The Role of "Biotics" in the Modulation of the Intestinal Microbiota in Metabolic-Associated Steatotic Liver Disease

Introduction. There are quite a lot of research results that indicate the active influence of dysbiotic changes in the intestinal microbiota on the pathogenetic mechanisms of metabolic-associated steatotic liver disease (MASLD). This determines the active development of such a direction as the modulation of the intestinal microbiota (primarily using pre-, pro-, post- and synbiotics) in this category of patients to influence both the development of hepatic steatosis and the progression to metabolic dysfunction-associated steatohepatitis. The aim of the study. To summarize information from recent publications on the results of research on "biotics" in modifying the intestinal microbiota in patients with metabolic-associated steatotic liver disease. Materials and methods. A systematic and comparative analysis of the current scientific literature on various methods for modifying the intestinal microbiota in patients with MASLD was conducted. Information was collected from leading databases such as PubMed, NCBI, and Medline. Results. The available results on the manipulation of the human intestinal microbiota with the help of various so-called "biotics" for influencing the course of MASLD and restoring health indicate a significant prospect of such intervention: normalization of lipid metabolism, reduction of the severity of insulin resistance, the level of liver enzymes, pro-inflammatory cytokines, the degree of steatosis against the background of improving anthropometric indicators and restoring normal intestinal barrier permeability. Separately, the possibility of the influence of such therapy on the activity of hepatocyte mitochondria - one of the leading participants in the pathogenesis of MASLD is considered. Conclusions. The state of the intestinal microbiota plays an important role in the etiopathogenesis of metabolic-associated steatotic liver disease, so its modulation to restore eubiosis is a promising treatment method, which is confirmed by the results of most current studies. However, further studies with a unified design and the use of improved technologies for studying the intestinal microbiota are needed, which will provide a better understanding of the possibilities of modulating the intestinal microbiota in metabolic-associated steatotic liver disease, taking into account the type of probiotic strain required, its dosage, duration of treatment and other aspects.