-Alcántar, R., & Torre, A. (2019). Fisiopatología y opciones de tratamiento a futuro en la encefalopatía hepática. Revista de Gastroenterología de México, 84(2), 195-203.
Green, E. W., & Mitra, A. (2022). Diagnosis and management of hepatic encephalopathy: A summary for patients. *Clinical Liver Disease*, 20(3), 90-92.
Grgurevic, I., Podrug, K., Mikolasevic, I., Kukla, M., Madir, A., & Tsochatzis, E. A. (2020). Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach. *Canadian Journal of Gastroenterology and Hepatology*, 2020, e9181368.
Gu, W., Hortlik, H., Erasmus, H. P., Schaaf, L., Zeleke, Y., Uschner, F. E., ... & Más autores. (2022). Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018).
Hepatic Encephalopathy: Definition, Pathogenesis, Clinical Features of Hepatic Encephalopathy. (2023, June 30). [Citado el 7 de julio de 2023].
Huang, D. Q., Terrault, N. A., Tacke, F., Gluud, L. L., Arrese, M., Bugianesi, E., ... & Más autores. (2023). Global epidemiology of cirrhosis — aetiology, trends, and predictions. Nat Rev Gastroenterol Hepatol, 1-11.
Jalan, R., & Rose, C. F. (2022). Heretical thoughts into hepatic encephalopathy. Journal of Hepatology, 77(2), 539-548.
Kasper, P., Tacke, F., & Michels, G. (2022). [Management of acutely decompensated liver cirrhosis in emergency and critical care medicine]. *Medizinische Klinik - Intensivmedizin und Notfallmedizin*, 117(1), 73-82.
Li, B., Zhang, C., & Zhan, Y. T. (2018). Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its Epidemiology, Risk Factors, Clinical Presentation, Diagnosis, Management, and Prognosis. *Canadian Journal of Gastroenterology and Hepatology*, 2018, e2784537.
Luo, M., Ma, P., Li, L., & Cao, W. K. (2019). Advances in psychometric tests for screening minimal hepatic encephalopathy: From paper-and-pencil to computer-aided assessment. Turkish Journal of Gastroenterology: The Official Journal of Turkish Society of Gastroenterology, 30(5), 398-407.
Luo, M., Yu, X. B., Hu, S. J., & Bai, F. H. (2020). EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis. Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association, 26(3), 120-128.
Moctezuma-Velazquez, C., Castro-Narro, G., Simó, P., Viayna, E., Aceituno, S., Soler, M., ... & Belaiche, J. (2022). Economic evaluation of long-term albumin uses in cirrhosis patients from the Mexican healthcare system perspective. *Annals of Hepatology*, 27(2), 100673.
Pawar, V. B., Surude, R. G., Sonthalia, N., Zanwar, V., Jain, S., Contractor, Q., ... & Mishra, S. (2019). Minimal Hepatic Encephalopathy in Indians: Psychometric Hepatic Encephalopathy Score and Inhibitory Control Test for Diagnosis and Rifaximin or Lactulose for Its Reversal. Journal of Clinical and Translational Hepatology, 7(4), 304-312.
Perez, I. C., Bolte, F. J., Bigelow, W., Dickson, Z., & Shah, N. L. (2021). Step by Step: Managing the Complications of Cirrhosis. Hepatic Medicine: Evidence and Research, 13, 45-57.
Principales resultados de la Encuesta Nacional de Salud y Nutrición 2020 (2021, junio 10). [Archivo PDF]. Disponible en: [Enlace] (Añadir el enlace si está disponible)
Puentes, J. C. P., Rocha, H., Nicolau, S., & Ferrão, G. (2018). Effectiveness of the MELD/Na Score and the Child–Pugh Score for the Identification of Palliative Care Needs in Patients with Cirrhosis of the Liver. Indian Journal of Palliative Care, 24(4), 526-528.
Rivera-Flores, R., Morán-Villota, S., Cervantes-Barragán, L., López-Macias, C., & Uribe, M. (2020). Manipulation of microbiota with probiotics as an alternative for treatment of hepatic encephalopathy. Nutrition, 73, 110693.
Shahgond, L., Patel, C., Thakur, K., Sarkar, D., Acharya, S., & Patel, P. (2022). Therapeutic potential of probiotics – Lactobacillus plantarum UBLP40 and Bacillus clausii UBBC07 on thioacetamide-induced acute hepatic encephalopathy in rats. Metabolic Brain Disease, 37(1), 185-195.
Tapper, E. B., Henderson, J. B., Parikh, N. D., Ioannou, G. N., & Lok, A. S. (2019). Incidence of and Risk Factors for Hepatic Encephalopathy in a Population-Based Cohort of Americans with Cirrhosis. Hepatology Communications, 3(11), 1510-1519.
Thanapirom, K., Wongwandee, M., Suksawatamnuay, S., Thaimai, P., Siripon, N., Makhasen, W., ... & Poovorawan, Y. (2023). Psychometric Hepatic Encephalopathy Score for the Diagnosis of Minimal Hepatic Encephalopathy in Thai Cirrhotic Patients. Journal of Clinical Medicine, 12(2), 519.
Torres, D. S., Abrantes, J., & Brandão-Mello, C. E. (2020). Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil. *Scientific Reports*, 10(1), 8610.
Trebicka, J., Fernandez, J., Papp, M., Caraceni, P., Laleman, W., Gambino, C., ... & Angeli, P. (2020). The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. *Journal of Hepatology*, 73(4), 842-854.
Velarde-Ruiz Velasco, J. A., García-Jiménez, E. S., Aldana-Ledesma, J. M., Tapia-Calderón, D. K., Tornel-Avelar, A. I., Lazcano-Becerra, M., ... & Más autores. (2022). Evaluación y manejo de emergencias en el paciente con cirrosis. Rev Gastroenterol México, 87(2), 198-215.
Voicu, D. F., Anghel, L., Baroiu, L., & Stan, D. (2020). About Minimal Hepatic Encephalopathy. BRAIN Broad Research in Artificial Intelligence and Neuroscience, 11(1Sup1), 70-77.
Wang, M. W., Ma, W. J., Wang, Y., Ma, X. H., Xue, Y. F., Guan, J., ... & Ren, Z. F. (2023). Comparison of the effects of probiotics, rifaximin, and lactulose in the treatment of minimal hepatic encephalopathy and gut microbiota. Frontiers in Microbiology, 14, 1091167.
Woodhouse, C. A., Patel, V. C., Singanayagam, A., & Shawcross, D. L. (2018). Review article: the gut microbiome as a therapeutic target in the pathogenesis and treatment of chronic liver disease. Alimentary Pharmacology & Therapeutics, 47(2), 192-202.
Xia, X., Chen, J., Xia, J., Wang, B., Liu, H., Yang, L., ... & Xie, Y. (2018). Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis. Journal of International Medical Research, 46(9), 3596-3604.
Xu, X. Y., Ding, H. G., Li, W. G., Jia, J. D., Wei, L., Duan, Z. P., ... & Shang, J. Y. (2019). Chinese guidelines on management of hepatic encephalopathy in cirrhosis. World Journal of Gastroenterology, 25(36), 5403-5422.
Yeverino-Gutiérrez, M. L., González-González, M. del R., & González-Santiago, O. (2020). Mortality From Alcohol-Related Liver Cirrhosis in Mexico (2000–2017). *Frontiers in Public Health*, 8. https://www.frontiersin.org/articles/10.3389/fpubh.2020.524356
Ahmadi, S., Wang, S., Nagpal, R., Wang, B., Jain, S., Razazan, A., & Wang, T. D. (2019). A human-origin probiotic cocktail ameliorates aging-related leaky gut and inflammation via modulating the microbiota/taurine/tight junction axis. JCI Insight, 5(9), e132055.
Bellafante, D., Gioia, S., Faccioli, J., Riggio, O., Ridola, L., & Nardelli, S. (2023). Old and New Precipitants in Hepatic Encephalopathy: A New Look at a Field in Continuous Evolution. Journal of Clinical Medicine, 12(3), 1187.
Butterworth, R. F. (2019). Hepatic Encephalopathy in Cirrhosis: Pathology and Pathophysiology. Drugs, 79(Suppl 1), 17-21.
Coronel-Castillo, C. E., Contreras-Carmona, J., Frati-Munari, A. C., Uribe, M., & Méndez-Sánchez, N. (2020). Efficacy of rifaximin in the different clinical scenarios of hepatic encephalopathy. Revista de Gastroenterología de México, 85(1), 56-68.
Di Marco, L., La Mantia, C., & Di Marco, V. (2022). Hepatitis C: Standard of Treatment and What to Do for Global Elimination. Viruses, 14(3), 505.
Enomoto, H., Ueno, Y., Hiasa, Y., Nishikawa, H., Hige, S., Takikawa, Y., ... & Nishiguchi, S. (2020). Transition in the etiology of liver cirrhosis in Japan: a nationwide survey. Journal of Gastroenterology, 55(3), 353-362.
Faccioli, J., Nardelli, S., Gioia, S., Riggio, O., & Ridola, L. (2022). Minimal Hepatic Encephalopathy Affects Daily Life of Cirrhotic Patients: A Viewpoint on Clinical Consequences and Therapeutic Opportunities. *Journal of Clinical Medicine*, 11(23), 7246.
González-Regueiro, J. A., Higuera-de la Tijera, M. F., Moreno-Alcántar, R., & Torre, A. (2019). Fisiopatología y opciones de tratamiento a futuro en la encefalopatía hepática. Revista de Gastroenterología de México, 84(2), 195-203.
Green, E. W., & Mitra, A. (2022). Diagnosis and management of hepatic encephalopathy: A summary for patients. *Clinical Liver Disease*, 20(3), 90-92.
Grgurevic, I., Podrug, K., Mikolasevic, I., Kukla, M., Madir, A., & Tsochatzis, E. A. (2020). Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach. *Canadian Journal of Gastroenterology and Hepatology*, 2020, e9181368.
Gu, W., Hortlik, H., Erasmus, H. P., Schaaf, L., Zeleke, Y., Uschner, F. E., ... & Más autores. (2022). Trends and the course of liver cirrhosis and its complications in Germany: Nationwide population-based study (2005 to 2018).
Hepatic Encephalopathy: Definition, Pathogenesis, Clinical Features of Hepatic Encephalopathy. (2023, June 30). [Citado el 7 de julio de 2023].
Huang, D. Q., Terrault, N. A., Tacke, F., Gluud, L. L., Arrese, M., Bugianesi, E., ... & Más autores. (2023). Global epidemiology of cirrhosis — aetiology, trends, and predictions. Nat Rev Gastroenterol Hepatol, 1-11.
Jalan, R., & Rose, C. F. (2022). Heretical thoughts into hepatic encephalopathy. Journal of Hepatology, 77(2), 539-548.
Kasper, P., Tacke, F., & Michels, G. (2022). [Management of acutely decompensated liver cirrhosis in emergency and critical care medicine]. *Medizinische Klinik - Intensivmedizin und Notfallmedizin*, 117(1), 73-82.
Li, B., Zhang, C., & Zhan, Y. T. (2018). Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its Epidemiology, Risk Factors, Clinical Presentation, Diagnosis, Management, and Prognosis. *Canadian Journal of Gastroenterology and Hepatology*, 2018, e2784537.
Luo, M., Ma, P., Li, L., & Cao, W. K. (2019). Advances in psychometric tests for screening minimal hepatic encephalopathy: From paper-and-pencil to computer-aided assessment. Turkish Journal of Gastroenterology: The Official Journal of Turkish Society of Gastroenterology, 30(5), 398-407.
Luo, M., Yu, X. B., Hu, S. J., & Bai, F. H. (2020). EncephalApp Stroop App predicts poor sleep quality in patients with minimal hepatic encephalopathy due to hepatitis B-induced liver cirrhosis. Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association, 26(3), 120-128.
Moctezuma-Velazquez, C., Castro-Narro, G., Simó, P., Viayna, E., Aceituno, S., Soler, M., ... & Belaiche, J. (2022). Economic evaluation of long-term albumin uses in cirrhosis patients from the Mexican healthcare system perspective. *Annals of Hepatology*, 27(2), 100673.
Pawar, V. B., Surude, R. G., Sonthalia, N., Zanwar, V., Jain, S., Contractor, Q., ... & Mishra, S. (2019). Minimal Hepatic Encephalopathy in Indians: Psychometric Hepatic Encephalopathy Score and Inhibitory Control Test for Diagnosis and Rifaximin or Lactulose for Its Reversal. Journal of Clinical and Translational Hepatology, 7(4), 304-312.
Perez, I. C., Bolte, F. J., Bigelow, W., Dickson, Z., & Shah, N. L. (2021). Step by Step: Managing the Complications of Cirrhosis. Hepatic Medicine: Evidence and Research, 13, 45-57.
Principales resultados de la Encuesta Nacional de Salud y Nutrición 2020 (2021, junio 10). [Archivo PDF]. Disponible en: [Enlace] (Añadir el enlace si está disponible)
Puentes, J. C. P., Rocha, H., Nicolau, S., & Ferrão, G. (2018). Effectiveness of the MELD/Na Score and the Child–Pugh Score for the Identification of Palliative Care Needs in Patients with Cirrhosis of the Liver. Indian Journal of Palliative Care, 24(4), 526-528.
Rivera-Flores, R., Morán-Villota, S., Cervantes-Barragán, L., López-Macias, C., & Uribe, M. (2020). Manipulation of microbiota with probiotics as an alternative for treatment of hepatic encephalopathy. Nutrition, 73, 110693.
Shahgond, L., Patel, C., Thakur, K., Sarkar, D., Acharya, S., & Patel, P. (2022). Therapeutic potential of probiotics – Lactobacillus plantarum UBLP40 and Bacillus clausii UBBC07 on thioacetamide-induced acute hepatic encephalopathy in rats. Metabolic Brain Disease, 37(1), 185-195.
Tapper, E. B., Henderson, J. B., Parikh, N. D., Ioannou, G. N., & Lok, A. S. (2019). Incidence of and Risk Factors for Hepatic Encephalopathy in a Population-Based Cohort of Americans with Cirrhosis. Hepatology Communications, 3(11), 1510-1519.
Thanapirom, K., Wongwandee, M., Suksawatamnuay, S., Thaimai, P., Siripon, N., Makhasen, W., ... & Poovorawan, Y. (2023). Psychometric Hepatic Encephalopathy Score for the Diagnosis of Minimal Hepatic Encephalopathy in Thai Cirrhotic Patients. Journal of Clinical Medicine, 12(2), 519.
Torres, D. S., Abrantes, J., & Brandão-Mello, C. E. (2020). Cognitive and neurophysiological assessment of patients with minimal hepatic encephalopathy in Brazil. *Scientific Reports*, 10(1), 8610.
Trebicka, J., Fernandez, J., Papp, M., Caraceni, P., Laleman, W., Gambino, C., ... & Angeli, P. (2020). The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. *Journal of Hepatology*, 73(4), 842-854.
Velarde-Ruiz Velasco, J. A., García-Jiménez, E. S., Aldana-Ledesma, J. M., Tapia-Calderón, D. K., Tornel-Avelar, A. I., Lazcano-Becerra, M., ... & Más autores. (2022). Evaluación y manejo de emergencias en el paciente con cirrosis. Rev Gastroenterol México, 87(2), 198-215.
Voicu, D. F., Anghel, L., Baroiu, L., & Stan, D. (2020). About Minimal Hepatic Encephalopathy. BRAIN Broad Research in Artificial Intelligence and Neuroscience, 11(1Sup1), 70-77.
Wang, M. W., Ma, W. J., Wang, Y., Ma, X. H., Xue, Y. F., Guan, J., ... & Ren, Z. F. (2023). Comparison of the effects of probiotics, rifaximin, and lactulose in the treatment of minimal hepatic encephalopathy and gut microbiota. Frontiers in Microbiology, 14, 1091167.
Woodhouse, C. A., Patel, V. C., Singanayagam, A., & Shawcross, D. L. (2018). Review article: the gut microbiome as a therapeutic target in the pathogenesis and treatment of chronic liver disease. Alimentary Pharmacology & Therapeutics, 47(2), 192-202.
Xia, X., Chen, J., Xia, J., Wang, B., Liu, H., Yang, L., ... & Xie, Y. (2018). Role of probiotics in the treatment of minimal hepatic encephalopathy in patients with HBV-induced liver cirrhosis. Journal of International Medical Research, 46(9), 3596-3604.
Xu, X. Y., Ding, H. G., Li, W. G., Jia, J. D., Wei, L., Duan, Z. P., ... & Shang, J. Y. (2019). Chinese guidelines on management of hepatic encephalopathy in cirrhosis. World Journal of Gastroenterology, 25(36), 5403-5422.
Yeverino-Gutiérrez, M. L., González-González, M. del R., & González-Santiago, O. (2020). Mortality From Alcohol-Related Liver Cirrhosis in Mexico (2000–2017). *Frontiers in Public Health*, 8. https://www.frontiersin.org/articles/10.3389/fpubh.2020.524356