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Role of gut-liver axis and glucagon-like peptide-1 receptor agonists in the treatment of metabolic dysfunction-associated fatty liver disease.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2024 Jun 21; Vol. 30 (23), pp. 2964-2980. - Publication Year :
- 2024
-
Abstract
- Metabolic dysfunction-associated fatty liver disease (MAFLD) is a hepatic manifestation of the metabolic syndrome. It is one of the most common liver diseases worldwide and shows increasing prevalence rates in most countries. MAFLD is a progressive disease with the most severe cases presenting as advanced fibrosis or cirrhosis with an increased risk of hepatocellular carcinoma. Gut microbiota play a significant role in the pathogenesis and progression of MAFLD by disrupting the gut-liver axis. The mechanisms involved in maintaining gut-liver axis homeostasis are complex. One critical aspect involves preserving an appropriate intestinal barrier permeability and levels of intestinal lumen metabolites to ensure gut-liver axis functionality. An increase in intestinal barrier permeability induces metabolic endotoxemia that leads to steatohepatitis. Moreover, alterations in the absorption of various metabolites can affect liver metabolism and induce liver steatosis and fibrosis. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of drugs developed for the treatment of type 2 diabetes mellitus. They are also commonly used to combat obesity and have been proven to be effective in reversing hepatic steatosis. The mechanisms reported to be involved in this effect include an improved regulation of glycemia, reduced lipid synthesis, β-oxidation of free fatty acids, and induction of autophagy in hepatic cells. Recently, multiple peptide receptor agonists have been introduced and are expected to increase the effectiveness of the treatment. A modulation of gut microbiota has also been observed with the use of these drugs that may contribute to the amelioration of MAFLD. This review presents the current understanding of the role of the gut-liver axis in the development of MAFLD and use of members of the GLP-1 RA family as pleiotropic agents in the treatment of MAFLD.<br />Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest related to this article.<br /> (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
- Subjects :
- Humans
Non-alcoholic Fatty Liver Disease drug therapy
Non-alcoholic Fatty Liver Disease metabolism
Non-alcoholic Fatty Liver Disease microbiology
Animals
Metabolic Syndrome drug therapy
Metabolic Syndrome metabolism
Metabolic Syndrome microbiology
Hypoglycemic Agents therapeutic use
Hypoglycemic Agents pharmacology
Diabetes Mellitus, Type 2 drug therapy
Diabetes Mellitus, Type 2 metabolism
Diabetes Mellitus, Type 2 microbiology
Incretins therapeutic use
Incretins metabolism
Intestinal Mucosa metabolism
Intestinal Mucosa drug effects
Intestinal Mucosa microbiology
Glucagon-Like Peptide-1 Receptor Agonists
Glucagon-Like Peptide-1 Receptor agonists
Glucagon-Like Peptide-1 Receptor metabolism
Gastrointestinal Microbiome drug effects
Liver metabolism
Liver drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 30
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 38946874
- Full Text :
- https://doi.org/10.3748/wjg.v30.i23.2964