Clin Mol Hepatol.  2021 Jan;27(1):110-124. 10.3350/cmh.2020.0125.

Lactobacillus attenuates progression of nonalcoholic fatty liver disease by lowering cholesterol and steatosis

  • 1Institue for Liver and Digestive Diseases, Hallym University College of Medicine, Chuncheon, Korea
  • 2Department of Pathology, Hallym University College of Medicine, Chuncheon, Korea
  • 3Chong Kun Dang Bio Research Institute, Ansan, Korea
  • 4Department of Agricultural Biotechnology, Seoul National University, Seoul, Korea
  • 5Department of Life Science, Gachon University, Sungnam, Korea
  • 6Department of Medicine, College of Medicine, Kyungpook National University, Daegu, Korea
  • 7Department of Microbiome, ChunLab, Inc., Seoul, Korea


Nonalcoholic fatty liver disease (NAFLD) is closely related to gut-microbiome. There is a paucity of research on which strains of gut microbiota affect the progression of NAFLD. This study explored the NAFLD-associated microbiome in humans and the role of Lactobacillus in the progression of NAFLD in mice.
The gut microbiome was analyzed via next-generation sequencing in healthy people (n=37) and NAFLD patients with elevated liver enzymes (n=57). Six-week-old male C57BL/6J mice were separated into six groups (n=10 per group; normal, Western, and four Western diet + strains [109 colony-forming units/g for 8 weeks; L. acidophilus, L. fermentum, L. paracasei, and L. plantarum]). Liver/body weight ratio, liver pathology, serum analysis, and metagenomics in the mice were examined.
Compared to healthy subjects (1.6±4.3), NAFLD patients showed an elevated Firmicutes/Bacteroidetes ratio (25.0±29.0) and a reduced composition of Akkermansia and L. murinus (P<0.05). In the animal experiment, L. acidophilus group was associated with a significant reduction in liver/body weight ratio (5.5±0.4) compared to the Western group (6.2±0.6) (P<0.05). L. acidophilus (41.0±8.6), L. fermentum (44.3±12.6), and L. plantarum (39.0±7.6) groups showed decreased cholesterol levels compared to the Western group (85.7±8.6) (P<0.05). In comparison of steatosis, L. acidophilus (1.9±0.6), L. plantarum (2.4±0.7), and L. paracasei (2.0±0.9) groups showed significant improvement of steatosis compared to the Western group (2.6±0.5) (P<0.05).
Ingestion of Lactobacillus, such as L. acidophilus, L. fermentum, and L. plantarum, ameliorates the progression of nonalcoholic steatosis by lowering cholesterol. The use of Lactobacillus can be considered as a useful strategy for the treatment of NAFLD.


Nonalcoholic fatty liver disease; Probiotics; Gut microbiome; Cholesterol
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