From:  Metabolic dysfunction-associated steatotic liver disease (MASLD): emerging insights into gut microbiota interactions and therapeutic perspectives

 The effects of microbial intervention on MASLD

Gut microbiota speciesMechanismClinical statusLimitationsRefs
Escherichia coli

  • Boosts gut permeability.

  • Activates inflammasomes.

  • Induces oxidative stress and mitochondrial dysfunction.

  • Exacerbates fatty liver.

  • Causes liver damage.

Further studies are needed to investigate the various effects of different E. coli strains on the liver.[16, 26–29]
Ruminococcus

  • Boosts gut permeability.

  • Activates TLR4 pathway.

  • Produces SCFAs and improves insulin sensitivity.

  • Induces hepatic steatosis and inflammation.

  • Ruminococcus abundance positively correlates with liver fibrosis severity.

Current evidence remains primarily correlative, though preliminary experimental data suggest potential causal mechanisms.[34–38]
Prevotella

  • Participates in polysaccharide degradation and SCFA metabolism.

  • Disrupts immune tolerance and alters host-microbial balance.

  • Positively correlates with dietary fiber intake.

  • Children with MASLD have higher Prevotella content.

The therapeutic protocol demonstrates relatively low correlation with lifestyle interventions and conventional medications.[39, 40, 44–46]
Faecalibacterium

  • Produces butyrate and inhibits endotoxin translocation to the liver.

  • Activates AMPK pathway to enhance insulin sensitivity.

  • Decreased GM diversity and reduced Faecalibacterium abundance.

Further research is required to determine the optimal dosage regimen, administration route, and mechanism of action.[47–50, 53, 54]
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MASLD: metabolic dysfunction-associated steatotic liver disease; SCFAs: short-chain fatty acids