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World J Gastroenterol. Apr 28, 2026; 32(16): 116187
Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.116187
Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.116187
Modulation of the gut-liver axis by oxymatrine alleviates metabolic dysfunction-associated steatotic liver disease
Jing-Fang Xiong, Department of Geriatrics, Hangzhou Red Cross Hospital, Hangzhou 310003, Zhejiang Province, China
Ying He, Department of Pharmacy, Hangzhou Red Cross Hospital, Hangzhou 310003, Zhejiang Province, China
Na Jiang, Department of Infectious Disease, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Yi-Hui Liu, Hong Xu, Department of Gastroenterology and Hepatology, Hangzhou Red Cross Hospital, Hangzhou 310003, Zhejiang Province, China
Gao-Feng Chen, Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Chang-Qing Zhao, Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Shu-Yan Zhang, Yi-Jun Wu, The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Author contributions: Xiong JF, He Y, Jiang N, Liu YH, Chen GF, Zhao CQ, Zhang SY, and Wu YJ performed the experiments, acquired and analyzed data; Xiong JF, He Y, and Xu H wrote the manuscript; Xiong JF and Xu H designed and coordinated the study; He Y, Jiang N, Chen GF, Zhao CQ, and Zhang SY interpreted the data; Xu H revised the manuscript and obtained the funding; all authors approved the final version of the article.
Supported by National Natural Science Foundation of China, No. 82074100; Hangzhou Science and Technology Bureau, No. 20201203B175; and Scientific Research Fund for TCM in Zhejiang Province, No. 2023ZL551 and No. 2023ZL558.
Institutional animal care and use committee statement: All animal procedures were approved by the Animal Experimentation Ethics Committee of Zhejiang Eyong Pharmaceutical Research and Development Center (No. ZJEY-20230508-01).
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: No additional data are available.
Corresponding author: Hong Xu, Chief Physician, Department of Gastroenterology and Hepatology, Hangzhou Red Cross Hospital, No. 208 Huancheng Dong Road, Hangzhou 310003, Zhejiang Province, China. hongxuhzrc@aliyun.com
Received: November 5, 2025
Revised: December 19, 2025
Accepted: February 9, 2026
Published online: April 28, 2026
Processing time: 163 Days and 23.6 Hours
Revised: December 19, 2025
Accepted: February 9, 2026
Published online: April 28, 2026
Processing time: 163 Days and 23.6 Hours
Core Tip
Core Tip: Oxymatrine alleviates metabolic dysfunction-associated steatotic liver disease, primarily through modulation of the gut microbiome (increasing Lactobacillus, reducing Firmicutes/Bacteroidetes ratio) and the hepatic metabolome (increasing luteolin, decreasing adrenic acid). Fecal microbiota transplantation from oxymatrine donors recapitulated this protection, establishing a causal gut-liver axis for this natural alkaloid and offering a microbiota-guided therapeutic perspective.