The Role of Gut Microbiota in Metabolic Dysfunction-Associated Fatty Liver Disease (MASLD)

Abstract

Gut microbiota plays a critical role in developing and progressing metabolic dysfunction-associated steatotic liver disease (MASLD). Studies show reduced microbial diversity and specific shifts in bacterial populations in MASLD patients, with harmful species increasing and beneficial ones decreasing. These changes contribute to liver fat accumulation by impairing fiber fermentation, disrupting bile acid metabolism, increasing intestinal permeability, and promoting inflammation. The progression of MASLD is linked to evolving microbiota changes, and probiotics like Lactobacillus plantarum show potential in mitigating disease by restoring gut balance. Thus, gut microbiota serves as both a key factor and therapeutic target in MASLD. Interventions on microbiota are possible targets in treating MASLD or preventing progression toward advanced stages. At the same time, prebiotics and probiotics have shown results in ameliorating MASLD, post-biotic therapy, immuno-nutrition, bacteria engineering, or phages, which have been applied only in experimental studies.