Study of the importance of intestinal microbiota in patients with heart failure - Randomized, double-blind study

• Grant number: 17/01372-0
• Support Opportunities: Regular Research Grants
• Start date: September 01, 2018
• End date: February 28, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Sandrigo Mangini
• Grantee: Sandrigo Mangini
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• City of the host institution: São Paulo
• Associated researchers: Fernando Bacal ; Tatiana Teixeira Gomes

Abstract

Heart failure (HF) is the inability that the heart presents in to provide blood supply to the body. It is also characterized by an intense inflammatory activity that can be evidenced by increase of circulating cytokines, as like tumor necrosis factor alpha (TNF-±). Studies evidence that, the levels increase as cardiac function becomes worse. There is also an imbalance between anabolism and catabolism, being this imbalance evidenced by cachexia, that is very common in patients with advanced HF. Cachexia is multifactorial and it is considered a predictor of mortality. In an attempt to improve the therapies and thus, the survival of these patients, many studies have been carried out in an attempt to discover the exact mechanisms that lead to cachexia. In addition to the imbalance between anabolism and catabolism, there is the hypothesis that, the gastrointestinal tract, more precisely the intestine, can collaborate with cachexia. Studies suggest that, the intestinal mucosa, due to hypoperfusion, becomes more permeable to some substances, as like endotoxins, being the lipopolysaccharide (LPS) one of them. The circulating LPS can stimulate the increase of TNF-±, further increasing the inflammation and, consequently, contributing to the worsening of prognosis. The intestinal microbiota is also affected by hypoperfusion, contributing with increase of permeability. Probiotics can benefit the equilibrium of the microbiota, supporting to maintain a less permeable barrier. In view of the importance of microbiota to inflammation in the prognosis of the patients and the performance of microbiota in maintenance of intestinal barrier, this study has as primary objective to verify the influence of supplementation of the probiotic Lactobacillus acidophilus LA-14 in the lowering of serum levels of TNF-± in the patients with HF. (AU)