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. 2020 Winter;13(1):64-76.

Protective effects of synbiotic soymilk fortified with whey protein concentrate and zinc sulfate against bile duct ligated-induced hepatic encephalopathy

Yahya Jalilpiran  1   2 , Nader Tanideh  3 , Samane Rahmdel  4 , Negar Azarpira  5 , Maral Mokhtari  6 , Zohreh Mazloom  1
Affiliations

Protective effects of synbiotic soymilk fortified with whey protein concentrate and zinc sulfate against bile duct ligated-induced hepatic encephalopathy

Yahya Jalilpiran et al. Gastroenterol Hepatol Bed Bench. 2020 Winter.

Abstract

Aim: This study aimed to compare the effects of synbiotic soymilk fortified with whey protein concentrate and zinc sulfate with lactulose on bile duct ligated-induced HE.

Background: Hepatic encephalopathy (HE) is seriously associated with neuromuscular and cognitive alterations.

Methods: Eighty-two Sprague Dawley rats were randomly assigned into seven groups (sham, bile duct ligation (BDL), BDL + lactulose, BDL + soymilk (SM), BDL + Synbiotic soymilk (SSM), BDL + SSM + whey protein concentrate (WPC), BDL + SSM + WPC + ZnSO4). Different SM products, lactulose, and normal saline were administered via oral gavage (2 mL/rat/day). The serum and liver markers as well as liver histopathology were assessed after 28 days.

Results: The SM products significantly reduced the serum alanine aminotransferase, albumin, and ammonia (P < 0.05). The levels of aspartate aminotransferase, endotoxin, and liver interleukin-6 improved significantly in all treatments, except for those receiving SM. SSM and SSM + WPC + ZnSO4 were the only effective products in reducing serum alkaline phosphatase (P < 0.05). Furthermore, the liver total antioxidant capacity was greater (P<0.05) in the SSM + WPC and SSM + WPC + ZnSO4 groups. The histopathological examinations confirmed the efficiency of all SM products in reducing liver fibrosis. Liver bile duct proliferation diminished only in the SSM + WPC and SSM + WPC+ ZnSO4 groups (P<0.05).

Conclusion: This study showed the positive effects of different SM products, especially SSM + WPC and SSM + WPC + ZnSO4, on HE. Further studies are required to confirm our findings.

Keywords: Hepatic encephalopathy; Soymilk; Synbiotic; Whey protein; Zinc sulfate.

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Figures

Figure 1
Figure 1
Effect of different treatments on serum endotoxin levels; BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters indicate significant differences (P< 0.05) between treatments
Figure 2
Figure 2
Effect of different treatments on liver total antioxidant capacity levels; BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters reveal significant differences (P< 0.05) between treatments
Figure 3
Figure 3
Effect of different treatments on Liver IL6 levels; BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters represent significant differences (P< 0.05) between treatments
Figure 4
Figure 4
Effect of different treatments on Bile duct proliferation (BDP) (n = 6); BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters indicate significant differences (P< 0.05) between treatments
Figure 5
Figure 5
Effect of different treatments on Liver inflammation score (n = 6); BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters reveal significant differences (P< 0.05) between treatments
Legend Figure 1
Legend Figure 1
The histopathological photomicrographs of the liver in bile duct ligated rats treated with lactulose and different soymilk products; BDL (A), BDL + L (B), BDL + SM (C), BDL + SSM (D), BDL + SSM + WPC (E), BDL + SSM + WPC + ZnSO4 (F). Septal ductular proliferation grade (2) was noticed in groups B, C, D. In group E, ductular proliferation was limited to the portal area (refer to Fig. 4) (H & E × 400). BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPI, whey protein concentrate
Legend Figure 2
Legend Figure 2
The histopathological photomicrographs of the liver in bile duct ligated rats treated with lactulose and different soymilk products; BDL (A), BDL + L (B), BDL + SM (C), BDL + SSM (D), BDL + SSM + WPI (E), BDL + SSM + WPI + ZnSO4 (F). In group F, liver fibrosis was limited to the portal area. In other groups the fibrosis score also decreased compared to the BDL group (A) (refer to Fig. 6) (Masson’s trichrome × 400). BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate
Figure 6
Figure 6
Effect of different treatments on Liver fibrosis score (n = 6); BDL, bile duct ligation; L, lactulose; SM, soymilk; SSM, synbiotic soymilk; WPC, whey protein concentrate. Data are presented as mean ± SD. Different lowercase letters show significant differences (P< 0.05) between treatments
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