The Microbiome and Metabolic Dysfunction-Associated Steatotic Liver Disease

Area of Science:

• Microbiology
• Hepatology
• Gastroenterology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive liver fat accumulation, inflammation, and potential damage.
• The gut and liver microbiota play a significant role in MASLD pathogenesis.
• Bacteriophages (phages) are increasingly recognized for their influence on microbial communities and disease states.

Purpose of the Study:

• To review the role of tissue microbiota, including intestinal and hepatic microbes, in MASLD.
• To explore the history, occurrence, and impact of bacteriophages in MASLD.
• To define microbiota metabolism of bile acids and dietary amino acids (tryptophan, histidine) and their metabolites in MASLD.

Main Methods:

• Narrative review of existing literature.
• Evaluation of the composition and function of intestinal and hepatic microbiota.
• Analysis of bacteriophage roles and phage therapy potential.
• Examination of microbial metabolism of bile acids and specific dietary components.

Main Results:

• Both periodontitis and intestinal dysbiosis can contribute to MASLD development.
• Specific microorganisms and their metabolites are implicated in MASLD pathogenesis.
• Microbiota-targeted therapies, including phage therapy, show promise for MASLD treatment.

Conclusions:

• The microbiota, including bacteriophages, is central to MASLD development and progression.
• Novel therapeutic strategies targeting the microbiota offer new avenues for MASLD management.
• Phage therapy, while not yet FDA-approved for clinical use, is under active investigation and may represent a future treatment for MASLD.