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A study showed that probiotic-fermented Pueraria lobata (Willd.) Ohwi significantly reduced the abundance of Bacteroidetes and Akkermansia muciniphila while increasing the abundance of Firmicutes and Lactobacillus , which modulated aberrant gut microbiota composition and activated nuclear transcription factor (erythroid-derived 2)-like 2 (Nrf2)-mediated signals, thereby improving lipid accumulation and inflammation and exerting antioxidant effects and ultimately preventing ALD ( in vivo and in vitro , which is inseparable from its impact on the gut microbiota ( Table 1 Research overview of TCMs and NPs targeting gut microbiota for liver disease therapy

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This structural modification significantly extends its half-life and enhances resistance to proteolytic degradation, thereby enabling prolonged biological activity in vivo

One strategic approach involves combining metabolic inhibitors with key signaling pathway modulators to establish a dual-targeted metabolicsignaling axis

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