{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:17:33Z","timestamp":1791497853916,"version":"4.3.4"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To evaluate if VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      [a high-concentration multi-strain probiotic mix containing one strain of\n                      <jats:italic>Streptococcus thermophilus<\/jats:italic>\n                      BT01, three strains of\n                      <jats:italic>Bifidobacteria<\/jats:italic>\n                      (\n                      <jats:italic>B. breve<\/jats:italic>\n                      BB02;\n                      <jats:italic>B. animalis<\/jats:italic>\n                      subspecies [subsp.]\n                      <jats:italic>lactis<\/jats:italic>\n                      BL03, previously identified as\n                      <jats:italic>B. longum<\/jats:italic>\n                      BL03; and\n                      <jats:italic>B. animalis<\/jats:italic>\n                      subsp.\n                      <jats:italic>lactis<\/jats:italic>\n                      BI04, previously identified as\n                      <jats:italic>B. infantis<\/jats:italic>\n                      BI04), and four strains of\n                      <jats:italic>Lactobacilli<\/jats:italic>\n                      (\n                      <jats:italic>L. acidophilus<\/jats:italic>\n                      BA05,\n                      <jats:italic>L. plantarum<\/jats:italic>\n                      BP06,\n                      <jats:italic>L. paracasei<\/jats:italic>\n                      BP07, and\n                      <jats:italic>L. helveticus<\/jats:italic>\n                      BD08, previously identified as\n                      <jats:italic>L. delbrueckii<\/jats:italic>\n                      subsp.\n                      <jats:italic>bulgaricus<\/jats:italic>\n                      BD08)] therapy could improve hepatic parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We enrolled 60 Caucasian patients aged \u2265 18 years of either sex with the diagnosis of non-alcoholic fatty liver disease (NAFLD), according to practice guidance, in a double-blind, placebo-controlled study. Patients were randomized to take placebo or VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      , 2 sachets\/day in the morning for 3 months. VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      and placebo were self-administered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We did not observe any change in body mass index (BMI), circumferences, fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and adiponectin (ADN) with neither treatment. A statistically significant triglycerides (Tg) decrease (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05 vs. baseline, and\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05 vs. placebo, respectively) and high-sensitivity C-reactive protein (Hs-CRP) decrease (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05 vs. baseline) was observed in the group of patients being treated with VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      compared with placebo. Transaminases and gamma-glutamyltransferase (\u03b3-GT) were significantly reduced in VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05 vs. baseline and placebo, respectively) compared with the placebo group. Aspartate aminotransferase (AST)\/alanine aminotransferase (ALT) ratio and hepatic steatosis index (HSI) were significantly lower than the VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05 vs. baseline and placebo, respectively) compared with the placebo group. All patients reported an improvement or the disappearance of hepatic steatosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Probiotic therapy with VSL#3\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ameliorates hepatic parameters and echography grading, while reducing Tg and the inflammatory status, without any difference between men and women.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2022.846873","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T11:48:19Z","timestamp":1653392899000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":45,"title":["Probiotic Therapy With VSL#3\u00ae in Patients With NAFLD: A Randomized Clinical Trial"],"prefix":"10.3389","volume":"9","author":[{"given":"Giuseppe","family":"Derosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigina","family":"Guasti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"D\u2019Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Martinotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Valentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Di Matteo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo M.","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Maresca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni V.","family":"Gaudio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Maffioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1126\/science.1204265","article-title":"Human fatty liver disease: old questions and new insights.","volume":"332","author":"Cohen","year":"2011","journal-title":"Science."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1007\/s00018-019-03011-w","article-title":"The links between the gut microbiome and non-alcoholic fatty liver disease (NAFLD).","volume":"76","author":"Safari","year":"2019","journal-title":"Cell Mol Life Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"E01","DOI":"10.3810\/pgm.2008.07.1800","article-title":"Nonalcoholic fatty liver disease: hepatic manifestation of obesity and the metabolic syndrome.","volume":"120","author":"Boppidi","year":"2008","journal-title":"Postgrad Med."},{"key":"B4","first-page":"40","article-title":"The cardiometabolic risk: a new concept for old diseases.","volume":"1","author":"Derosa","year":"2019","journal-title":"Nutrafoods."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17040447","article-title":"Gut microbiota and lifestyle interventions in NAFLD.","volume":"17","author":"Houghton","year":"2016","journal-title":"Int J Mol Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1111\/bcp.12899","article-title":"The role of nutraceuticals for the treatment of non-alcoholic fatty liver disease.","volume":"83","author":"Del Ben","year":"2017","journal-title":"Br J Clin Pharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1038\/nature12506","article-title":"Richness of human gut microbiome correlates with metabolic markers.","volume":"500","author":"Le Chatelier","year":"2013","journal-title":"Nature."},{"key":"B8","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document. 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