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Patients with NAFLD exhibit unique signatures of the intestinal microbiome marked by the priority of Gram-negative bacteria, decreased ratio of <jats:italic>Firmicutes\/Bacteroidetes<\/jats:italic> (F\/B), and increased <jats:italic>Prevotella<\/jats:italic> and <jats:italic>Lachnospiraceae<\/jats:italic>. The intestinal microbiota is involved in the metabolism of bile acids. Ursodeoxycholic acid (UDCA) is a key determinant in maintaining the dynamic communication between the host and gut microbiota. It generally shows surprising therapeutic potential in NAFLD with several mechanisms, such as improving cellular autophagy, apoptosis, and mitochondrial functions. This action is based on its direct or indirect effect, targeting the farnesoid X receptor (FXR) and various other nuclear receptors. This review aims to discuss the current studies on the involvement of the microbiome\u2013UDCA interface in NAFLD therapy and provide prospective insights into future preventative and therapeutic approaches for NAFLD.<\/jats:p>","DOI":"10.3389\/fphar.2024.1371574","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T04:41:41Z","timestamp":1710996101000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["Understanding the role of ursodeoxycholic acid and gut microbiome in non-alcoholic fatty liver disease: current evidence and perspectives"],"prefix":"10.3389","volume":"15","author":[{"given":"Qingyi","family":"Mao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beibei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenluo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengque","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5323","DOI":"10.3390\/nu14245323","article-title":"Gut microbiota in non-alcoholic fatty liver disease patients with inflammatory bowel diseases: a complex interplay","volume":"14","author":"Abenavoli","year":"2022","journal-title":"Nutrients"},{"key":"B2","doi-asserted-by":"publisher","first-page":"5688","DOI":"10.1038\/s41598-019-42059-3","article-title":"Randomized, double-blind, placebo-controlled study of a multispecies probiotic mixture in nonalcoholic fatty liver disease","volume":"9","author":"Ahn","year":"2019","journal-title":"Sci. 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