[Research progress on the mechanism and targeted therapy of monocytes-macrophages in metabolic associated fatty liver disease].

Metabolic-associated fatty liver disease (MAFLD) is a chronic liver condition closely related to metabolic dysfunction and has become one of the most prevalent liver diseases in China. Its pathogenesis involves a complex interplay between metabolic disturbances and chronic inflammation. The monocyte-macrophage system, as a central component of innate immunity, plays a dual role in the progression of MAFLD: on the one hand, it is involved in maintaining hepatic immune homeostasis; yet under certain conditions, it also drives inflammatory responses and promotes the fibrotic processes. This review systematically outlines the dynamic composition, phenotypic transitions, and underlying molecular mechanisms of hepatic macrophage populations during MAFLD progression. Additionally, it explores the complex and stage-dependent functional adaptations of the monocyte-macrophage system throughout the disease course and summarizes the emerging therapeutic strategies targeting this system, along with their clinical translations. This review aims to provide a theoretical foundation and insights for further elucidation of the monocyte-macrophage system's role in MAFLD and for developing novel immunometabolic therapeutic interventions to treat this disease.