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This study demonstrates that genetic susceptibility to MASLD, specifically in PNPLA3I148M carriers, is significantly influenced by the state of the gut microbiota and intestinal barrier function. Disruption of intestinal homeostasis amplifies liver injury via increased gut-derived metabolites such as ceramides. Importantly, restoring gut microbiota balance through fecal microbiota transplantation (FMT) and targeted use of the bacterium Akkermansia muciniphila or its membrane protein Amuc_1100 reversed hepatic damage, suggesting novel therapeutic avenues.
