Nonalcoholic Fatty Liver Disease: Modulating Gut Microbiota to Improve Severity?

International audienceGut microbiota plays a role in the pathophysiology of metabolic diseases which also include nonalcoholic fatty liver diseases (NAFLD), through the gut-liver axis. To date, clinical guidelines recommend a weight loss goal of 7 to 10% to improve features of NAFLD. Nevertheless, since this target is not easily achieved by all patients, alternative therapeutic options are currently being evaluated. This review focusses on therapeutics that aims to modulate the gut microbiota and the gut-liver axis. We will herein discuss how probiotics, prebiotics, synbiotic, fecal microbiota transfer, polyphenols, specific diets and exercise interventions have been shown to modify gut microbiota signatures, improve NAFLD outcomes and detail, when available, the different mechanisms by which these beneficial outcomes might occur. Apart from probiotics which have already been tested in human RCTs, most of these potential therapeutics have been studied in animals. Their efficacy still warrants confirmation in humans using appropriate design