Research advances on gut microbiota dysbiosis and chronic liver diseases: a review

The gut microbiota is fundamental to human health, maintaining intricate symbiotic interactions with the host. Accumulating evidence highlights a critical association between gut microbiota dysbiosis and the initiation and progression of chronic liver diseases (CLDs). Particularly hepatitis B virus (HBV)/hepatitis C virus (HCV) infection, alcoholic liver disease (ALD), metabolic-associated steatotic liver disease (MASLD), and cirrhosis. This microbial imbalance may contribute to the progression of CLDs primarily via the "gut-liver axis," the mechanisms involve gut barrier dysfunction, abnormal immune regulation, and metabolic alterations. This review synthesizes cutting-edge research on the interplay between gut dysregulation and CLDs, elaborating molecular mechanistic pathways including the TLR4/NF-κB signaling pathway, AMPK pathway, and farnesoid X receptor (FXR)-mediated bile acid signaling. Additionally, it discusses clinically oriented therapeutic strategies targeting microbiota modulation, including probiotics, fecal microbiota transplantation (FMT), and personalized dietary interventions, offering innovative insights for the prevention and management of chronic liver diseases.