The effects of next generation probiotics on metabolic dysfunction-associated steatotic liver disease: a parallel, double-blind, randomized, placebo-controlled trialOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
Researchers tested three next generation probiotic strains, Lactobacillus delbrueckii subsp. lactis (LL001), L. helveticus (LH001), and Pediococcus pentosaceus KID7 (PPKID7), in adults with metabolic dysfunction-associated steatotic liver disease (MASLD). The goal was to see whether these strains improve liver function and reshape the stool microbiome.
How was it studied?
In this double-blind, placebo-controlled trial, 110 MASLD patients were randomized to one of the three probiotics (9 x 10^9 CFU per day) or placebo, all alongside silymarin, for 8 weeks. Blood and stool samples, including 16S rRNA sequencing, were collected at baseline and study end.
What did they find?
LL001 lowered alanine transaminase (87.3 to 71.1 U/L) and aspartate transaminase (64.9 to 50.0 U/L); LH001 reduced body weight (78.4 to 77.2 kg); PPKID7 lowered cholesterol (186.1 to 178.0 mmol/L). Probiotic treatment reduced Proteobacteria and increased Ruminococcaceae and Lachnospiraceae in the LL001 group, with a broader tendency across groups toward lower Haemophilus and Ruminococcus_g2 and higher Bifidobacterium.
Why it matters
This is among the few MASLD probiotic trials to pair clinical liver markers with gut microbiome data, linking specific strain effects to shifts in gut bacterial composition. The findings support probiotics as an adjunct approach to standard hepatoprotective therapy, though the authors note the short duration and lack of a placebo-only arm as limitations.