Metabolic dysfunction-associated fatty liver disease (MASLD), previously known as NAFLD or MAFLD, is a liver condition associated with metabolic syndrome and affects over 30% of the global adult population. MASLD is typically diagnosed when more than 5% of liver cells (hepatocytes) exhibit steatosis alongside metabolic conditions like obesity, type 2 diabetes, or dyslipidemia. While many patients only experience steatosis with minimal symptoms, some progress to metabolic dysfunction-associated steatohepatitis (MASH), a more severe form involving inflammation, liver cell death, and fibrosis. MASH significantly increases the risk of cirrhosis and liver cancer (hepatocellular carcinoma), making MASLD a leading cause of liver-related deaths and transplants worldwide.

The transition from MASLD to MASH is linked to various stressors such as hypoxia, metabolic stress, and insulin resistance, which activate immune cells and trigger a chronic inflammatory response. This inflammatory cascade leads to liver damage, fibrosis, and a heightened risk of cirrhosis. Current research is uncovering new therapeutic targets, including anti-inflammatory drugs like IL-17A inhibitors, that show promise in reducing liver damage.

Reference: Mladenić K, Lenartić M, Marinović S, Polić B, Wensveen FM. The “Domino effect” in MASLD: The inflammatory cascade of steatohepatitis. Eur J Immunol. 2024 Apr;54(4):e2149641. doi: 10.1002/eji.202149641. Epub 2024 Feb 5. PMID: 38314819.