A meta-analysis including small randomized controlled trials conducted in patients with NAFLD found that microbial therapies (probiotics, prebiotics, and synbiotics—(PPS)) significantly reduced body mass index and alanine transaminase (ALT) levels but not markers of inflammation (tumor necrosis factor-alpha (TNF-α) and C-reactive protein (CRP)) [22]. Here, TNF is linked to metabolic dysfunction-associated steatotic liver disease.