The Effects of Probiotics, Prebiotics and Synbiotics in Non-Alcoholic Fat Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH): A Systematic Review

• Published in: International journal of molecular sciences 2022-08, Vol.23 (15), p.8805
• Main Authors: Carpi, Rodrigo Zamignan, Barbalho, Sandra M, Sloan, Katia Portero, Laurindo, Lucas Fornari, Gonzaga, Heron Fernando, Grippa, Paulo Cesar, Zutin, Tereza L Menegucci, Girio, Raul J S, Repetti, Cláudia Sampaio Fonseca, Detregiachi, Cláudia Rucco Penteado, Bueno, Patrícia C Santos, Mazuqueli Pereira, Eliana de Souza Bastos, Goulart, Ricardo de Alvares, Haber, Jesselina Francisco Dos Santos
• Format: Article
• Language: English
• Subjects: Alcohol use; Bacteria; Blood glucose; Clinical trials; Deregulation; Diabetes; Digestive system; Dyslipidemia; Enzymes; Fatty acids; Fatty liver; Fibrosis; Gastrointestinal Microbiome; Hepatitis; Homeostasis; Humans; Immune system; Inflammation; Insulin; Insulin resistance; Intestinal microflora; Intestine; Lipids; Liver; Liver - metabolism; Liver cancer; Liver diseases; Meta-analysis; Metabolism; Metabolites; Microbiota; Microorganisms; Mortality; Nervous system; Non-alcoholic Fatty Liver Disease - metabolism; Pathophysiology; Patients; Prebiotics; Probiotics; Probiotics - therapeutic use; Review; Risk analysis; Risk factors; Steatosis; Synbiotics; Systematic review; Triglycerides
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms23158805

Modifications in the microbiota caused by environmental and genetic reasons can unbalance the intestinal homeostasis, deregulating the host's metabolism and immune system, intensifying the risk factors for the development and aggravation of non-alcoholic fat liver disease (NAFLD). The use of probiotics, prebiotics and synbiotics have been considered a potential and promising strategy to regulate the gut microbiota and produce beneficial effects in patients with liver conditions. For this reason, this review aimed to evaluate the effectiveness of probiotics, prebiotics, and symbiotics in patients with NAFLD and NASH. Pubmed, Embase, and Cochrane databases were consulted, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed. The clinical trials used in this study demonstrated that gut microbiota interventions could improve a wide range of markers of inflammation, glycemia, insulin resistance, dyslipidemia, obesity, liver injury (decrease of hepatic enzymes and steatosis and fibrosis). Although microbiota modulators do not play a healing role, they can work as an important adjunct therapy in pathological processes involving NAFLD and its spectrums, either by improving the intestinal barrier or by preventing the formation of toxic metabolites for the liver or by acting on the immune system.