Antioxidant protective effects of lactitol against endotoxemia in patients with chronic viral hepatitis.

Although antiviral drugs are widely used in the clinic, progression to liver cirrhosis and hepatocellular carcinoma cannot yet be entirely prevented. The aim of this study was to determine the effects of lactitol in chronic viral hepatitis patients with endotoxemia. Ninety-four patients with chronic viral hepatitis were separated into two groups based on plasma endotoxin levels: one group with endotoxemia (≥ 45 ng/l, n=60) and one group without endotoxemia (<45 ng/l, n=34). Sixty patients with gut-derived endotoxemia were randomly and evenly divided into a lactitol treatment group and a control group. Plasma endotoxin levels in patients with chronic viral hepatitis exhibited a negative correlation with superoxide dismutase (SOD) activity (P<0.001) and a positive correlation with levels of malondialdehyde (MDA) (P<0.001). The levels of SOD in the lactitol-treated group increased (P<0.01), while the levels of MDA decreased (P<0.01). Plasma endotoxin levels decreased (P<0.01) and the number of lactobacilli and bifidobacteria in the intestinal tract increased (P<0.01 for all). These results suggest that lactitol administration is capable of reducing injury caused by oxidants through regulating intestinal flora and decreasing gut-derived endotoxemia in patients with chronic viral hepatitis.