Nutritional Approach Targeting Gut Microbiota in NAFLD—To Date

Moszak, Małgorzata; Szulińska, Monika; Walczak-Gałęzewska, Marta; Bogdański, Paweł

doi:10.3390/ijerph18041616

Cited by 11 publications

(6 citation statements)

References 228 publications

(252 reference statements)

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“…Similarly, results were reproduced in individuals with obesity and obesityrelated disorders [198,199,202,203]. Translating the evidence from these researches, it can now be assumed that prebiotics and probiotics are capable of regulating the metabolism also of NAFLD subjects [204][205][206][207][208][209]. For example, studies conducted to identify the effect of novel probiotics on NAFLD induced by a fructose-rich diet underlined the ability of intestinal flora to improve OS.…”

Section: Modulation Of Gut-liver Axis: Effects On Oxidative Stressmentioning

confidence: 92%

Oxidative Stress in Non-Alcoholic Fatty Liver Disease

Smirne

Croce

Benedetto

et al. 2022

Livers

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Non-alcoholic fatty liver disease (NAFLD) is a challenging disease caused by multiple factors, which may partly explain why it still remains an orphan of adequate therapies. This review highlights the interaction between oxidative stress (OS) and disturbed lipid metabolism. Several reactive oxygen species generators, including those produced in the gastrointestinal tract, contribute to the lipotoxic hepatic (and extrahepatic) damage by fatty acids and a great variety of their biologically active metabolites in a “multiple parallel-hit model”. This leads to inflammation and fibrogenesis and contributes to NAFLD progression. The alterations of the oxidant/antioxidant balance affect also metabolism-related organelles, leading to lipid peroxidation, mitochondrial dysfunction, and endoplasmic reticulum stress. This OS-induced damage is at least partially counteracted by the physiological antioxidant response. Therefore, modulation of this defense system emerges as an interesting target to prevent NAFLD development and progression. For instance, probiotics, prebiotics, diet, and fecal microbiota transplantation represent new therapeutic approaches targeting the gut microbiota dysbiosis. The OS and its counter-regulation are under the influence of individual genetic and epigenetic factors as well. In the near future, precision medicine taking into consideration genetic or environmental epigenetic risk factors, coupled with new OS biomarkers, will likely assist in noninvasive diagnosis and monitoring of NAFLD progression and in further personalizing treatments.

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Section: Modulation Of Gut-liver Axis: Effects On Oxidative Stressmentioning

confidence: 92%

Oxidative Stress in Non-Alcoholic Fatty Liver Disease

Smirne

Croce

Benedetto

et al. 2022

Livers

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“…The most studied prebiotics in patients with NAFLD are fructooligosaccharides. Finally, synbiotics are a mix of probiotics and prebiotics [19][20][21].…”

Section: Prebiotics and Probiotics In Nafldmentioning

confidence: 99%

Prebiotics and Probiotics: Therapeutic Tools for Nonalcoholic Fatty Liver Disease

Mijangos-Trejo,

Nuño-Lambarri,

Barbero-Becerra

et al. 2023

IJMS

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Alterations in the gut–liver axis and changes in the gut microbiome are among the risk factors for the pathogenesis of non-alcoholic fatty liver disease (NAFLD). These patients show increased bacterial overgrowth in the small intestine and impaired intestinal permeability. Therefore, therapeutic options such as probiotics or prebiotics have been investigated to modulate intestinal microbiota composition to improve NAFLD. Most in vivo and in vitro probiotic studies have focused on reducing hepatic fat accumulation. The beneficial effects of probiotics on NAFLD have been demonstrated in animal models, and the most widely used microorganisms are those of the Lactobacillus and Bifidobacterium genera. In animal models, probiotics help restore the intestinal microbiota and improve the integrity of the intestinal barrier. This narrative review summarizes published evidence and the likely benefits of probiotics and prebiotics as a therapeutic option for patients with NAFLD.

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“…10 Numerous previous studies have shown that probiotics, prebiotics, and synbiotics (PPS) can improve the metabolic function of the liver and delay the progression of liver steatosis and fibrosis by improving the intestinal flora and alleviating the risk factors of NAFLD. [10][11][12][13][14] In this meta-analysis, we aim to explore whether synbiotics can improve metabolic function, liver fibrosis, and steatosis in NAFLD patients by including relevant studies from the last decade.…”

Section: Introductionmentioning

confidence: 99%

The effect of synbiotics in patients with NAFLD: a systematic review and meta-analysis

Cai

Dong

Chen

et al. 2023

Therap Adv Gastroenterol

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Background: Nonalcoholic fatty liver disease (NAFLD) is the highest incidence of chronic liver disease worldwide, seriously endangering human health, and its pathogenesis is still unclear. In the recent years, increasing evidence has shown that intestinal flora plays an important role in the occurrence and development of NAFLD. Synbiotics can alter gut microbiota and may be a treatment option for NAFLD in the future. Objectives: To systematically investigate the therapeutic effect of synbiotic supplementation on NAFLD patients. Design: A systematic review and meta-analysis were conducted. Data sources and methods: We conducted a search on four databases (PubMed, Embase, Cochrane Library, and Web of Science) to identify relevant studies. Eligible studies were then screened, and data from the included studies were extracted, combined, and analyzed. Result: This study analyzed 10 randomized controlled trials involving 634 patients with NAFLD. The results showed that synbiotic supplementation could significantly reduce the level of alanine aminotransferase (mean difference (MD) = −8.80; (95% CI [−13.06, −4.53]), p < 0.0001), aspartate aminotransferase (MD = −9.48; 95% CI [−12.54, −6.43], p < 0.0001), and γ-glutamyl transferase (MD = −12.55; 95% CI [−19.40, −5.69], p = 0.0003) in NAFLD patients. In the field of metabolism, synbiotic supplementation could significantly reduce the level of total cholesterol (MD = −11.93; 95% CI [−20.43, −3.42], p = 0.006) and low-density lipoprotein cholesterol (MD = −16.2; 95% CI [−19.79, −12.60], p < 0.0001) and increase the level of high-density lipoprotein cholesterol (MD = 1.56; 95% CI [0.43, 2.68], p = 0.007) in NAFLD patients. In addition, synbiotic supplementation could significantly reduce liver stiffness measurement indicator (MD = −1.09; 95% CI [−1.87, −0.30], p = 0.006) and controlled attenuation parameter indicator (MD = −37.04; 95% CI [−56.78, −17.30], p = 0.0002) in NAFLD patients. Conclusion: Based on the current evidence, synbiotic supplementation can improve liver function, adjust lipid metabolism, and reduce the degree of liver fibrosis in patients with NAFLD, but these effects need to be confirmed by further studies.

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Nutritional Approach Targeting Gut Microbiota in NAFLD—To Date

Cited by 11 publications

References 228 publications

Oxidative Stress in Non-Alcoholic Fatty Liver Disease

Oxidative Stress in Non-Alcoholic Fatty Liver Disease

Prebiotics and Probiotics: Therapeutic Tools for Nonalcoholic Fatty Liver Disease

The effect of synbiotics in patients with NAFLD: a systematic review and meta-analysis

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