Multi-target modulation of traditional Chinese medicine based on the liver-gut axis: a new therapeutic strategy for NAFLD.

As one of the most common liver diseases, non-alcoholic fatty liver disease (NAFLD) has attracted widespread international attention given its rising incidence. The current mainstay of treatment for NAFLD is controlled diet with controlled exercise. Significantly, the development of NAFLD is proposed to be related to the liver-gut axis. The gut barrier function may be disrupted in the case of gut microbial dysbiosis, which may increase the entry of bacteria, lipopolysaccharides and endotoxins into the liver, causing an inflammatory response, increasing the load on the liver, and triggering lipid deposition, thereby advancing the progression of NAFLD. Simultaneously, liver injury can further alter intestinal permeability, inducing systemic inflammatory response, creating a vicious cycle that may subsequently exacerbate the development of NAFLD. Accordingly, the present review focused on the exploration of the relationship between the liver-gut axis and NAFLD, dissection of the biological mechanism of NAFLD induced by liver-gut axis dysfunction, and comprehensive elucidation of the research progress of Chinese medicine on the regulation of the liver-gut axis for treating NAFLD. It is expected that these findings may provide fresh and insightful evidence for the development of suitable preventive and therapeutic strategies of NAFLD.