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Review
. 2025 Jun 4:12:1615839.
doi: 10.3389/fmed.2025.1615839. eCollection 2025.

Gut microbiota in liver diseases: initiation, development and therapy

Jian-Xiu Yu  1 , Jun Wu  1 , Xin Chen  1 , Su-Gang Zang  1 , Xue-Bin Li  1 , Li-Pei Wu  1 , Shi-Hai Xuan  1
Affiliations
Review

Gut microbiota in liver diseases: initiation, development and therapy

Jian-Xiu Yu et al. Front Med (Lausanne). .

Abstract

The gut microbiota plays a pivotal role in the pathogenesis and progression of various liver diseases, including viral hepatitis, alcoholic fatty liver disease, metabolic dysfunction-associated steatotic liver disease, drug-induced hepatitis, liver cirrhosis, hepatocellular carcinoma, and other hepatic disorders. Research indicates that dysbiosis of the gut microbiota can disrupt the integrity of the intestinal barrier and interfere with the immune functions of the gut-liver axis, thereby mediating the progression of liver diseases. Analysis of microbial composition and metabolites in fecal samples can assess the diversity of gut microbiota and the abundance of specific microbial populations, providing auxiliary diagnostic information for liver diseases. Furthermore, interventions such as fecal microbiota transplantation, probiotics, prebiotics, bacteriophages, and necessary antibiotic treatments offer multiple approaches to modulate the gut microbiota, presenting promising new strategies for the prevention and treatment of liver diseases. This review summarizes the latest research advances on the role of gut microbiota in liver diseases, offering novel theoretical foundations and practical directions for the diagnosis and treatment of hepatic disorders.

Keywords: alcoholic fatty liver disease; gut microbiota; liver cirrhosis; metabolic dysfunction-associated steatotic liver disease; viral hepatitis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of the gut microbiota in the development of MASLD (by Figdraw). LPS, lipopolysaccharide; ZO-1, Zonula occludens-1; TMAO, Trimethylamine-N-oxide; TLR4: Toll-like Receptor 4; NF-KB, Nuclear Factor kappa-light-chain-enhancer of activated B cells; SCFA, short-chain fatty acid.
Figure 2
Figure 2
Mechanisms of the gut microbiota in the development of LC (by Figdraw). DAO, Diamine oxidase; BA, Bile acids; IL-8, Interleukin-8; SIBO, Small intestinal bacterial overgrowth; TNF-alpha, Tumor necrosis factor-alpha.
Figure 3
Figure 3
Mechanisms of the gut microbiota in the development of HCC (by Figdraw). ROS, Reactive oxygen species; IL-6, Interleukin-6; M1, Macrophage 1; M2, Macrophage 2; PBP1B, Penicillin binding protein 1B.
See this image and copyright information in PMC

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