The Intestinal Microbiome and the Metabolic Syndrome-How Its Manipulation May Affect Metabolic-Associated Fatty Liver...

Area of Science:

• Gastroenterology and Hepatology
• Microbiology
• Metabolic Disorders

Background:

• Metabolic-associated fatty liver disease (MAFLD) is a growing global health concern, largely driven by obesity.
• The intestinal microbiome (IM) significantly impacts host metabolism, gut barrier function, and the development of metabolic syndrome (MS).
• Alterations in the IM are implicated in the pathogenesis and progression of both MAFLD and MS.

Purpose of the Study:

• To review the role of the intestinal microbiome in the development of metabolic syndrome and MAFLD.
• To discuss the current applications and potential of fecal microbial transplantation (FMT) for modulating the IM in MAFLD.

Main Methods:

• This narrative review synthesizes existing literature on the IM, MS, MAFLD, and FMT.
• Key findings from studies investigating the relationship between IM dysbiosis and metabolic diseases are discussed.
• Current evidence regarding FMT as a therapeutic strategy for MAFLD is examined.

Main Results:

• The IM plays a critical role in metabolic regulation and gut health, with dysbiosis contributing to MAFLD and MS.
• Lifestyle modifications, a cornerstone of MAFLD treatment, also impact the IM.
• FMT, an established treatment for recurrent *Clostridioides difficile* infection, is being explored for its potential to alter the IM and treat MAFLD.

Conclusions:

• The intestinal microbiome is a key factor in the development and progression of MAFLD and associated metabolic dysfunction.
• Fecal microbial transplantation represents a promising avenue for therapeutic intervention in MAFLD by targeting the gut microbiome.
• Further research is warranted to establish the efficacy and safety of FMT for MAFLD treatment.