Microbiome and gut-liver interactions: From mechanisms to therapies

Nov 3, 2025World journal of gastroenterology

How Gut Bacteria and the Liver Work Together: From Understanding to Treatments

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Abstract

Disruption of the gut-liver axis is associated with several liver diseases, including alcohol-associated hepatitis and metabolic dysfunction-associated steatotic liver disease.

  • The gut-liver axis is influenced by gut microbiota, bile acids, immune responses, and metabolic pathways.
  • Dysbiosis, characterized by lower microbial diversity and pathogenic species dominance, can change bile acid metabolism and increase gut permeability.
  • In cholangiopathies, the gut microbiome may influence immune dysregulation and fibrosis through complex interactions with the host.
  • Emerging therapies targeting the microbiota, such as fecal microbiota transplantation and antibiotics, may help restore microbial balance and improve liver function.
  • Precision medicine approaches that incorporate genomics, metabolomics, and microbiomics could personalize treatment for liver diseases.

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