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Review
. 2024 Feb 28;30(8):833-842.
doi: 10.3748/wjg.v30.i8.833.

Fecal microbiota transplantation for treatment of non-alcoholic fatty liver disease: Mechanism, clinical evidence, and prospect

Xiao-Xia Qiu  1 , Sheng-Li Cheng  2 , Yan-Hui Liu  3 , Yu Li  4 , Rui Zhang  5 , Nan-Nan Li  6 , Zheng Li  7
Affiliations
Review

Fecal microbiota transplantation for treatment of non-alcoholic fatty liver disease: Mechanism, clinical evidence, and prospect

Xiao-Xia Qiu et al. World J Gastroenterol. .

Abstract

The population of non-alcoholic fatty liver disease (NAFLD) patients along with relevant advanced liver disease is projected to continue growing, because currently no medications are approved for treatment. Fecal microbiota transplantation (FMT) is believed a novel and promising therapeutic approach based on the concept of the gut-liver axis in liver disease. There has been an increase in the number of pre-clinical and clinical studies evaluating FMT in NAFLD treatment, however, existing findings diverge on its effects. Herein, we briefly summarized the mechanism of FMT for NAFLD treatment, reviewed randomized controlled trials for evaluating its efficacy in NAFLD, and proposed the prospect of future trials on FMT.

Keywords: Efficacy; Fecal microbiota transplantation; Mechanism; Non-alcoholic fatty liver disease; Randomized controlled trial.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Homeostatic and disrupted gut-liver crosstalk, and mechanism of fecal microbiota transplantation for non-alcoholic fatty liver disease treatment. Left: Healthy/homeostatic condition; Middle: In non-alcoholic fatty liver disease (NAFLD), the intestinal barrier can be disrupted, which facilitates the translocation of microbes and microbial metabolites to the liver, thus promoting hepatic steatosis, inflammation and fibrosis; Right: Fecal microbiota transplantation is used to recover microbial diversity and abundance and restore homeostatic gut-liver crosstalk, and consequently attenuate the symptoms of NAFLD; FMT: Fecal microbiota transplantation.
Figure 2
Figure 2
Flow diagram for the process of study selection. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; HDL-C: High-density lipoprotein cholesterol; HOMA-IR: Homeostatic model assessment of insulin resistance; LDL-C: Low-density lipoprotein cholesterol.
Figure 3
Figure 3
Pooled analysis depicting the effects of fecal microbiota transplantation on serum triglycerides, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, homeostatic model assessment of insulin resistance and body mass index measured by weighted mean difference in patients with non-alcoholic fatty liver disease. A: Serum triglycerides; B: Cholesterol; C: Low-density lipoprotein cholesterol (LDL-C); D: High-density lipoprotein cholesterol (HDL-C); E: Alanine aminotransferase (ALT); F: Aspartate aminotransferase (AST); G: Homeostatic model assessment of insulin resistance (HOMA-IR); H: Body mass index (BMI). FMT: Fecal microbiota transplantation; NAFLD: Non-alcoholic fatty liver disease; WMD: Weighted mean difference.
See this image and copyright information in PMC

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