Experimental acute alcohol pancreatitis-related liver damage and endotoxinemia: Protective effect of a probiotic but not of metronidazole

Objective: The aim of this study was to test the effect of gut manipulation by either a novel probiotic or by metronidazole on either endotoxinemia and on the severity of liver damage in the course of acute pancreatitis under alcohol intoxication. Materials and Methods: SD rats were fed for 1 week through an intragastric tube a liquid diet with either: A) 1ml t.i.d of a probiotic mixture (L. acidophilus, L. helveticus and Bifidobacteria in an enriched medium), B) metronidazole 20mg/kg t.i.d or C) standard diet. Then, a caerulein-induced acute pancreatitis was produced and at full-blown process, rats were fed an alcohol-rich diet. Probiotic and metronidazole treatment was prolonged for further 2 weeks. Transaminases and endotoxinemia were checked at the entry into the study, after 6h, 24h and at sacrifice, 2 weeks later. Liver samples were obtained for histological scoring. Results: Probiotic but not metronidazole improved the AP-induced increase of endotoxinemia and transaminases. The addition of alcohol worsened such parameters to a limited extent in probiotic-treated group, while metronidazole had a negative effect on the liver damage. Conclusion: Gut flora pre-treatment with probiotic was able to exert an effective protection against endotoxin/bacterial translocation as well as liver damage in the course of acute pancreatitis and concomitant heavy alcohol consumption. The beneficial effect of probiotic on liver histology seems to be correlated with endotoxinemia. The employ of metronidazole failed to affect such phenomenon and, on the contrary, further worsened liver damage with the addition of alcohol on the background of the ongoing acute pancreatic inflammation.