The Interplay Between Gut–Brain Interaction Disorders and Liver Diseases

Disorders of the gut-brain interactions (DGBI) and metabolic liver diseases (MASLD/ MASH), including their end–stage cirrhosis, are included in a pathogenetic continuum, within which each component can be a significant driver of progression. A key link is systemic subclinical inflammation (low–grade inflammation) induced by portal endotoxemia and neuroimmune dysregulation. Objective. To systematize current data on the mechanisms of interactions and treatment methods for DGBI and liver diseases. The article presents the concepts of Bottom–Up and Top–Down signaling modulation, as well as current data on microbiota changes in DGBI and liver diseases. Particular attention is paid to diagnostic capabilities and therapeutic methods for targeting significant pathophysiological links. Conclusion. Understanding the role of the relationship between DGBI and liver disease underscores the need for interdisciplinary teams focused on comprehensive treatment of disorders of the gut–liver–brain axis. Future research should focus on identifying biomarkers of microbiota imbalances and developing pharmacotherapeutic interventions targeting the key mechanism of progression – systemic inflammation.