Al-Busafi SA, Alwassief A, Madian A, Atalla H, Alboraie M, Elbahrawy A, Eslam M. Exploring the interplay between metabolic dysfunction-associated fatty liver disease and gut dysbiosis: Pathophysiology, clinical implications, and emerging therapies. World J Hepatol 2025; 17(8): 108730 [DOI: 10.4254/wjh.v17.i8.108730]
Corresponding Author of This Article
Said A Al-Busafi, MD, Associate Professor, Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Alkoudh.123, Muscat 123, Oman. busafis@squ.edu.om
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2025; 17(8): 108730 Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.108730
Exploring the interplay between metabolic dysfunction-associated fatty liver disease and gut dysbiosis: Pathophysiology, clinical implications, and emerging therapies
Said A Al-Busafi, Ahmed Alwassief, Ali Madian, Hassan Atalla, Mohamed Alboraie, Ashraf Elbahrawy, Mohammed Eslam
Said A Al-Busafi, Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
Ahmed Alwassief, Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
Ali Madian, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Assiut 71524, Egypt
Hassan Atalla, Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura University, Mansoura 35516, Egypt
Mohamed Alboraie, Ashraf Elbahrawy, Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
Mohammed Eslam, Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney 2145, New South Wales, Australia
Co-corresponding authors: Said A Al-Busafi and Ahmed Alwassief.
Author contributions: Al-Busafi SA contributed to conceptualized the review, performed the literature search, drafted the article, designed artwork (Figures/Tables), supervised the project, and critically revised the manuscript; Alwassief A contributed to assisted with the literature review, co-supervised the project, drafted the article, and critically revised the manuscript; Madian A contributed to assisted in the literature review and final drafting, revision, and preparation of the manuscript; Atalla H, Alboraie M and Elbahrawy A contributed to assisted in the literature review and preparation of the manuscript; Eslam M contributed to assisted in the literature review and critical revision of the final version of the manuscript. All authors approved the submitted version and agreed to be accountable for the work.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Said A Al-Busafi, MD, Associate Professor, Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Alkoudh.123, Muscat 123, Oman. busafis@squ.edu.om
Received: April 27, 2025 Revised: May 26, 2025 Accepted: July 24, 2025 Published online: August 27, 2025 Processing time: 123 Days and 22 Hours
Core Tip
Core Tip: The pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD) is profoundly influenced by gut dysbiosis, a condition that exacerbates disease progression through mechanisms such as compromised intestinal barrier function, endotoxemia, and dysregulated bile acid metabolism. Understanding and addressing this issue is of utmost importance in the management of MAFLD. Advances in microbiome-based diagnostics, including machine learning models and microbial biomarkers, now provide non-invasive tools for early detection and risk stratification, enhancing clinical decision-making. The emergence of therapies targeting the gut-liver axis, such as probiotics, fecal microbiota transplantation, and farnesoid X receptor agonists, demonstrates significant potential in mitigating hepatic inflammation and restoring metabolic homeostasis.
