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<p>Metabolic dysfunction-associated steatotic liver disease (MASLD) represents the most prevalent chronic liver disorder worldwide and is closely linked to metabolic comorbidities such as obesity, type&#xa0;2 diabetes mellitus, and dyslipidemia. In recent years, the role of the microbiome in human health and disease has gained considerable attention. Particularly in chronic metabolic and inflammatory conditions and also in functional gastrointestinal disorders, the gut microbiota is recognized as a&#xa0;central mediator connecting lifestyle, metabolism, and systemic health. The gut–liver axis encompasses bidirectional communication between the intestine and the liver through the biliary tract, the portal circulation, and soluble mediators in the bloodstream. Maintenance of this axis is crucial for hepatic and metabolic homeostasis. Dysbiosis—characterized by altered microbial composition or reduced microbial diversity—can disrupt intestinal barrier integrity, promote translocation of microbial products, and interfere with bile acid, energy, and lipid metabolism. These disturbances are critical in the pathogenesis and progression of MASLD and related metabolic diseases. This review provides an overview of current insights into gut–liver–microbiome interactions, delineates the molecular and metabolic pathways through which the gut–liver axis modulates disease progression, and discusses microbiome-targeted interventions—including probiotics, prebiotics, fecal microbiota transplantation, and dietary strategies—as potential therapeutic approaches for MASLD and associated metabolic disorders.</p>

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Einfluss der Darm-Leber-Achse auf die mit metabolischer Dysfunktion assoziierte steatotische Lebererkrankung und metabolische Erkrankungen

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Münevver Demir,
  • Frank Tacke

摘要

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents the most prevalent chronic liver disorder worldwide and is closely linked to metabolic comorbidities such as obesity, type 2 diabetes mellitus, and dyslipidemia. In recent years, the role of the microbiome in human health and disease has gained considerable attention. Particularly in chronic metabolic and inflammatory conditions and also in functional gastrointestinal disorders, the gut microbiota is recognized as a central mediator connecting lifestyle, metabolism, and systemic health. The gut–liver axis encompasses bidirectional communication between the intestine and the liver through the biliary tract, the portal circulation, and soluble mediators in the bloodstream. Maintenance of this axis is crucial for hepatic and metabolic homeostasis. Dysbiosis—characterized by altered microbial composition or reduced microbial diversity—can disrupt intestinal barrier integrity, promote translocation of microbial products, and interfere with bile acid, energy, and lipid metabolism. These disturbances are critical in the pathogenesis and progression of MASLD and related metabolic diseases. This review provides an overview of current insights into gut–liver–microbiome interactions, delineates the molecular and metabolic pathways through which the gut–liver axis modulates disease progression, and discusses microbiome-targeted interventions—including probiotics, prebiotics, fecal microbiota transplantation, and dietary strategies—as potential therapeutic approaches for MASLD and associated metabolic disorders.