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REVIEW article

Front. Pharmacol.

Sec. Ethnopharmacology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1669805

Dysregulated Bile Acid Metabolism Drives Lipid Peroxidation and Ferroptosis in NAFLD: Therapeutic Potential for Traditional Chinese Medicine

Provisionally accepted
Jing  LiuJing Liu1*Fuxing  LiFuxing Li2Qianru  ZengQianru Zeng2Wenxiao  HuWenxiao Hu2Le  YangLe Yang2Shengping  LuoShengping Luo2Dingxiang  LiDingxiang Li2Yihui  DengYihui Deng2*
  • 1Other
  • 2Hunan University of Chinese Medicine, Changsha, China

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

Non-alcoholic fatty liver disease (NAFLD), characterized by abnormal lipid accumulation in hepatocytes, is prevalent in conditions such as type 2 diabetes mellitus and obesity, which are associated with dysregulated glucose and lipid metabolism. Bile acids (BAs) are critical regulators of lipid and glucose homeostasis. Emerging research suggests that disturbances in BA metabolism not only exacerbate metabolic imbalance but also promote ferroptosis via lipid peroxidation. This review differs by systematically linking BA regulation, ferroptosis, and TCM, highlighting the multi-component and multi-target advantages of TCM in preventing and treating NAFLD. We summarize the mechanisms by which BAs regulate hepatic lipid synthesis and oxidation, and how lipid peroxidation connects to ferroptosis through glutathione/glutathione disulfide (GSH/GSSG) and reactive oxygen species (ROS). Finally, we review studies on TCM modulation of BA metabolism and ferroptosis to improve lipid peroxidation and metabolic disorders, providing timely insights into innovative therapeutic strategies for NAFLD.

Keywords: Non-alcoholic fatty liver disease, Bile acids, Lipid Peroxidation, ferroptosis, Traditional Chinese Medicine

Received: 20 Jul 2025; Accepted: 21 Aug 2025.

Copyright: © 2025 Liu, Li, Zeng, Hu, Yang, Luo, Li and Deng. 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: Yihui Deng, Hunan University of Chinese Medicine, Changsha, China

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