Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as one of the most prevalent chronic liver diseases globally, and its pathogenesis is closely linked to the imbalance of intestinal microbiota and their metabolites. This article reviews the mechanisms through which intesti...

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Main Authors: Chao Cui, Shuai Gao, Jingfei Shi, Kai Wang
Format: Article
Language:English
Published: Gastroenterology Council for Gut and Liver 2025-07-01
Series:Gut and Liver
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Online Access:http://gutnliver.org/journal/view.html?doi=10.5009/gnl240539
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author Chao Cui
Shuai Gao
Jingfei Shi
Kai Wang
author_facet Chao Cui
Shuai Gao
Jingfei Shi
Kai Wang
author_sort Chao Cui
collection DOAJ
description Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as one of the most prevalent chronic liver diseases globally, and its pathogenesis is closely linked to the imbalance of intestinal microbiota and their metabolites. This article reviews the mechanisms through which intestinal microbiota influence the progression of MASLD via the gut-liver axis, elaborating on the complex roles of immune cell hyperactivation, impaired intestinal barrier function, and intestinal microbial metabolites such as short-chain fatty acids and bile acids. The imbalance of intestinal microbiota not only directly promotes the development of MASLD but also further exacerbates disease progression through abnormalities in their metabolites. Various novel therapeutic strategies are being actively developed on the basis of gut-liver axis theory, including probiotic/prebiotic/synbiotic treatment, fecal microbiota transplantation, and targeted drug therapy. These strategies aim to precisely regulate microbial homeostasis and improve glucose and lipid metabolism, thereby alleviating hepatic inflammation and fibrosis and optimizing the therapeutic outcomes of patients with MASLD. In the future, as research progresses, we will further uncover the interaction mechanisms between intestinal microbiota and MASLD and continuously explore more effective treatment methods, with the goal of improving the prognosis and quality of life for MASLD patients.
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spelling doaj-art-121ef40852a74889804ef2b0df5a58672025-08-20T03:30:19ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-07-0119447950710.5009/gnl240539gnl240539Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver DiseaseChao Cui0Shuai Gao1Jingfei Shi2Kai Wang3Department of Infectious Disease, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaDepartment of Infectious Disease, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaDepartment of Clinical and Basic Medicine, Shandong First Medical University, Jinan, ChinaDepartment of Infectious Disease, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, ChinaMetabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as one of the most prevalent chronic liver diseases globally, and its pathogenesis is closely linked to the imbalance of intestinal microbiota and their metabolites. This article reviews the mechanisms through which intestinal microbiota influence the progression of MASLD via the gut-liver axis, elaborating on the complex roles of immune cell hyperactivation, impaired intestinal barrier function, and intestinal microbial metabolites such as short-chain fatty acids and bile acids. The imbalance of intestinal microbiota not only directly promotes the development of MASLD but also further exacerbates disease progression through abnormalities in their metabolites. Various novel therapeutic strategies are being actively developed on the basis of gut-liver axis theory, including probiotic/prebiotic/synbiotic treatment, fecal microbiota transplantation, and targeted drug therapy. These strategies aim to precisely regulate microbial homeostasis and improve glucose and lipid metabolism, thereby alleviating hepatic inflammation and fibrosis and optimizing the therapeutic outcomes of patients with MASLD. In the future, as research progresses, we will further uncover the interaction mechanisms between intestinal microbiota and MASLD and continuously explore more effective treatment methods, with the goal of improving the prognosis and quality of life for MASLD patients.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240539non-alcoholic fatty liver disease; gastrointestinal microbiome; enterohepatic circulation; metabolome; therapeutics
spellingShingle Chao Cui
Shuai Gao
Jingfei Shi
Kai Wang
Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
Gut and Liver
non-alcoholic fatty liver disease; gastrointestinal microbiome; enterohepatic circulation; metabolome; therapeutics
title Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
title_full Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
title_fullStr Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
title_full_unstemmed Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
title_short Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease
title_sort gut liver axis the role of intestinal microbiota and their metabolites in the progression of metabolic dysfunction associated steatotic liver disease
topic non-alcoholic fatty liver disease; gastrointestinal microbiome; enterohepatic circulation; metabolome; therapeutics
url http://gutnliver.org/journal/view.html?doi=10.5009/gnl240539
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