MetALD: new insights and unraveling therapeutic potential

Abstract

Metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease are leading contributors to chronic liver disease globally, with incidence rates escalating in parallel with the worldwide increase in metabolic dysfunction and harmful alcohol use. A recent Delphi Consensus statement introduced the term metabolic and alcohol-associated liver disease (MetALD) to emphasize the synergistic contributions of metabolic and alcohol-related factors to liver injury. While this conceptual framework advances our understanding of heterogeneous liver disease etiologies, it also presents new diagnostic and therapeutic challenges. This review presents current evidence on the prevalence of MetALD, as well as its heterogeneous disease risk profiles, underlying pathogenesis, clinical diagnostic biomarkers, and evolving treatment strategies. Particular emphasis is placed on the necessity for robust preclinical models that accurately replicate the multifactorial pathogenesis of MetALD. Emerging therapies, including fecal microbiota transplantation and dietary supplementation, are critically evaluated, alongside perspectives on future pharmacological innovations for MetALD management.

Keywords

MetALD / prevalence / pathogenesis / diagnosis / treatment

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