In this study, we systematically collected relevant literature in the past five years on the intervention of natural
polysaccharides in
alcoholic liver disease (ALD) and reviewed the pharmacological activities and potential mechanisms of action. Natural
polysaccharides are effective in preventing liver tissue degeneration, inhibiting the alcohol-induced expression of inflammatory factors, inactivation of
antioxidant enzymes, and abnormal hepatic
lipid deposition. Natural
polysaccharides regulate the expression of
proteins, such as
tight junction proteins, production of small molecule metabolites, and balance of intestinal flora in the intestinal tract to alleviate ALD. Natural
polysaccharides also exert
therapeutic effects by modulating inflammatory, oxidative, lipid metabolism, and other pathways in the liver. Natural
polysaccharides also inhibit alcohol-induced intestinal abnormalities by regulating intestinal flora and feeding back into the liver via the gut-liver axis. However, existing research on natural
polysaccharides has many shortcomings: for example, most of the natural
polysaccharides for testing are total
polysaccharides or crude
polysaccharides, progress in research on in vivo metabolic processes and mechanisms is slow, and the degree of industrialisation is insufficient. Finally, we discuss the difficulties in studying natural
polysaccharides and future directions to provide a theoretical basis for their development and application.