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REVIEW article

Front. Immunol.

Sec. Comparative Immunology

Unveiling the Gut-Liver Axis: the behind-the-scenes "Manipulator" of Human Immune Function

Provisionally accepted
Peizhe  LiPeizhe LiYu  WangYu WangYanan  DongYanan DongXin  ZhangXin Zhang*
  • Changchun University of Chinese Medicine, Changchun, China

The final, formatted version of the article will be published soon.

Abstract: The "gut-liver axis" enables bidirectional immunoregulation between the intestine and the liver through the portal venous circulation, bile acid metabolism, and the neuro-lymphatic network. This paper reviews its physiological pathways (vascular, biliary, neural, and lymphatic), immunomodulatory mechanisms (interaction of innate/adaptive immune cells, balance between inflammation and tolerance), and associations with diseases such as PSC, MAFLD, and IBD. Metabolites of gut microbiota activate immune cell receptors to regulate the differentiation of Tregs, while cytokines (such as IL-6) and chemokines (such as CCR9) drive the synergy of gut-liver immunity. In pathological conditions, dysbiosis, endotoxin translocation, and bile acid metabolic disorders trigger immunological dysregulation through this axis. Strategies such as targeted fecal microbiota transplantation and bile acid receptor (FXR) agonists show clinical potential. This paper systematically elaborates on the physiological and immunoregulatory mechanisms of the "gut-liver axis", explores the associations between its abnormalities and immune diseases, as well as the prospects of translational medicine. It is proposed that future research should deepen the analysis of single-cell interactions, conduct personalized interventions, and establish a new paradigm of "gut-liver axis medicine" to provide cross-organ solutions for the precise prevention and control of immune-related diseases.

Keywords: Gut-liver axis, Immunoregulation, Gut Microbiota, Bile acids, Immune function

Received: 05 Jun 2025; Accepted: 27 Oct 2025.

Copyright: © 2025 Li, Wang, Dong and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xin Zhang, 15567001758@163.com

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