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. 2024 Aug 30:11:1372755.
doi: 10.3389/fnut.2024.1372755. eCollection 2024.

Probiotics-role in alleviating the impact of alcohol liver disease and alcohol deaddiction: a systematic review

Grisilda Vidya Bernhardt  1 , Pooja Shivappa  1 , Janita R Pinto  2 , Rashmi Ks  3 , Jayachithra Ramakrishna Pillai  4 , Suresh Kumar Srinivasamurthy  5 , Vijay Paul Samuel  6
Affiliations

Probiotics-role in alleviating the impact of alcohol liver disease and alcohol deaddiction: a systematic review

Grisilda Vidya Bernhardt et al. Front Nutr. .

Abstract

Background: There are few efficient treatment options for alcohol addiction, which continues to be a serious public health concern. The possible contribution of gut microbiota to the onset and progression of alcohol addiction has been brought to light by recent studies. Probiotics have become a cutting-edge intervention in the treatment of alcohol consumption disorder because of its favorable effects on gut health. The purpose of this systematic review is to assess the body of research on the advantages of probiotics in treating alcoholism and associated neuroinflammatory conditions.

Methods: To find pertinent research published from January 2012 to 2023, a thorough search of electronic databases, including PubMed, Scopus, Google Scholar and Web of Science, was carried out. Included were studies looking at how probiotics affect neuroinflammation, gut- brain axis regulation, alcohol addiction, and related behaviors.

Findings: Several investigations have shown how beneficial probiotics are in reducing systemic inflammation and alcoholic liver disease (ALD). Probiotic treatments successfully corrected the imbalance of microbiota, decreased intestinal permeability, and stopped the passage of bacterial constituents such lipopolysaccharides (LPS) into the bloodstream. Additionally, probiotics helped to regulate neurotransmitter pathways, especially those connected to GABA, glutamate, and dopamine, which are intimately linked to behaviors related to addiction. Furthermore, it was shown that probiotics altered the expression of neurotransmitter signaling and dopamine receptors.

Conclusion: There is strong evidence from this systematic study that probiotics have potential advantages in treating alcohol addiction. The potential of probiotic therapies is demonstrated by the way they modulate important neurotransmitter pathways implicated in addiction, decrease neuroinflammation, and restore the balance of gut flora. To fully investigate the therapeutic potential of probiotics in treating alcohol addiction and enhancing the general wellbeing of those afflicted by this condition, more research is necessary.

Keywords: alcohol addiction; alcohol liver disease; alcohol use disorder; dysbiosis; gut microbiota; gut-brain axis; neuroinflammation; probiotics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Results of risk of bias analysis of intention-to-treat studies. (A) Risk of Bias by article included on each domain. (B) Overall risk of Bias percentage on each domain (16).
Figure 2
Figure 2
Flowchart of PRISMA.
Figure 3
Figure 3
Probiotics affect the alcohol-related gut-microbiota-liver-brain axis, impacting each organ through direct and indirect mechanisms. (A) They enhance digestion, strengthen tight junctions, and protect the intestinal crypts and mucous layer. (B) Probiotics mitigate alcohol-induced dysbiosis by reducing harmful bacteria, improving gut permeability, and lowering the translocation of pathogen-associated molecular patterns (PAMPs) to the liver. (C) They reduce neuroinflammation by decreasing proinflammatory cytokines, potentially alleviating alcohol-induced anxiety and depression. By controlling gut permeability and substance translocation, probiotics help prevent disruption of the blood-brain barrier (BBB) and neuroinflammation. Probiotics also influence dopamine regulation by increasing dopamine transporter expression. (D) Probiotics improve liver health by reducing steatosis, hepatic encephalopathy, and cirrhosis, primarily through the normalization of inflammatory processes by decreasing PAMPs, particularly lipopolysaccharides (LPS), via the Toll-like receptor 4 (TLR4) pathway, and by increasing fibroblast growth factor 21 (FGF21) production. FGF21 impacts the brain by reducing dopamine availability at postsynaptic receptors through increased dopamine transporter transcription in the nucleus accumbens.
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