Clinical efficacy of probiotics in the treatment of alcoholic liver disease: a systematic review and meta-analysis
What this study found
Probiotic supplementation improved liver function and serum albumin in patients with alcoholic liver disease. Compared with control, probiotics significantly reduced ALT (MD = -13.36, 95% CI: -15.80, -10.91; P < 0.00001), AST (MD = -16.99, 95% CI: -20.38, -13.59; P < 0.00001), and GGT (MD = -18.79, 95% CI: -28.23, -9.34; P < 0.0001), and increased albumin (MD = 0.19, 95% CI: 0.02, 0.36; P = 0.03). Bilirubin was not significantly different, inflammatory markers were inconsistent, and no serious adverse events were reported. The authors concluded that probiotics may have a beneficial…
- Study & population
- Systematic review and meta-analysis of 9 controlled studies in adults with alcoholic liver disease, including alcoholic fatty liver disease, alcoholic hepatitis, and alcoholic cirrhosis, conducted in multiple countries.
- Intervention
- Across the included trials, the active intervention was probiotic supplementation using different strains or combinations, including Lacticaseibacillus rhamnosus R0011 plus Lactobacillus helveticus R0052, Lactobacillus subtilis/Streptococcus faecium, Lactobacillus casei Shirota YIT 9029, Lactobacillus casei,…
- Key limitation
- The evidence base was small and heterogeneous, with different probiotic strains or combinations, varied ALD subtypes, and short treatment durations of 7 to 60 days.
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Open PDFOriginal abstract
Objective Alcoholic liver disease (ALD) is a liver damage disease caused by long-term heavy drinking. Currently, there is no targeted pharmaceutical intervention available for the treatment of this disease. To address this, this paper evaluates the efficacy and safety of probiotic preparation in treating ALD through conducting a meta-analysis, and provides a valuable insight for clinical decision-making. Methods A systematic search was conducted across databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang, and CBM from the inception dates to October 15, 2023, to identify clinical randomized controlled trials on probiotic preparations in the treatment of ALD. After the literature underwent screening, data extraction, and quality assessment, RevMan 5.3 and Stata 14.2 were employed for data analysis and processing. Results A total of 9 randomized controlled trials fulfilled the inclusion criteria. The results of the meta-analysis showed that probiotic preparation could significantly improve the liver function of patients with alcoholic liver disease compared with the control group. Probiotic intervention led to a significant reduction in the levels of alanine aminotransferase (MD=-13.36,95%CI:-15.80,-10.91;P<0.00001),aspartate aminotransferase (MD=-16.99,95%CI:-20.38,-13.59;P<0.00001),γ-glutamyl transpeptidase (MD=-18.79,95% CI:-28.23,-9.34; P<0.0001). Concurrently, the level of serum albumin (MD=0.19,95% CI:0.02,0.36;P=0.03) was increased. Furthermore, probiotic intervention could also modulate the composition of intestinal flora in patients with alcoholic liver disease, leading to an augmentation in Bifidobacteria and a reduction in Escherichia coli. However, in patients with alcoholic liver disease, probiotic intervention showed no significant effects on total bilirubin (MD=-0.01,95% CI:-0.17,0.15;P=0.91), tumor necrosis factor-α (MD=0.03,95% CI:-0.86,0.92;P=0.94) and interleukin-6 (MD=-5.3,95% CI:-16.04,5.45;P=0.33). Conclusion The meta-analysis indicates that probiotics can improve liver function in alcoholic liver disease, reduce inflammatory responses, regulate intestinal flora, which have potential value in the treatment of alcoholic liver disease. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023472527.