Frontiers | Targeting the Gut microbiota: The Application and Prospects of Probiotics, Fecal Microbiota Transplantation, and Natural products in MASLD

Provisionally accepted1Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China2Jiangsu Province Hospital of Chinese Medicine, Nanjing, China3Beijing University of Chinese Medicine, Beijing, China4The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaMetabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver condition globally. Studies have revealed distinct differences in the gut microbiota (GM) composition between healthy individuals and MASLD patients, suggesting a crucial role of GM in disease initiation and progression. This review summarizes characteristic gut microbial alterations in MASLD, examines the relationship between GM and their metabolites in MASLD pathogenesis, and discusses potential mechanistic pathways. Furthermore, we summarize the potential therapeutic applications of probiotics, fecal microbiota transplantation (FMT), and natural products in managing MASLD through GM modulation.Although current evidence indicates these interventions may slow or prevent MASLD progression, most research remains limited to animal experiments and small-scale clinical studies. The scarcity of high-quality clinical evidence has created a significant gap between theoretical research and clinical application. Therefore, this article aims to summarize This is a provisional file, not the final typeset article existing findings, explore the prospects of GM-targeted strategies for MASLD treatment, and propose future research directions in this field.Keywords: FMT, GM, Gut-liver axis, MASLD, Natural Products, ProbioticsReceived: 30 Oct 2025; Accepted: 22 Jan 2026. Copyright: © 2026 Li, Zhai, Qiao, Wang, Yang, Zheng, Shi, Geng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. * Correspondence: Wenwen Geng Jia Wang Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Read More