Safety and efficacy of probiotics in the treatment of ALD.

The incidence of alcoholic liver disease (ALD) in China has been increasing in recent years, causing serious socioeconomic and public health burden. However, the treatment of ALD lacks a clear, unified, and effective plan. However, there is still lack of systematic analysis and evaluation of the efficacy and safety of probiotic in the treatment of ALD. A computerized search was performed to identify randomized controlled trials of probiotic and combined probiotic therapy in alcohol-induced liver injury. The control group received placebo or conventional treatment. Retrieval period from database creation to January7, 2022. Both investigators independently searched literature, extracted data, and assessed risk of bias using RevMan 5.4 software and rated the quality of the level of evidence for the outcome indicators according to the GRADE criteria evaluation. Altogether 10 studies with 835 patients were included. Meta-analysis showed significantly better liver function in test group than control group. The inflammatory level in the experimental group was significantly lower than that in the control group. The intestinal flora of the experimental group was effectively improved. But only Bifidobacteria and Lactobacilli were indigenous; meta-analysis showed that the adverse reactions in the experimental group were slightly higher than those in the control group, but the results were insignificant. Current evidence shows that compared with conventional therapy, probiotic or probiotic combination therapy can effectively improve liver function, modulate the gut microbiota environment, and reduce inflammation in alcoholic liver by modulating the gut microbiota, but the safety needs further investigation. There are limitations in the quantity and quality of the included trials. This study shows that the use of probiotics therapy has a good regulating effect on liver function, intestinal flora, inflammatory level, and blood lipid level in ALD patients.