Intestinal microbiome-targeted therapies improve liver function in alcohol-related liver disease by restoring bifidobacteria: a systematic review and meta-analysis

Xin Chi; Xiu Sun; Danying Cheng; Shunai Liu; Calvin Q Pan; Huichun Xing

doi:10.3389/fphar.2023.1274261

Intestinal microbiome-targeted therapies improve liver function in alcohol-related liver disease by restoring bifidobacteria: a systematic review and meta-analysis

Front Pharmacol. 2024 Jan 8:14:1274261. doi: 10.3389/fphar.2023.1274261. eCollection 2023.

Authors

Xin Chi^{1

2

3}, Xiu Sun^{1

2

3}, Danying Cheng^{1

4

3}, Shunai Liu^{2

3}, Calvin Q Pan^{1

5

3}, Huichun Xing^{1

4

3}

Affiliations

¹ Center of Liver Diseases Division, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
² Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
³ National Center for Infectious Diseases, Beijing, China.
⁴ Peking University Ditan Teaching Hospital, Beijing, China.
⁵ Division of Gastroenterology and Hepatology, NYU Langone Health, New York University School of Medicine, New York, NY, United States.

Abstract

Objective: To systematically evaluate the efficacy of intestinal microbiome-targeted therapies (MTTs) in alcohol-related liver disease (ALD). Methods: With pre-specified keywords and strategies, we searched databases including Cochrane Library, PubMed, EMBASE, CNKI, Wanfang Data, and Weipu for RCTs on intestinal MTTs in ALD patients from January 2000 to May 2021. Two researchers independently conducted literature screening, data extraction, and quality evaluation according to the eligible criteria. Outcomes of interest included the effects of intestinal MTTs on ALT, AST, GGT, TBIL, TNF-α, IL-6, intestinal Escherichia coli, and Bifidobacteria when compared to the control group. Pooled data were compiled and analyzed with Revman 5.4 software. Results: Among 5 RCTs included with 456 ALD patients who received probiotics, the therapeutic pooled effects in the experimental group were the followings: ALT (MD = -7.16.95% CI: 10.71∼-3.60; p < 0.0001)、AST (MD = -25.11.95% CI: 30.57∼-19.47; p < 0.00001)、GGT (MD = -6.72.95% CI: 11.91∼-1.53; p = 0.01)、IL-6(SMD = -0.82.95% CI: 1.10∼-0.54; p < 0.00001), which were significantly better than those in the placebo or standard treatment group respectively, while the difference of TBIL (SMD = -0.06, 95%CI: 0.29-0.16; p = 0.59), TNF-α(SMD = -0.53.95% CI: 1.57-0.50; p = 0.31)in the two groups was not significant. After intestinal MTT treatment, the number of intestinal Bifidobacteria increased significantly (MD = 0.79.95% CI: 0.00-1.58; p = 0.05)in the experimental group. However, there were no significant changes in the number of E. coli in both groups (SMD = -0.29.95% CI: 0.92-0.34; p = 0.36). Conclusion: Intestinal MTTs can significantly improve liver function, associated with the increase of intestinal Bifidobacteria, which may be beneficial to ALD. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021246067, Identifier CRD42021246067.

Keywords: alcohol-related liver disease; intestinal microbiota; meta-analysis; microbiome-targeted therapies; systematic review.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Key R&D Program of China (2022YFC2304500); National Key R&D Program of China (2021YFC2301801); the Beijing Municipal of Science and Technology Major Project (20220383ky); Capital’s Funds for Health Improvement and Research of China (CFH 2020-1-22171); The Digestive Medical Coordinated Development Center of Beijing Hospitals Authority under Grant No. XXT26.