Role of gut-brain axis dysregulation in the pathogenesis of non-alcoholic fatty liver disease: mechanisms and therapeutic implications.

Non-alcoholic fatty liver disease (NAFLD) has emerged as a global health challenge due to its rising prevalence and strong association with metabolic syndrome. Recent studies highlight the critical role of the gut-brain axis (GBA)-a bidirectional communication system between the gut, brain, and liver-in NAFLD pathogenesis. Dysregulation of this axis can worsen metabolic dysfunction, inflammation, and liver injury. This review discusses the mechanisms driving GBA dysregulation in NAFLD, including alterations in gut microbiota, increased intestinal permeability, neuroinflammation, and imbalances in the autonomic nervous system (ANS). We also explore therapeutic strategies, such as microbiota modulation, vagus nerve stimulation, and neuroprotective interventions, that may help mitigate the effects of GBA dysfunction on NAFLD progression.