Wu · Nutrients 2026 · Scoping review · n=121 studies

Gut-Liver Axis Dysfunction in Alcohol-Associated Liver Disease and the Potential Role of Sheep Yogurt: A Scoping Review and Mechanistic Framework.

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Level 5 - mechanism / opinion, no new human data

Scoping review identifying zero direct experimental or clinical studies, synthesizing indirect and mechanistic evidence.

PubMed 42588172 · doi:10.3390/nu18152549 · record verified 2026-08-28

What was done

A PRISMA-ScR-guided scoping review searched PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar from January 2006 to February 2026. The authors mapped evidence across alcohol-associated liver disease (ALD) pathophysiology, gut barrier integrity, microbial ecology, bile acid/tryptophan signaling, nutritional vulnerability, fermented dairy interventions, and ovine dairy matrix characteristics. Evidence was categorized as direct, indirect, or mechanistic inference.

What was found

From 1,388 identified records, 121 sources were included. Zero eligible studies directly tested sheep yogurt or defined sheep yogurt preparations in ALD-relevant experimental or clinical models (0 direct studies). Indirect evidence from other fermented dairy, isolated probiotics, postbiotics, and microbial preparations showed potential modulation of intestinal permeability, inflammatory signaling, and liver injury in non-ALD or general settings, but no quantitative efficacy data exist for sheep yogurt in ALD.

Why it matters

This review establishes that theoretical mechanistic rationales for sheep yogurt in ALD are entirely unverified, cautioning against therapeutic or dietary claims prior to direct experimental testing.

Limits

There are no direct in vivo, animal, or human clinical trials evaluating sheep yogurt in ALD. Extrapolating effects from isolated probiotics, cow dairy, or non-ALD disease models fails to account for the unique intact ovine food matrix. Findings are limited to narrative and scoping synthesis without meta-analysis.

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