SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Nutrition and Microbes
Effects of Probiotics on Liver Function, Inflammation, and Gut Microbiota in Alcoholic Liver Injury: A Systematic Review and Meta-Analysis
Provisionally accepted
Mohamed J. Saadh1
Zahraa Sabah Ghnim2*Morug Salih Mahdi2Vimal Arora2M. M. Rekha2Ashish Sharma3Bhanu Juneja4Zafar Aminov5Waam Mohammed Taher6Mariem Alwan7Mahmood Jasem Jawad8Atheer Khdyair Hamad9- 1The University of Jordan School of Pharmacy, Amman, Jordan
- 2United Nations Iraq, Baghdad, Iraq
- 3University of Rajasthan, Jaipur, India
- 4Chitkara University Chitkara Design School, Rajpura, India
- 5Samarkand State Medical University, Samarkand, Uzbekistan
- 6National Taiwan University of Science and Technology, Taipei City, Taiwan
- 7Al-Farahidi University, Baghdad, Iraq
- 8Al Zahrawi Hospital, Al Nakheel, United Arab Emirates
- 9Gilgamesh University, Baghdad, Iraq
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Purpose: This systematic review and meta-analysis aimed to evaluate the effects of probiotic supplementation on alcohol metabolism, liver function biomarkers, inflammatory indicators, and gut microbiota composition in patients with alcoholic liver disease (ALD), providing insights into their potential therapeutic role. Methods: A comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases identified clinical studies assessing probiotic interventions in adults with ALD. Results: A total of 12 clinical trials conducted between 2008 and 2025 were included. Probiotic supplementation resulted in significant reductions in liver enzymes, including ALT (WMD = - 10.10; 95% CI: -15.34, -4.87) and AST (WMD = –13.05; 95% CI: -21.33, -4.78). No significant effects were observed for GGT or ALP. Probiotics did not significantly influence blood alcohol or acetaldehyde levels. Regarding inflammatory markers, probiotics did not significantly affect LPS, TNF-α, IL-1β, or IL-6, and IL-10. Microbial analyses showed an increase in beneficial gut bacteria, including Lactobacillus, Bifidobacterium, Faecalibacterium, and Prevotella, and a decrease in pathogenic taxa such as Escherichia and Shigella. Conclusion: Probiotic supplementation shows promising benefits for improving liver enzyme profiles and modulating the gut microbiota in patients with ALD. However, inconsistent effects on markers of inflammation and alcohol metabolism highlight the need for large-scale, high-quality randomized trials to confirm the therapeutic potential of probiotics in ALD.
Keywords: alcohol, Inflammation, Liver, Meta-analysis, probiotic
Received: 02 Oct 2025; Accepted: 02 Dec 2025.
Copyright: © 2025 J. Saadh, Sabah Ghnim, Salih Mahdi, Arora, M. Rekha, Sharma, Juneja, Aminov, Mohammed Taher, Alwan, Jasem Jawad and Khdyair Hamad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zahraa Sabah Ghnim
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.