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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Hepatol. Jul 27, 2026; 18(7): 121954
Published online Jul 27, 2026. doi: 10.4254/wjh.121954
Poria in Fuling Zexie decoction for treating metabolic dysfunction-associated steatotic liver disease: Underlying mechanisms and key bioactive substances
Xing-Xin Yang, Jie Yu, Wei-Dong Chen, Yue Zhang, Yan-Yan Wang, Qi-Di Zhou, Yan-Mei Tang, Peng-Quan Wang, Huan Yang, Di-Hong Gong, Yu-Xuan Tao
Yu-Xuan Tao, Di-Hong Gong, Huan Yang, Peng-Quan Wang, Yan-Mei Tang, Qi-Di Zhou, Jie Yu, Xing-Xin Yang, College of Pharmaceutical Science, Yunnan University of Chinese Medicine, Yunnan Key Laboratory of Southern Medicine Utilization, Kunming 650500, Yunnan Province, China
Yan-Yan Wang, Yue Zhang, Wei-Dong Chen, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
Co-first authors: Yu-Xuan Tao and Di-Hong Gong.
Co-corresponding authors: Jie Yu and Xing-Xin Yang.
Author contributions: Tao YX and Gong DH contributed to writing-original draft, methodology, and they contributed equally to this manuscript and are co-first authors; Tao YX contributed to investigation; Tao YX, Tang YM, Zhou QD, Wang YY, Zhang Y, and Yang XX contributed to writing - review and editing; Gong DH and Yang H contributed to visualization; Yang H contributed to formal analysis; Wang PQ contributed to software and data curation; Chen WD, Yu J, and Yang XX contributed to project administration and funding acquisition; Yu J and Yang XX contributed equally to this manuscript and are co-corresponding authors. All authors approved the final manuscript.
AI contribution statement: No AI tools have been used in the preparation, drafting, data analysis, or revision of this manuscript.
Institutional review board statement: All human cell experiments were performed using authenticated commercial cell lines, and no human-derived biological samples were obtained. Our Institutional Ethics Committee granted an institutional review board waiver for this study.
Institutional animal care and use committee statement: Approval was obtained from the Ethical Committee on Animal Care and Experimentation of the Yunnan University of Chinese Medicine (Approval No. R-062023206).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: All data used to support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Xing-Xin Yang, College of Pharmaceutical Science, Yunnan University of Chinese Medicine, Yunnan Key Laboratory of Southern Medicine Utilization, No. 1076 Yuhua Road, Kunming 650500, Yunnan Province, China. yxx78945@163.com
Received: April 9, 2026
Revised: May 10, 2026
Accepted: June 2, 2026
Published online: July 27, 2026
Processing time: 110 Days and 0.2 Hours
Core Tip

Core Tip: This study clarified the specific contribution of Poria (PR) as the “sovereign” drug in Fuling Zexie decoction (FZD) for metabolic dysfunction-associated steatotic liver disease. We confirmed that PR plays an irreplaceable role and its removal significantly weakened the therapeutic efficacy of FZD. The superior effects of FZD were attributed to diverse active components (six derived from PR), the specific regulation of five metabolic pathways (biotin, ascorbate/aldarate, alanine/aspartate/glutamate, inositol phosphate, and galactose metabolism), and 148 differential metabolites. Additionally, incorporating PR dregs enhanced antioxidant and anti-inflammatory activities, indicating that water-insoluble polysaccharides are key bioactive constituents.

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