Exploring the interplay between metabolic dysfunction-associated fatty liver disease and gut dysbiosis: Pathophysiology, clinical implications, and emerging therapies

Table 2 Emerging therapies for metabolic dysfunction-associated fatty liver disease

Therapy	Mechanism of action	Clinical evidence
Probiotics	Improve gut barrier function, reduce endotoxemia, and modulate immune response	Reduction in liver aminotransferases, improved insulin sensitivity[9,12]
Prebiotics	Promote beneficial bacteria, reduce metabolic endotoxemia	Alleviation of liver steatosis, improved metabolic parameters[1,9]
Synbiotics	Combine probiotics and prebiotics to enhance gut microbiota modulation	Similar benefits to probiotics and prebiotics[1,9]
FMT	Restore gut microbiota composition, reduce intestinal permeability	Reduction in liver steatosis, improved metabolic markers[2,9]
Postbiotics	Bioactive compounds produced by probiotics	Emerging evidence for improved liver function[12,154]
Phage therapy	Target harmful bacteria using bacteriophages	Potential in modulating gut microbiota and liver function[12,154]
Engineered bacteria	Target specific pathways involved in MAFLD	Promising preclinical data, ongoing clinical trials[12,154]
Mycobiotics	Fungal probiotics with anti-inflammatory and anti-fibrotic properties	Reduction in inflammation and liver fibrosis[1,9]

FMT: Fecal microbiota transplantation; MAFLD: Metabolic-associated fatty liver disease.