The Gut Microbiome and Ferroptosis in MAFLD

Metabolic-associated fatty liver disease(MAFLD)is a new disease definition,and is proposed to replace the previous name,nonalcoholic fatty liver disease(NAFLD).Globally,MAFLD/NAFLD is the most common liver disease,with an incidence rate ranging from 6%to 35%in adult populations.The pathogenesis of MAFLD/NAFLD is closely related to insulin resistance(IR),and the genetic susceptibility to acquired metabolic stress-associated liver injury.Similarly,the gut microbiota in MAFLD/NAFLD is being revaluated by scientists,as the gut and liver influence each other via the gut-liver axis.Ferroptosis is a novel form of programmed cell death caused by iron-dependent lipid peroxidation.Emerging evidence suggests that ferroptosis has a key role in the pathological progression of MAFLD/NAFLD,and inhibition of ferroptosis may become a novel therapeutic strategy for the treatment of NAFLD.This review focuses on the main mechanisms behind the promotion of MAFLD/NAFLD occurrence and development by the intestinal microbiota and ferroptosis.It outlines new strategies to target the intestinal microbiota and ferroptosis to facilitate future MAFLD/NAFLD therapies.