Background: Non-alcoholic fatty liver disease is the most prevalent widespread liver disease that may progress to liver fibrosis and cirrhosis.
Aim: To compare the possible hepatoprotective effects of probiotics versus silymarin on a model of non-alcoholic fatty liver disease in adult male albino rats.Materials and methods: Five equal groups were created by randomly dividing fifty adult albino male rats; group I (control). Rats in the remaining groups received a high-fat, high-fructose diet daily for eight weeks, then they were divided into: groups II in which the animals were sacrificed after 8 weeks and group III in which the animals were left without treatment for a further 4 weeks, groups IV and V were given high fat high fructose diet for 8 weeks then received oral probiotics and silymarin daily (respectively) for further four weeks, then they were sacrificed.  Following the experiment, liver samples were exposed to hematoxylin and eosin, Masson`s trichrome, and immunohistochemical techniques including proliferating cell nuclear antigen (PCNA) and hepatocyte-paraffin-1. Histomorphometric studies were also done.Results: A high-fat high-fructose diet resulted in liver vacuolations, a significant increase in collagen deposition, and PCNA expression, while Hepatocyte Paraffin-1 expression showed a significant decrease. Significant improvement of all histological aspects was noticed in probiotics and silymarin-treated groups. However, the silymarin-treated group showed a better effect compared to the probiotic-treated group.Conclusion: administration of both probiotics and silymarin improved Non-alcoholic fatty liver disease. However, silymarin was superior to probiotics.