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World J Exp Med. Dec 20, 2025; 15(4): 107316
Published online Dec 20, 2025. doi: 10.5493/wjem.v15.i4.107316
Gut microbiota and metabolic-associated steatosis liver disease: Unveiling mechanisms and opportunities for therapeutic intervention
Amelia Rifai, Susanto Hendra Kusuma, Rini Bachtiar, Nu'man AS Daud, Muhammad Luthfi Parewangi, Fardah Akil, Resha Dermawansyah Rusman
Resha Dermawansyah Rusman, Fardah Akil, Muhammad Luthfi Parewangi, Nu'man AS Daud, Rini Bachtiar, Susanto Hendra Kusuma, Amelia Rifai, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar 90245, Sulawesi Selatan, Indonesia
Author contributions: Rusman RD conceived and designed the study, collected the data, performed the analysis, and drafted the manuscript; Akil F and Parewangi ML supervised the study and provided critical revisions and intellectual input; Daud NAS and Bachtiar R contributed to data interpretation and literature review; Kusuma SH and Rifai A assisted in manuscript editing and final approval of the version to be published; All authors read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Corresponding author: Resha Dermawansyah Rusman, MD, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan Km. 10, Makassar 90245, Sulawesi Selatan, Indonesia. reshadermawan@unhas.ac.id
Received: May 30, 2025
Revised: July 3, 2025
Accepted: September 18, 2025
Published online: December 20, 2025
Processing time: 204 Days and 2.8 Hours
Core Tip

Core Tip: Metabolic-associated steatotic liver disease (MASLD) has developed into a worldwide health dilemma closely related to metabolic diseases such as obesity and type 2 diabetes mellitus. Mounting evidence highlights the importance of the gut microbiota in the pathogenesis of MASLD, as gut dysbiosis induced by increased gut permeability, endotoxemia and the action of microbial metabolites have been demonstrated to lead to hepatic steatosis, inflammation and fibrosis. Therapeutic potential of modulating gut microbiota with probiotics, prebiotics, synbiotics and microbiota-derived interventions is an emerging approach. Herein, we cover the gut–liver axis in MASLD drawing on insights from mechanistic pathways to microbiota-based therapeutic strategies that may transform MASLD management.