Manipulating the Gut Microbiome to Alleviate Steatotic Liver Disease: Current Progress and Challenges

IF 10.1 1区 工程技术 Q1 ENGINEERING, MULTIDISCIPLINARY
Ernesto Saenz , Nathally Espinosa Montagut , Baohong Wang , Christoph Stein-Thöringer , Kaicen Wang , Honglei Weng , Matthias Ebert , Kai Markus Schneider , Lanjuan Li , Andreas Teufel
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Abstract

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.

操纵肠道微生物组缓解脂肪肝:当前的进展与挑战
代谢功能障碍相关性脂肪性肝病(MASLD)的发病率之高令人震惊;据估计,它影响着全球四分之一的人口,是全球最常见的肝脏疾病。脂肪性肝病的特点是肝脏脂肪过度堆积,通常与肥胖、血脂异常和胰岛素抵抗等并发症有关;然而,它也可能在瘦弱的人身上表现出来。因此,针对这种复杂的疾病开发有效的疗法至关重要。目前,治疗 MASLD 的药物尚未获得批准,因此迫切需要研究替代方法。大量研究表明,MASLD 是一种多发性疾病,经常与饮食习惯导致的代谢紊乱有关。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)的发生和发展过程中起着根本性的作用。在这篇综述中,我们仔细研究了基于肠道微生物群的治疗 MASLD 和代谢功能障碍相关性脂肪性肝炎 (MASH) 新兴领域的文献,包括粪便微生物群移植 (FMT)、益生菌、益生元、短链脂肪酸、抗生素、代谢途径靶向和免疫检查点激酶阻断等干预措施。
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来源期刊
Engineering
Engineering Environmental Science-Environmental Engineering
自引率
1.60%
发文量
335
审稿时长
35 days
期刊介绍: Engineering, an international open-access journal initiated by the Chinese Academy of Engineering (CAE) in 2015, serves as a distinguished platform for disseminating cutting-edge advancements in engineering R&D, sharing major research outputs, and highlighting key achievements worldwide. The journal's objectives encompass reporting progress in engineering science, fostering discussions on hot topics, addressing areas of interest, challenges, and prospects in engineering development, while considering human and environmental well-being and ethics in engineering. It aims to inspire breakthroughs and innovations with profound economic and social significance, propelling them to advanced international standards and transforming them into a new productive force. Ultimately, this endeavor seeks to bring about positive changes globally, benefit humanity, and shape a new future.
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