Conclusion This meta- analysis supports the potential use of microbial therapies in the treatment of NAFLD and sheds light on their potential mode of action .
Context Nonalcoholic fatty liver disease ( NAFLD ) is a highly prevalent and underdiagnosed comorbidity of many chronic diseases that is associated with altered intestinal bacterial communities .
This association has prompted research into alternative treatments aim ed at modulating intestinal microbiota .
Given the novelty of these treatments , scarce evidence regarding their effectiveness in clinical population s exists .
Objective This meta- analysis sought to systemically review and quantitatively synthesize evidence on prebiotic , probiotic , and synbiotic therapies for patients with NAFLD in r and omized controlled trials .
Probiotics reduce the inflammatory response induced by a high-fat diet in the liver of young rats.
Nonalcoholic fatty liver disease ( NAFLD ) is the most common form of chronic liver disease in the pediatric population . Preliminary evidence suggests a potential therapeutic utility of probiotics for this condition . Here , we tested the potential effect of the probiotic VSL#3 ( a multistrain preparation composed of Streptococcus thermophilus and several species of Lactobacillus and Bifidobacteria ) on oxidative and inflammatory damage induced by a high-fat diet in the liver of young rats . At weaning , young male Sprague-Dawley rats were r and omly divided into 3 groups ( n = 6 ) fed a st and ard , nonpurified diet ( Std ; 5.5 % of energy from fat ) or a high-fat liquid diet ( HFD ; 71 % of energy from fat ) . One of the HFD groups received by gavage VSL#3 ( 13 x 10(9 ) bacteria x kg(-1 ) x d(-1 ) ) . After 4 wk , the HFD rats had greater body weight gain , fat mass , serum aminotransferase , and liver weight than rats fed the Std diet . The HFD induced liver lipid peroxidation , tumor necrosis factor ( TNFalpha ) production , protein S-nitrosylation , inducible nitric oxide synthase ( iNOS ) , cyclooxygenase (COX)-2 expression , and metalloproteinase ( MMP ) activity . Moreover , in the HFD group , PPARalpha expression was less than in rats fed the Std diet . In rats fed the HFD diet and treated with VSL#3 , liver TNFalpha levels , MMP-2 and MMP-9 activities , and expression of iNOS and COX-2 were significantly lower than in the HFD group . In VSL#3-treated rats , PPARalpha expression was greater than in the HFD group . A modulation of the nuclear factor-kappaB pathway by VSL#3 was also demonstrated . Our data suggest that VSL#3 administration could limit oxidative and inflammatory liver damage in patients with NAFLD
Conclusion This meta- analysis supports the potential use of microbial therapies in the treatment of NAFLD and sheds light on their potential mode of action .
Context Nonalcoholic fatty liver disease ( NAFLD ) is a highly prevalent and underdiagnosed comorbidity of many chronic diseases that is associated with altered intestinal bacterial communities .
This association has prompted research into alternative treatments aim ed at modulating intestinal microbiota .
Given the novelty of these treatments , scarce evidence regarding their effectiveness in clinical population s exists .
Objective This meta- analysis sought to systemically review and quantitatively synthesize evidence on prebiotic , probiotic , and synbiotic therapies for patients with NAFLD in r and omized controlled trials .