{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:09:21Z","timestamp":1791587361280,"version":"4.3.4"},"reference-count":138,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Modifications in the microbiota caused by environmental and genetic reasons can unbalance the intestinal homeostasis, deregulating the host\u2019s metabolism and immune system, intensifying the risk factors for the development and aggravation of non-alcoholic fat liver disease (NAFLD). The use of probiotics, prebiotics and synbiotics have been considered a potential and promising strategy to regulate the gut microbiota and produce beneficial effects in patients with liver conditions. For this reason, this review aimed to evaluate the effectiveness of probiotics, prebiotics, and symbiotics in patients with NAFLD and NASH. Pubmed, Embase, and Cochrane databases were consulted, and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed. The clinical trials used in this study demonstrated that gut microbiota interventions could improve a wide range of markers of inflammation, glycemia, insulin resistance, dyslipidemia, obesity, liver injury (decrease of hepatic enzymes and steatosis and fibrosis). Although microbiota modulators do not play a healing role, they can work as an important adjunct therapy in pathological processes involving NAFLD and its spectrums, either by improving the intestinal barrier or by preventing the formation of toxic metabolites for the liver or by acting on the immune system.<\/jats:p>","DOI":"10.3390\/ijms23158805","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T21:09:18Z","timestamp":1659992958000},"page":"8805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":139,"title":["The Effects of Probiotics, Prebiotics and Synbiotics in Non-Alcoholic Fat Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH): A Systematic Review"],"prefix":"10.3390","volume":"23","author":[{"given":"Rodrigo Zamignan","family":"Carpi","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-876X","authenticated-orcid":false,"given":"Sandra M.","family":"Barbalho","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"},{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Mar\u00edlia (UNIMAR), Marilia 17525-902, SP, Brazil"},{"name":"School of Food and Technology of Marilia (FATEC), Marilia 17506-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8776-561X","authenticated-orcid":false,"given":"Katia Portero","family":"Sloan","sequence":"additional","affiliation":[{"name":"Texas Institute for Kidney and Endocrine Disorders, Lufkin, TX 75904, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-0982","authenticated-orcid":false,"given":"Lucas Fornari","family":"Laurindo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heron Fernando","family":"Gonzaga","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"},{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Mar\u00edlia (UNIMAR), Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Cesar","family":"Grippa","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Mar\u00edlia (UNIMAR), Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza L. Menegucci","family":"Zutin","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, School of Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"},{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Mar\u00edlia (UNIMAR), Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul J. S.","family":"Girio","sequence":"additional","affiliation":[{"name":"Department of Animal Sciences, School of Veterinary Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Sampaio Fonseca","family":"Repetti","sequence":"additional","affiliation":[{"name":"Department of Animal Sciences, School of Veterinary Medicine, University of Mar\u00edlia (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Rucco Penteado","family":"Detregiachi","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Mar\u00edlia (UNIMAR), Marilia 17525-902, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia C. 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