The Role of Gut Microbiome-Targeted Therapy in Nonalcoholic Fatty Liver Disease

To review the role and progress of microbiome-targeting therapies in nonalcoholic fatty liver disease (NAFLD). This review summarizes recent clinical trials of probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) and analyzes the potential clinical impact of reverse dysbiosis in NAFLD. Though results might be mixed, the recent randomized clinical trials and systemic reviews indicate probiotics, prebiotics, and synbiotics are promising therapies that improve transaminitis and hepatic steatosis. The scarcity of FMT clinical trials limits the power to conclude the direct impact of FMT on NAFLD. Given the rapidly growing prevalence of NAFLD and the lack of effective pharmacological intervention, there is an urgent need for the development of novel therapeutic strategies. Despite the advancements in and promising results of gut microbiome (GM) restoring remedies, further studies are needed to assess their beneficial efficacy, safety, and sustainability to develop novel pharmacologic approaches to NAFLD.