The Metabolic-Immune Axis in MASH: Is the Macrophage Signature the Key to Liver Disease Staging?

The clinical management of metabolic dysfunction-associated steatohepatitis (MASH) hinges on accurate staging, yet liver biopsy remains the invasive gold standard (1). Non-invasive biomarkers that capture the dynamic interplay between metabolic stress and immune remodeling are urgently needed. The advent of high-throughput omics techniques, even at the single-cell or nuclear level, has shed light on the role of immune cells in metabolic dysfunction-associated steatotic liver disease (MASLD) and its progression to MASH (2).