{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:54:04Z","timestamp":1785876844940,"version":"3.56.0"},"reference-count":48,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100022719","name":"Environment and Ecology Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022719","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"NSFC","doi-asserted-by":"publisher","award":["82400998"],"award-info":[{"award-number":["82400998"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","em-consulte.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Biomedicine &amp; Pharmacotherapy"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.biopha.2026.119656","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:01:01Z","timestamp":1781694061000},"page":"119656","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Synbiotics and antioxidants synergistically attenuate disease progression in metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.1016","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5552-7534","authenticated-orcid":false,"given":"Zhilu","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyun","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oi Yee Pessy","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-2843","authenticated-orcid":false,"given":"Jessica YL","family":"Ching","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis KL","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nor Norman","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew C.","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.biopha.2026.119656_bib1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1136\/gutjnl-2011-300342","article-title":"Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography","volume":"61","author":"Wong","year":"2012","journal-title":"Gut"},{"issue":"7","key":"10.1016\/j.biopha.2026.119656_bib2","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"issue":"9","key":"10.1016\/j.biopha.2026.119656_bib3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S2468-1253(22)00317-X","article-title":"Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis","volume":"8","author":"Quek","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"issue":"11","key":"10.1016\/j.biopha.2026.119656_bib5","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1136\/gutjnl-2023-330110","article-title":"Global prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus: an updated systematic review and meta-analysis","volume":"72","author":"En Li Cho","year":"2023","journal-title":"Gut"},{"key":"10.1016\/j.biopha.2026.119656_bib6","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3350\/cmh.2024.0431","article-title":"Epidemiology of metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Younossi","year":"2025","journal-title":"Clin. Mol. Hepatol."},{"issue":"2 1","key":"10.1016\/j.biopha.2026.119656_bib7","doi-asserted-by":"crossref","first-page":"S99","DOI":"10.1002\/hep.20973","article-title":"Nonalcoholic fatty liver disease: from steatosis to cirrhosis","volume":"43","author":"Farrell","year":"2006","journal-title":"Hepatology"},{"issue":"30","key":"10.1016\/j.biopha.2026.119656_bib8","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.3748\/wjg.v24.i30.3361","article-title":"Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis","volume":"24","author":"Leoni","year":"2018","journal-title":"World J. Gastroenterol."},{"issue":"5","key":"10.1016\/j.biopha.2026.119656_bib9","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/s41575-020-0269-9","article-title":"Gut microbiota and human NAFLD: disentangling microbial signatures from metabolic disorders","volume":"17","author":"Aron-Wisnewsky","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib10","doi-asserted-by":"crossref","DOI":"10.3390\/nu12020542","article-title":"Beneficial Effects of Lactobacillus plantarum Strains on Non-Alcoholic Fatty Liver Disease in High Fat\/High Fructose Diet-Fed Rats","volume":"12","author":"Park","year":"2020","journal-title":"Nutrients"},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib11","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/jhep.2003.50048","article-title":"Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease","volume":"37","author":"Li","year":"2003","journal-title":"Hepatology"},{"key":"10.1016\/j.biopha.2026.119656_bib12","doi-asserted-by":"crossref","DOI":"10.1016\/j.phrs.2024.107398","article-title":"The effect of synbiotics on liver enzymes, obesity indices, blood pressure, lipid profile, and inflammation in patients with non-alcoholic fatty liver: A systematic review and meta-analysis of randomized controlled trials","volume":"208","author":"Musazadeh","year":"2024","journal-title":"Pharmacol. Res."},{"issue":"8","key":"10.1016\/j.biopha.2026.119656_bib13","doi-asserted-by":"crossref","first-page":"4915","DOI":"10.1016\/j.clnu.2021.06.023","article-title":"Effects of probiotics on body adiposity and cardiovascular risk markers in individuals with overweight and obesity: A systematic review and meta-analysis of randomized controlled trials","volume":"40","author":"Pontes","year":"2021","journal-title":"Clin. Nutr."},{"issue":"3","key":"10.1016\/j.biopha.2026.119656_bib14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017995","article-title":"Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials","volume":"9","author":"Koutnikova","year":"2019","journal-title":"BMJ Open."},{"issue":"6","key":"10.1016\/j.biopha.2026.119656_bib15","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1053\/j.gastro.2020.01.031","article-title":"Synbiotics Alter Fecal Microbiomes, But Not Liver Fat or Fibrosis, in a Randomized Trial of Patients With Nonalcoholic Fatty Liver Disease","volume":"158","author":"Scorletti","year":"2020","journal-title":"Gastroenterology"},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib16","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1186\/s12916-024-03744-x","article-title":"Strategic interventions in clinical randomized trials for metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity in the pediatric population: a systematic review with meta-analysis and bibliometric analysis","volume":"22","author":"Omana-Guzman","year":"2024","journal-title":"BMC Med."},{"issue":"4","key":"10.1016\/j.biopha.2026.119656_bib17","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1038\/nrd.2015.3","article-title":"Non-alcoholic steatohepatitis: emerging molecular targets and therapeutic strategies","volume":"15","author":"Musso","year":"2016","journal-title":"Nat. Rev. Drug. Discov."},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib18","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib19","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1002\/hep.21690","article-title":"Subcutaneous vitamin E ameliorates liver injury in an in vivo model of steatocholestasis","volume":"46","author":"Soden","year":"2007","journal-title":"Hepatology"},{"issue":"6","key":"10.1016\/j.biopha.2026.119656_bib20","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1007\/s00394-023-03179-9","article-title":"Aerobic exercise and vitamin E improve high-fat diet-induced NAFLD in rats by regulating the AMPK pathway and oxidative stress","volume":"62","author":"Bai","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"10.1016\/j.biopha.2026.119656_bib21","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1146\/annurev-nutr-071714-034347","article-title":"Vitamin E: A Role in Signal Transduction","volume":"35","author":"Zingg","year":"2015","journal-title":"Annu. Rev. Nutr."},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib22","first-page":"103","article-title":"Omega-3 fatty acids and nonalcoholic fatty liver disease in adults and children: where do we stand?","volume":"22","author":"Spooner","year":"2019","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"issue":"16","key":"10.1016\/j.biopha.2026.119656_bib23","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1001\/jama.2011.520","article-title":"Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial","volume":"305","author":"Lavine","year":"2011","journal-title":"JAMA"},{"issue":"12","key":"10.1016\/j.biopha.2026.119656_bib24","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1056\/NEJMc1006581","article-title":"Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis","volume":"363","author":"Violi","year":"2010","journal-title":"N. Engl. J. Med."},{"issue":"8","key":"10.1016\/j.biopha.2026.119656_bib25","doi-asserted-by":"crossref","DOI":"10.3390\/nu10081126","article-title":"Evaluation of a High Concentrate Omega-3 for Correcting the Omega-3 Fatty Acid Nutritional Deficiency in Non-Alcoholic Fatty Liver Disease (CONDIN)","volume":"10","author":"Tobin","year":"2018","journal-title":"Nutrients"},{"issue":"9","key":"10.1016\/j.biopha.2026.119656_bib26","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1007\/s00125-018-4675-2","article-title":"Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebo-controlled study","volume":"61","author":"Eriksson","year":"2018","journal-title":"Diabetologia"},{"issue":"5","key":"10.1016\/j.biopha.2026.119656_bib27","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.chom.2020.08.005","article-title":"Human-Gut-DNA Virome Variations across Geography, Ethnicity, and Urbanization","volume":"28","author":"Zuo","year":"2020","journal-title":"Cell. Host Microbe"},{"issue":"11","key":"10.1016\/j.biopha.2026.119656_bib28","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1136\/gutjnl-2019-319635","article-title":"Southern Chinese populations harbour non-nucleatum Fusobacteria possessing homologues of the colorectal cancer-associated FadA virulence factor","volume":"69","author":"Yeoh","year":"2020","journal-title":"Gut"},{"key":"10.1016\/j.biopha.2026.119656_bib29","article-title":"Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: a 24-week, double-blind, randomised controlled trial","author":"Ng","year":"2021","journal-title":"Gut"},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib30","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/medicina55020026","article-title":"Oxidative Stress and Antioxidant Biomarkers in Clinical and Experimental Models of Non-Alcoholic Fatty Liver Disease","volume":"55","author":"Ore","year":"2019","journal-title":"Medicina"},{"issue":"6","key":"10.1016\/j.biopha.2026.119656_bib31","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1002\/hep.20701","article-title":"Design and validation of a histological scoring system for nonalcoholic fatty liver disease","volume":"41","author":"Kleiner","year":"2005","journal-title":"Hepatology"},{"issue":"10","key":"10.1016\/j.biopha.2026.119656_bib32","doi-asserted-by":"crossref","first-page":"3046","DOI":"10.1194\/jlr.M007096","article-title":"Mass spectrometric profiling of oxidized lipid products in human nonalcoholic fatty liver disease and nonalcoholic steatohepatitis","volume":"51","author":"Feldstein","year":"2010","journal-title":"J. Lipid Res."},{"issue":"1-2","key":"10.1016\/j.biopha.2026.119656_bib33","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s11010-007-9461-2","article-title":"Saturated fatty acid-mediated endoplasmic reticulum stress and apoptosis are augmented by trans-10, cis-12-conjugated linoleic acid in liver cells","volume":"303","author":"Wei","year":"2007","journal-title":"Mol. Cell. Biochem."},{"key":"10.1016\/j.biopha.2026.119656_bib34","doi-asserted-by":"crossref","DOI":"10.1016\/j.phrs.2020.105218","article-title":"Endoplasmic reticulum stress and protein degradation in chronic liver disease","volume":"161","author":"Xia","year":"2020","journal-title":"Pharmacol. Res."},{"issue":"4","key":"10.1016\/j.biopha.2026.119656_bib35","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1002\/hep.26226","article-title":"Mitochondrial adaptations and dysfunctions in nonalcoholic fatty liver disease","volume":"58","author":"Begriche","year":"2013","journal-title":"Hepatology"},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib36","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/s41392-023-01503-7","article-title":"The mitophagy pathway and its implications in human diseases","volume":"8","author":"Wang","year":"2023","journal-title":"Signal. Transduct. Target. Ther."},{"issue":"1-2","key":"10.1016\/j.biopha.2026.119656_bib37","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.cell.2013.12.016","article-title":"Microbiota-generated metabolites promote metabolic benefits via gut-brain neural circuits","volume":"156","author":"De Vadder","year":"2014","journal-title":"Cell"},{"issue":"5","key":"10.1016\/j.biopha.2026.119656_bib38","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.2337\/db16-0924","article-title":"Butyrate Regulates Liver Mitochondrial Function, Efficiency, and Dynamics in Insulin-Resistant Obese Mice","volume":"66","author":"Mollica","year":"2017","journal-title":"Diabetes"},{"issue":"4","key":"10.1016\/j.biopha.2026.119656_bib39","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1089\/ars.2009.2531","article-title":"Mitochondrial dysfunction in diabetes: from molecular mechanisms to functional significance and therapeutic opportunities","volume":"12","author":"Sivitz","year":"2010","journal-title":"Antioxid. Redox Signal."},{"issue":"5","key":"10.1016\/j.biopha.2026.119656_bib40","doi-asserted-by":"crossref","DOI":"10.3390\/nu9050521","article-title":"Antioxidant Properties of Probiotic Bacteria","volume":"9","author":"Wang","year":"2017","journal-title":"Nutrients"},{"issue":"2","key":"10.1016\/j.biopha.2026.119656_bib41","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/jn\/133.2.461","article-title":"Microbial aromatic acid metabolites formed in the gut account for a major fraction of the polyphenols excreted in urine of rats fed red wine polyphenols","volume":"133","author":"Gonthier","year":"2003","journal-title":"J. Nutr."},{"issue":"11","key":"10.1016\/j.biopha.2026.119656_bib42","doi-asserted-by":"crossref","first-page":"3807","DOI":"10.3390\/nu13113807","article-title":"Colonic Medium-Chain Fatty Acids Act as a Source of Energy and for Colon Maintenance but Are Not Utilized to Acylate Ghrelin","volume":"13","author":"Gregor","year":"2021","journal-title":"Nutrients"},{"issue":"10","key":"10.1016\/j.biopha.2026.119656_bib43","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0139935","article-title":"Colonization of C57BL\/6 Mice by a Potential Probiotic Bifidobacterium bifidum Strain under Germ-Free and Specific Pathogen-Free Conditions and during Experimental Colitis","volume":"10","author":"Grimm","year":"2015","journal-title":"PLoS. One"},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/19490976.2020.1822729","article-title":"Metagenomic analysis reveals distinct patterns of gut lactobacillus prevalence, abundance, and geographical variation in health and disease","volume":"12","author":"Ghosh","year":"2020","journal-title":"Gut Microbes"},{"issue":"3","key":"10.1016\/j.biopha.2026.119656_bib45","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1002\/hep.28356","article-title":"The severity of nonalcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota","volume":"63","author":"Boursier","year":"2016","journal-title":"Hepatology"},{"issue":"1","key":"10.1016\/j.biopha.2026.119656_bib46","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/hep.30036","article-title":"Hepatocellular Carcinoma Is Associated With Gut Microbiota Profile and Inflammation in Nonalcoholic Fatty Liver Disease","volume":"69","author":"Ponziani","year":"2019","journal-title":"Hepatology"},{"issue":"3","key":"10.1016\/j.biopha.2026.119656_bib47","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1530\/JME-19-0260","article-title":"Glutamine-induced signaling pathways via amino acid receptors in enteroendocrine L cell lines","volume":"64","author":"Nakamura","year":"2020","journal-title":"J. Mol. Endocrinol."},{"issue":"979","key":"10.1016\/j.biopha.2026.119656_bib48","article-title":"Bifidobacteria and Butyrate-Producing Colon Bacteria: Importance and Strategies for Their Stimulation in the Human Gut","volume":"7","author":"Riviere","year":"2016","journal-title":"Front. Microbiol."}],"container-title":["Biomedicine &amp; Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S075333222600692X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S075333222600692X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:37:06Z","timestamp":1785875826000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S075333222600692X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":48,"alternative-id":["S075333222600692X"],"URL":"https:\/\/doi.org\/10.1016\/j.biopha.2026.119656","relation":{},"ISSN":["0753-3322"],"issn-type":[{"value":"0753-3322","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Synbiotics and antioxidants synergistically attenuate disease progression in metabolic dysfunction-associated steatotic liver disease","name":"articletitle","label":"Article Title"},{"value":"Biomedicine & Pharmacotherapy","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.biopha.2026.119656","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Masson SAS.","name":"copyright","label":"Copyright"}],"article-number":"119656"}}