Immune biomarkers in non-treatment-seeking heavy drinkers who used a probiotic supplement for 30 days: An open-label pilot study

Abstract

Alcohol use disorder (AUD) is associated with significant psychological and economic burdens, as well as physical comorbidities that can lead to death. Previous research has found that probiotics may reduce inflammatory biomarkers in persons with AUD and comorbid conditions such as cirrhosis of the liver. This relationship has not been explored in heavy drinkers without comorbid conditions. In a proof-of-concept study, individuals who were heavy drinkers without known comorbidities received a 30-day course of a daily probiotic supplement in an open-label pilot trial. Eligible participants (N = 16) met NIAAA guidelines for heavy alcohol use and did not report any preexisting medical problems. Blood samples were taken at four timepoints: prior to the probiotic course, at the midpoint, at the end, and after a washout period of at least one month. Immunoassays were conducted on plasma samples to quantify the following inflammatory biomarkers: IL-6, IL-8, IL-10, LBP, MCP-1, sCD14, sCD163, and TNF-α. Linear mixed models were used to test within-subjects changes in biomarker concentrations over the study period, with alcohol use included as a time-varying covariate. Biomarker concentrations did not change significantly. A higher number of heavy drinking days was statistically associated with higher concentrations of IL-6 (F_(1,8) = 6.66, p = 0.0326) and IL-8 (F_(1,17) = 6.38, p = 0.0218). Greater days since last drink was associated with a lower concentration of MCP-1 (F_(1,17) = 5.77, p = 0.028). In summary, biomarker trajectories were associated with alcohol consumption variables, but not probiotic use, in this open-label pilot study. Randomized controlled trials are needed to evaluate fully the potential benefits of probiotics in heavy drinkers without known comorbidities and under conditions of non-abstinence.

Keywords: alcohol use; cytokines; heavy drinking; immune activation; inflammation; probiotic.

Fig 1:

Study visit overview.

Fig 2:

CONSORT diagram.

Fig 3:

Mean Concentrations of Biomarkers over Visits 1-4. Notes: Error bars indicate +/− 1 standard error. Missing/outlier data exclusions were as follows: 3a) sCD14, 1 missing at Visit 1 and 1 missing at Visit 2; 3b) sCD163, 1 outlier at Visit 1; 3c) IL-10, 1 missing at Visit 2 and 2 missing at Visit 3; 3d) IL-6, 3 missing at Visit 1, 6 missing and 1 outlier at Visit 2, 5 missing at Visit 3, and 5 missing at Visit 4; 3e) IL-8, 1 outlier at Visit 1 and 1 outlier at Visit 4; 3f) LBP, 1 missing at Visit 1 and 1 outlier at Visit 2; 3g) MCP-1, 1 missing at Visit 1, 1 missing at Visit 2, and 1 missing at Visit 4; 3h) TNF-α, 1 outlier at Visit 2.