肠道菌群-胆汁酸-FXR轴在代谢相关脂肪性肝病中的作用机制及治疗干预新进展

Mechanisms and therapeutic advances of the gut microbiota-bile acid-FXR axis in metabolic dysfunction-associated fatty liver disease

摘要:

代谢相关脂肪性肝病（MAFLD）是一种与代谢异常密切相关的慢性肝病，严重威胁肝脏健康与代谢稳态。近年来，肠道菌群-胆汁酸-FXR轴作为肠道菌群、胆汁酸代谢系统与宿主肝肠通路之间的核心调控网络，逐渐成为MAFLD研究的重要方向。肠道菌群通过代谢产物、胆汁酸组成及信号分子调控FXR受体活性，进而影响肝脏脂质合成、炎症反应及纤维化进程，在MAFLD的发生、发展中起关键作用。该文系统综述了肠道菌群-胆汁酸-FXR轴介导肠肝互作的分子机制，探讨了该通路在MAFLD发病中的调控作用及其治疗干预新进展，旨在为MAFLD的精准治疗和微生态干预提供理论依据与研究基础。

Abstract:

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a chronic liver condition closely linked to metabolic disorders and poses a serious threat to hepatic health and systemic metabolic balance. In recent years, the gut microbiota-bile acid-farnesoid X receptor (FXR) axis has emerged as a key regulatory network bridging intestinal microbial communities, bile acid metabolism, and host gut-liver crosstalk, and has become a research hotspot in MAFLD. The gut microbiota regulates FXR activity through microbial metabolites, bile acid composition, and signaling molecules, thereby influencing hepatic lipid synthesis, inflammatory responses, and fibrotic progression, and ultimately playing a critical role in the onset and progression of MAFLD. This review systematically summarizes the molecular mechanisms by which the gut microbiota-bile acid-FXR axis mediates gut-liver interaction, explores its role in the pathogenesis of MAFLD, and highlights recent advances in therapeutic interventions, aiming to provide a theoretical foundation for precision treatment and microbiota-targeted strategies in the management of MAFLD.