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Will Probiotics Provide the Answer for Therapy of Non-alcoholic Fatty Liver Disease (NAFLD)? - A Systematic Review

Kulvinder Kochar Kaur, Gautam Allahbadia and Mandeep Singh

As per current definition recognized by Food and Agricultural Organization of the United Nations (FAO) and world health organization (WHO) working group experts is that probiotics are live strains of strictly selected microorganisms, which once administered in adequate amounts, give a health benefit to the host. Globally non-alcoholic fatty liver disease (NAFLD) represents the liver problems of metabolic syndrome (Met S) that is also mostly related to obesity type2 diabetes mellitus (T2DM), as well as dyslipidemia. The correlation between gut microbiota and NAFLD has been emphasized recently. Lot of evidence is there that gut microbiota influences hepatic lipid metabolism as well as affects the correlation between pro and anti-inflammatory effectors within the liver. Though experimental studies have shown a correlation between gut microbiota dysbiosis and NAFLD exactly getting the answers of mode by which gut dysbiosis causes NAFLD is a problem. The probable pathophysiology which intertwines gut microbiota dysbiosis to NAFLD might be summed up as interrupting the energy balance among harvest as well as energy expenditure (EE), aiding in hepatic inflammation (interfering with intestinal integrity, stimulate endotoxaemia and start inflammatory cascades associated with cytokines liberation) and changes in biochemistry, metabolism and gut microbiota associated metabolites (like bile acids, short chain fatty acids (SCFA’s), Aromatic amino acid (AAA) derivatives, branched chain amino acid (BCAA), choline, ethanol). With the deposit that probiotics or synbiotics might reverse the gut microbiota associated dysbiosis in cases of NAFLD, work has escalated to evaluate the therapeutic efficacy of probiotics or synbiotics in NAFLD patients. Randomised controlled trials (RCT’S) done in recent times point that probiotics or synbiotics might better the tranmsaminases, steatohepatitis and decrease inflammation. Inspite of promising outcomes more further studies are warranted to get an insight in the full part that gut microbiota play in the formation of NAFLD and its future continuation. Moreover more results are required to know the effectiveness, safety profile and maintenance in the form of an innovative pharmacologic method for curing NAFLD.