Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease

J Pediatr Gastroenterol Nutr. 2011 Jun;52(6):740-3. doi: 10.1097/MPG.0b013e31821f9b85.


Objective: Various lines of evidence suggest that malfunctioning of the gut-liver axis contributes to hepatic damage of rodents and humans with nonalcoholic fatty liver disease. We evaluated the effects of short-term probiotic treatment in children with obesity-related liver disease who were noncompliant with lifestyle interventions.

Patients and methods: Twenty obese children (age 10.7 ± 2.1 years) with persisting hypertransaminasemia and ultrasonographic (US) bright liver were enrolled in this double-blind, placebo-controlled pilot study. At baseline, patients underwent clinical and laboratory anthropometric evaluation, measurement of the US hepatorenal ratio, standard liver function tests, oral glucose tolerance test, serum tumor necrosis factor-alpha, the glucose hydrogen breath test, and evaluation of serum antibodies to antipeptidoglycan-polysaccharide polymers. After exclusion of causes of liver disease other than obesity, patients received either probiotic Lactobacillus rhamnosus strain GG (12 billion CFU/day) or placebo for 8 weeks.

Results: Multivariate analysis after probiotic treatment revealed a significant decrease in alanine aminotransferase (average variation vs placebo P = 0.03) and in antipeptidoglycan-polysaccharide antibodies (average variation vs placebo P = 0.03) irrespective of changes in BMI z score and visceral fat. Tumor necrosis factor-alpha, and US bright liver parameters remained fairly stable.

Conclusions: Probiotic L rhamnosus strain GG warrants consideration as a therapeutic tool to treat hypertransaminasemia in hepatopathic obese children noncompliant with lifestyle interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine Transaminase / blood
  • Antibodies / blood
  • Body Mass Index
  • Child
  • Double-Blind Method
  • Female
  • Humans
  • Intra-Abdominal Fat
  • Lactobacillus rhamnosus* / classification
  • Liver Diseases / blood
  • Liver Diseases / etiology
  • Liver Diseases / therapy*
  • Male
  • Multivariate Analysis
  • Obesity / complications*
  • Peptidoglycan / immunology
  • Pilot Projects
  • Polysaccharides / immunology
  • Probiotics / therapeutic use*
  • Species Specificity
  • Tumor Necrosis Factor-alpha / blood


  • Antibodies
  • Peptidoglycan
  • Polysaccharides
  • Tumor Necrosis Factor-alpha
  • Alanine Transaminase