The prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is alarmingly high; it is estimated to affect up to a quarter of the global population, making it the most common liver disorder worldwide. MASLD is characterized by excessive hepatic fat accumulation and is commonly associated with comorbidities such as obesity, dyslipidemia, and insulin resistance; however, it can also manifest in lean individuals. Therefore, it is crucial to develop effective therapies for this complex condition. Currently, there are no approved medications for MASLD treatment, so there is a pressing need to investigate alternative approaches. Extensive research has characterized MASLD as a multifaceted disease, frequently linked to metabolic disorders that stem from dietary habits. Evidence suggests that changes in the gut microbiome play a fundamental role in the development and progression of MASLD from simple steatosis to steatohepatitis and even hepatocellular carcinoma (HCC). In this review, we critically examine the literature on the emerging field of gut-microbiota-based therapies for MASLD and metabolic-dysfunction-associated steatohepatitis (MASH), including interventions such as fecal microbiota transplantation (FMT), probiotics, prebiotics, short-chain fatty acids, antibiotics, metabolic pathway targeting, and immune checkpoint kinase blockade.

中文翻译：

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操纵肠道微生物群以减轻脂肪肝病：当前进展和挑战


代谢功能障碍相关的脂肪肝病 (MASLD) 的患病率高得惊人；据估计，它影响着全球多达四分之一的人口，使其成为全球最常见的肝脏疾病。 MASLD 的特点是肝脏脂肪堆积过多，通常与肥胖、血脂异常和胰岛素抵抗等合并症有关；然而，它也可以体现在瘦人身上。因此，开发针对这种复杂病症的有效疗法至关重要。目前，尚无批准用于 MASLD 治疗的药物，因此迫切需要研究替代方法。广泛的研究表明 MASLD 是一种多方面的疾病，通常与饮食习惯引起的代谢紊乱有关。有证据表明，肠道微生物组的变化在 MASLD 从单纯脂肪变性到脂肪性肝炎甚至肝细胞癌 (HCC) 的发生和进展中发挥着重要作用。在这篇综述中，我们批判性地研究了基于肠道微生物群的 MASLD 和代谢功能障碍相关脂肪性肝炎 (MASH) 治疗这一新兴领域的文献，包括粪便微生物群移植 (FMT)、益生菌、益生元、短期治疗等干预措施。链脂肪酸、抗生素、代谢途径靶向和免疫检查点激酶阻断。