Crosstalk along the gut-liver axis in liver disease: Clinical and mechanistic aspects.

Bidirectional gut-liver interactions are central to the initiation and progression of many liver diseases, with gut-derived and liver-derived factors shaping injury, inflammation, and fibrosis.

• Why it matters: The field needs integrated clinical and mechanistic understanding of how gut permeability, microbiota, and immune signaling contribute to liver disease, including gaps for stratification and therapy.
• What they did: This review synthesizes evidence across autoimmune, metabolic, and toxic hepatobiliary disorders, focusing on intestinal permeability, microbiota composition, and immune signaling within the gut-liver axis.
• The result: The bidirectional model supports disease stratification, prevention, and therapy approaches, while highlighting key knowledge gaps and future research priorities.