{
  "abstract": "Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease with increasing global prevalence. However, substantial inter-individual variability in therapeutic response remains a major challenge for effective disease management. Although the gut microbiota is well recognized as a key contributor to MASH pathogenesis, its role in shaping pharmacological treatment response remains insufficiently understood and underexplored in clinical contexts. In this Review, we summarize evidence suggesting that gut microbiota-associated metabolites, including bile acids, short-chain fatty acids, sphingolipids, and other microbial products, may contribute to variability in therapeutic response across major pharmacological classes for MASH, including FXR agonists, PPAR agonists, FGF19/FGF21 analogues, thyroid hormone receptor-β agonists, and incretin-based therapies. However, for most therapeutic classes, direct clinical evidence linking microbiota features to inter-individual treatment response remains limited, and much of the mechanistic evidence is derived from preclinical studies. We integrate current evidence into a response-oriented conceptual framework linking microbiome composition and metabolic activity to biological processes relevant to drug efficacy. This framework identifies priorities for the prospective validation of microbiome-derived biomarkers and microbiome-informed patient stratification in MASH.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology, Zhaotong First People’s Hospital",
    "Department of Orthopedics, Zhaotong First People’s Hospital"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Pingping Yan"
    },
    {
      "affs": [
        1
      ],
      "name": "Shuheng Cai"
    },
    {
      "affs": [
        0
      ],
      "name": "Juzhi Xia"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6zdd0vncr2f99.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1968956",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13728350/?tool=EBI",
  "id": "6zdd0vncr2f99",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1968956/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "1312|Gut microbiota and health"
    ]
  ],
  "openalex": "W7223061851",
  "pdf_url": "https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1968956/pdf",
  "pmcid": "PMC13728350",
  "pmid": "42979067",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/6zdd0vncr2f99.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1968956",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1968956/full"
    },
    {
      "first_seen": "2026-11-04T15:20:46Z",
      "native_id": "PMC:PMC13728350",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13728350"
    },
    {
      "first_seen": "2026-11-07T12:21:22Z",
      "native_id": "PMC13728350",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fphar.2026.1968956"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Gut microbiota and health",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Gut microbiota and treatment response heterogeneity across pharmacological therapies for MASH",
  "title_text": "Gut microbiota and treatment response heterogeneity across pharmacological therapies for MASH",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:22Z",
  "url": "https://research.draconitic.com/paper/6zdd0vncr2f99",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}