Table 2.
Studies evaluating the therapeutic role of probiotics in human NAFLD/NASH.
| Study | Design | Probiotic Composition | Results |
|---|---|---|---|
| Loguercio, C., 2002 [140] | 10 patients with NASH No control group Two months intervention |
LAB: L. acidophilus, L, rhamnosus, L plantarum, L. salivarius, L. casei, L. bulgaricus, B. lactis, B. bifidus, B. breve, FOS, vitamins |
↓ liver enzymes: ALT and γGT ↓ TNF-α levels and oxidative stress Relapse after stopping the intervention |
| Loguercio, C., 2005 [141] | 22 patients with NASH No control group Three months intervention |
VSL#3: B. breve, B. longum, B. infantis, L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus, S. Thermophilus (2 capsules, twice a day) |
↓ liver enzymes ↓ oxidative stress |
| Aller, R., 2011 [142] | Patients with NAFLD: probiotic group n = 15 and control group n = 15 Three months intervention |
Mixture of 500 million L. bulgaricus + S. thermophiles | ↓ liver enzymes: ALT no difference in anthropometric metrics no difference in lipid/glucose metabolism no difference in IL-6 or TNF-α levels |
| Malaguarnera, M., 2012 [143] | Patients with NASH: Probiotic group n = 34 and control group n = 29 Biopsy pre and post-intervention Six months intervention |
Zirfos: FOS, B. longum, vitamins | ↓ liver enzymes: AST ↓ LDL-cholesterol and insulin resistance ↓ TNF-α levels and endotoxemia no difference in anthropometric metrics ↓ steatosis and NAS score no difference in ballooning, inflammation or fibrosis |
| Wong, V.W.S., 2013 [144] | Patients with NASH: probiotic group n = 10 and control group n = 10 Six months intervention |
Lepicol: L. deslbrueckii, L. acidophilus, L. rhamnosus, B. bifidum | ↓ liver steatosis by H-MRS ↓ liver enzymes: AST no difference in anthropometric metrics no difference in lipid/glucose metabolism |
| Nabavi, S., 2014 [145] | Patients with NAFLD: probiotic group n = 36 and control group n = 36 Two months intervention |
Probiotic yogurt containing L. acidophilus La5 and B. lactis Bb12 | ↓ liver enzymes: ALT and AST ↓ total cholesterol and LDL-cholesterol |
| Eslamparast, T., 2014 [146] | Patients with NAFLD: Probiotic group n = 26 and control group n = 26 Fibroscan© pre and post-intervention Seven months intervention |
Protexin: L. plantarum, L. bulgaricus, L. acidophilus, L. casei, B. bifidum, S. thermophilus, S. faecium, Torulopsis spp, Aspergillus oryzae |
↓ liver enzymes: AST, ALT and γGT ↓ TNF-α levels ↓ fibrosis assessed by transient elastography |
| Sepideh, A., 2015 [147] | Patients with NAFLD: probiotic group n = 21 and control group n = 21 Two months intervention |
Lactocare: L. casei, L. acidophilus, L. rhamnosus, L. bulgaricus, B. breve, B. longum, S. Thermophilus (2 capsules per day) |
↓ insulin resistance and IL-6 no difference in anthropometic metrics no difference in TNF-α levels |
ALT, alanine aminotransferase; AST, aspartate aminotransferase; FOS, fructooligosaccharides; γGT, γ-glutamyl transpeptidase; H-MRS, proton magnetic resonance spectroscopy; IL-6, interleukin-6; LDL, low density lipoprotein; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis, TNF-α, tumor necrosis factor α. Arrows indicate the differences in the intervention group as compared to the control group.