Table 2.
Intestinal flora regulation in primary sclerosing cholangitis treatment
|
Treatment
|
Results
|
Ref.
|
||
| Oral Antibiotics | Vancomycin | 125 mg four times daily for 90 d | Fecal calprotectin and serum GGT levels returned to normal | [94] |
| 125 mg four times daily for 12 wk | Significantly decreased ALP, MRS, ESR, and GGT levels. Fatigue, pruritus, diarrhea, and anorexia significantly improved | [91] | ||
| 50 mg/kg/d for 30 to 118 mo | Decreased ALT, AST, GGT, and ESR levels. Jaundice improved. The overall rate of positive serum autoantibodies decreased after 3.5 mo | [138] | ||
| Vancomycin and metronidazole | Vancomycin: 125 mg or 250 mg four times daily for 12 wk; Metronidazole: 250 mg or 500 mg three times daily for 12 wk | Decreased ALP and MRS levels. The decrease in ALP level was more pronounced following vancomycin administration | [90] | |
| Metronidazole with ursodeoxycholic acid | Taken together for 36 mo | Significantly decreased ALP and MRS levels | [98] | |
| Azithromycin | 500 mg three days per week for 6 wk | Decreased ALP and TBIL levels and cholestasis-related symptoms. The urine was turned dark in color again | [139] | |
| Rifaximin | 550 mg twice daily for 12 wk | Decreased GGT and CRP levels; Improved pruritus symptoms | [95] | |
| Minocycline | 100 mg twice daily for one year | Significantly decreased ALP and MRS levels | [100] | |
| Fecal microbiota transplantation at 24 wk | Significantly decreased ALP levels; Reduced AST levels (by at least 30%) | [107] | ||
| Probiotics | Lactobacilli and Bifidobacteria | Three months of: Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus salivarius, and Lactococcus lactis, Bifidobacterium bifidum, Bifidobacterium | Reduced ALP levels (by 15%) | [113] |
| Combined | Prednisolone (30 mg/d), salazosulfapyridine (3000 mg/d), and Lactobacillus casei Shirota (3 g/d) for 2 wk | Decreased ALP, ALT, AST, and GGT levels | [114] | |
ALP: Alkaline phosphatase; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; MRS: Mayo primary sclerosing cholangitis risk score; ESR: Erythrocyte sedimentation rate; GGT: Gamma-glutamyl transpeptidase; CRP: C-reactive protein; TBIL: Total bilirubin.