Pouya Bamneshin - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Mohamad Javad Pouryousefi Dezfuli - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Aida Zahednia - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Seyed Amir Hossein Mousavi - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Kian Khosravi - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a global public health care with a prevalence ofworldwide ۲۵٫۲%. ,It is characterized by the accumulation of fat in the liver, which can lead to inflammationscarring, and even liver failure. Probiotics have been suggested as a potential therapy for NAFLD due to theirability to modulate the gut microbiota and reduce inflammation. This systematic review aims to evaluate theeffects of probiotics on NAFLD.Methods: This review study was conducted through an advanced search of reputable scientific databasesincluding PubMed, Scopus, Web of Science, Medline and Google Scholar search engine. Articles withkeywords “Non-alcoholic fatty liver disease”, “Probiotics”, “Gut microbiota”, “Gut-liver axis”, “Randomizedclinical trial”, and MeSH terms of these keywords. Reviewed articles were clinical trials published in the last۱۰ years. The outcomes of interest will include changes in liver fat, alanine aminotransferase(ALT), aspartateaminotransferase(AST), pro-inflammatory cytokines, and other relevant indicators of NAFLD. The initialsearch yielded a total of ۴۳۸ articles. After screening titles and abstracts for relevance, ۳۵ articles were selectedfor full-text review. Also to ensure the completeness of the search results, the sources of the articles wereexamined. Among the selected articles, ۱۱ studies with ۶۴۵ participants met the inclusion criteria and wereincluded in the final analysis.Results: This review demonstrated that probiotics significantly reduced liver fat content, total cholesterol, bloodsugar, triglycerides(TG) and low-density lipoprotein(LDL) compared to placebo or no intervention. Probioticsalso improved liver enzyme levels, including alanine aminotransferase(ALT) and aspartate aminotransferase(AST), which are markers of liver damage. Furthermore, probiotics were found to have anti-inflammatoryeffects in NAFLD patients, with several studies reporting a significant reduction in pro-inflammatory cytokinessuch as tumor necrosis factor-alpha(TNF-α) and interleukin-۶ (IL-۶) in the probiotic group compared to thecontrol group. Probiotics also improved insulin resistance, which is a common complication of NAFLD.Conclusion: P ,robiotics may be an effective therapy for NAFLD. Probiotics can reduce liver fat contentimprove liver enzyme levels, reduce inflammation, and improve insulin resistance. However, further studiesare needed to determine the optimal dose, duration, and strain of probiotics for NAFLD treatment. Overall, thefindings provide evidence for the potential use of probiotics as a therapeutic option for NAFLD patients.

Non-alcoholic fatty liver disease, Probiotics, Gut microbiota, Gut-liver axis, Randomized clinicaltrial