THE IMPACT OF GUT MICROBIOME MODULATION ON NAFLD PROGRESSION

Introduction. Nonalcoholic fatty liver disease (NAFLD) represents a significant health burden worldwide, encompassing a continuum of liver damage ranging from simple fat accumulation to inflammation, fibrosis, and cirrhosis. Its close relationship with metabolic syndrome highlights its systemic nature, as it often coexists with obesity, insulin resistance, hypertension, and dyslipidemia. The growing prevalence of these conditions underscores the need for innovative approaches to manage NAFLD effectively. Emerging evidence suggests that gut microbiota plays a crucial role in NAFLD pathogenesis. Alterations in microbial composition, including an increased Firmicutes/Bacteroides (F/B) ratio, have been associated with metabolic disturbances and inflammatory processes that accelerate liver damage. Consequently, targeting gut microbiota through probiotics offers a promising therapeutic strategy to address these underlying mechanisms. This study focused on Saccharomyces boulardii CNCM I-745, Lactobacillus acidophilus (LA-5), and Bifidobacterium lactis (BB-12), probiotic strains known for their ability to modulate inflammation, restore gut barrier integrity, and optimize lipid metabolism. Their combined administration aims to reduce systemic inflammation and improve biochemical markers in NAFLD patients.The aim of the study was to explore the composition of gut microbiota in NAFLD patients and evaluate the impact of a combined probiotic intervention on biochemical and inflammatory markers and lipid profiles.Material and methods. The research involved 152 patients diagnosed with NAFLD, confirmed through imaging techniques and clinical parameters. Standard biochemical analyses and quantitative real-time PCR were used to assess metabolic risk factors and gut microbiota composition. Patients received a combined probiotic regimen, and changes in microbiota, biochemical, and lipid parameters were evaluated.Results. NAFLD patients exhibited significant gut microbiota dysbiosis, with an elevated proportion of Firmicutes and Actinobacteria. Probiotic therapy resulted in a substantial improvement in gut microbial balance, evidenced by a reduced F/B ratio. Additionally, improvements were observed in lipid metabolism, including reductions in triglycerides and cholesterol, along with an increase in HDL levels. Inflammatory markers such as high-sensitivity C-reactive protein also decreased significantly.Conclusions. The findings highlight the link between gut microbiota and metabolic disturbances in NAFLD. Probiotic intervention demonstrated a potential to correct dysbiosis, reduce systemic inflammation, and improve metabolic health, suggesting its role as an adjunctive treatment for NAFLD.