Meta-analysis of the Effects of Probiotics on Alcoholic Liver Disease

Background: Although probiotics are considered a possible treatment for alcoholic liver disease (ALD), their effectiveness in enhancing liver function in patients with ALD is still unclear. Objective: In this investigation we sought to determine the influence of probiotics on liver function markers in patients with ALD. with a focus on the efficacy of alanine aminotransferase (ALT). We also examined aspartate aminotransferase (AST), total bilirubin (TB), albumin (ALB), and gamma-glutamyl transferase (GGT). Methods: Through systematic searches of medical databases, including Web of Science, PubMed, Embase, Cochrane Library, Ovid, and Wan Fang, we identified 15 randomized controlled trials involving patients with alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Results: Probiotic therapy significantly reduced levels of ALT (standard mean difference [SMD], −0.50; 95% CI, −0.86 to −0.14; P = .007) and AST (SMD, −0.26; 95% CI, −0.52 to 0.00; P = .05). No significant effects were observed on TB (SMD, −0.90; 95% CI, −1.06 to 0.13; P = .12), ALB (SMD, 0.16; 95% CI, −0.06 to 0.37; P = .15), or GGT (SMD, 0.14; 95% CI, −0.11 to 0.40; P = .26) levels. Regional disparities were noted, with Asian patients showing a significant reduction in ALT levels. Patients undergoing treatments lasting 8 weeks or more also showed significant reductions in ALT levels. Furthermore, in this review we identified a more pronounced effect on ALT level reduction in subgroups with a higher proportion of male participants. Conclusion: According to this meta-analysis, administration of probiotics could assist in managing ALT levels in ALD patients, offering a novel approach to ALD treatment. Systematic Review Registration: PROSPERO registration No. CRD42024619024. © The Author(s) 2025. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)