Evidence map›Paper›PMID 41778620›Full record

SynthesisClinical and translational gastroenterology2026

The Efficacy of Gut Microbiome-Modulating Therapies on Liver Cirrhosis: A Systematic Review and Network Meta-Analysis.

Yi Wang, JiQi OuYang, Houyan Zhang, Yaocun Shen, Ziwei Guo, Wenliang Lv

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Clinical and translational gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yi WangDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.ORCID 0009-0000-2913-9805
JiQi OuYangDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Houyan ZhangDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yaocun ShenDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Ziwei GuoDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Wenliang LvDepartment of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Funding

High Level Chinese Medical Hospital Promotion Project of China No. HLCMHPP2023086
6 · The paper itself

Abstract

introductionGut microbiome-modulating therapies are potential strategies for managing liver cirrhosis, yet head-to-head comparisons to determine the optimal intervention are lacking. This study aimed to evaluate and rank the therapeutic efficacy of these therapies on liver function and disease progression in patients with liver cirrhosis.

methodsWe searched major databases (PubMed, Web of Science, Embase, Cochrane Library) for randomized controlled trials (RCTs) published from January 1, 2000, to December 30, 2024. Interventions included probiotics, prebiotics, synbiotics, and fecal microbiota transplantation vs placebo or standard care. Primary outcomes were hepatic function indicators; secondary outcomes included inflammatory markers. Data were analyzed using random-effects frequentist network meta-analyses. The study was registered on Prospective Register of Systematic Reviews (CRD420251000506).

resultsSeventeen studies comprising 1,051 individuals were included. Synbiotics demonstrated the most significant efficacy among all interventions, showing superior reduction in blood ammonia levels compared with placebo (mean difference [MD] -5.57), probiotics, and prebiotics. Prebiotics showed significant differences in lowering endotoxin levels compared with placebo (MD: -3.29) and probiotics. Furthermore, relative to placebo, prebiotics significantly reduced tumor necrosis factor-alpha (MD: -2.30) and interleukin-6 levels (MD: -4.60). DISCUSSION: This network meta-analysis advances current knowledge by establishing an evidence-based hierarchy of efficacy. Synbiotics are most effective for reducing blood ammonia, whereas prebiotics demonstrate superior efficacy in lowering endotoxin and inflammatory markers. These results support a personalized therapeutic approach: prioritizing synbiotics for patients with hyperammonemia and prebiotics for those characterized by systemic inflammation. Future high-quality RCTs are needed to standardize specific strain combinations.

Indexed as

Fecal Microbiota TransplantationGastrointestinal MicrobiomeLiver CirrhosisPrebioticsProbioticsDisease ProgressionHumansRandomized Controlled Trials as TopicSynbioticsTreatment OutcomePrebioticsgut microbiome–modulating therapiesliver cirrhosismeta-analysisrandomized controlled trial

Identifiers

PMID41778620
PMCPMC13193310

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.