{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:45:50Z","timestamp":1793918750458,"version":"4.8.0"},"reference-count":54,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["faseb.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The FASEB Journal"],"published-print":{"date-parts":[[2026,3,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) has become the most prevalent chronic liver condition globally, shifting the diagnostic paradigm toward an affirmative, metabolism\u2010focused framework. The gut\u2010liver axis is a central pathophysiological pathway. This review aims to synthesize revolutionary advances from 2023 to 2025 in understanding and treating MASLD by focusing on the gut microbiome's role. This comprehensive review analyzes cutting\u2010edge research published between 2023 and 2025. We examined evidence from landmark clinical trials, developments in next\u2010generation probiotics, the integration of artificial intelligence (AI) with multiomics for diagnostics, and studies clarifying the interplay between host genetics and the microbiome in MASLD pathogenesis. Causal links between gut dysbiosis and MASLD pathology are now firmly established. Fecal microbiota transplantation (FMT) effectively prevents hepatic encephalopathy recurrence, and next\u2010generation probiotics like\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Akkermansia muciniphila<\/jats:italic>\n                    <\/jats:styled-content>\n                    have entered MASLD\u2010specific trials. AI\u2010driven diagnostic tools have achieved regulatory qualification from the European Medicines Agency. Furthermore, host genetics, particularly PNPLA3 variants, are shown to not only predispose to MASLD but also shape specific microbial communities that functionally contribute to disease progression. The field is rapidly advancing from correlative observations to causal evidence, enabling the development of microbiome\u2010based biomarkers and personalized therapies. The future of MASLD management lies in precision strategies, such as bacteriophage therapy and functionally defined probiotics, which integrate metabolic, microbial, and genetic factors into individualized care, heralding a new therapeutic era.\n                  <\/jats:p>","DOI":"10.1096\/fj.202503607rr","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:55:41Z","timestamp":1773417341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Gut\u2010Liver Axis in Metabolic Dysfunction\u2010Associated Steatotic Liver Disease: From Mechanistic Insights to Precision Therapeutics"],"prefix":"10.1096","volume":"40","author":[{"given":"Shaoliang","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjie","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Nephrology, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qijun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangnan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5057-001X","authenticated-orcid":false,"given":"Honglin","family":"Luo","sequence":"additional","affiliation":[{"name":"Institute of Oncology, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region Guangxi Academy of Medical Sciences  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000520"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci24-0094"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11559-y"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003629"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-023-00904-3"},{"key":"e_1_2_13_8_1","first-page":"203","article-title":"The Gut\u2010Brain Axis: Interactions Between Enteric Microbiota, Central and Enteric Nervous Systems","volume":"28","author":"Carabotti M.","year":"2015","journal-title":"Annals of Gastroenterology"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2024.167120"},{"key":"e_1_2_13_10_1","article-title":"Molecular Mechanisms and Emerging Precision Therapeutics in the Gut Microbiota\u2010Cardiovascular Axis","volume":"17","author":"Ponce Alencastro J. 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