Probiotics for managing non-alcoholic fatty liver disease: efficacy and mechanistic insights

Non-alcoholic fatty liver disease (NAFLD) is a condition characterized by excess fat accumulation in the liver unrelated to alcohol consumption. Emerging scientific research suggests that probiotics supplementation is a useful therapeutic strategy for managing NAFLD without harmful side effects of conventional drugs. Several scientific studies suggest that, probiotics have the ability for enhancing production of beneficial microbial metabolites (e.g. SCFAs, indole), modulating gut microbiota composition, which in turn are connected to suppression of hepatic damage. Studies also suggest direct link of probiotics on modulation of liver enzymes, which are critical indicators of liver health. Probiotic strains such as Lactobacillus and Bifidobacterium are reported to have promising results in managing hepatic enzyme profile. Additionally, probiotics can also modulate the lipid metabolism, hepatic fat accumulation and most importantly enhancing anti-oxidant status of the liver. Probiotics can restore the intestinal integrity and reduce oxidative stress in NAFLD subjects, averting harmful bacterial endotoxin translocation that exacerbate hepatic damage. Despite the discrete scenario of promising health benefits of probiotic supplementation, further large-scale, long-term randomized controlled trials are necessary to establish standardized guidelines regarding the optimal strains, dosages, and treatment durations for probiotic use in NAFLD patients.