The liver is not only a detox organ but also a partner of the gut. In liver diseases such as MASLD (metabolic dysfunction-associated steatotic liver disease), cirrhosis or autoimmune hepatitis, there is almost always intestinal-liver crosstalk. Dysbiosis, oxidative stress and abnormal bile acids amplify liver inflammation and fibrosis.

Multi-omics makes this dialogue measurable and provides physicians with an additional tool to better understand patients even before liver values derail.

The clinical problem

• MASLD affects up to 25% of the population worldwide, often associated with obesity and metabolic syndrome.
• Liver values may remain normal for years, while inflammation and fibrosis increase silently.
• Classical diagnostics (biochemistry, ultrasound) provide limited information on immune activation and microbiome status.

Zhou et al, Ann Hepatol 2025 and Pirola et al, Lancet 2024 show that liver health is deeply intertwined with gut dysbiosis and epigenetic changes.

Multi-omics insights into the gut-liver axis

1. Oxidative stress and Nrf2/NF-κB crosstalk
   - Zhou et al., 2025: intestinal dysbiosis disrupts the Nrf2 pathway, which potentiates oxidative stress and fibrosis in MASLD.
2. Epigenome and liver microbiome
   - Pirola et al, Lancet 2024: Liver tissue contains its own microbial signature associated with epigenetic modifications (acetylation), crucial in MASLD progression.
3. Bile acids & immune regulation
   - Yan et al., Front Immunol 2025: bile acids influence intestinal-liver crosstalk via FXR and TGR5 signaling, determining inflammation and cholestasis.
4. Bacterial extracellular vesicles (BEVs)
   - Zhou et al, Front Cell Infect Microbiol 2025: bacteria communicate with the liver via extracellular vesicles that activate inflammatory pathways.
5. Therapeutic modulation
   - Deng et al, Lipids Health Dis 2025: high-intensity interval training (HIIT) and MICT improve liver function via gut-liver-mitochondrial crosstalk.

Innovative solutions for the clinic

1. Hepato-Gut Crosstalk Scan
   - My InnerSelfie combines DNA, metabolites (bile acids, SCFAs) and microbiome profiles into a liver risk profile.
2. Oxidative stress monitoring
   - Multi-omics detects subtle Nrf2/NF-κB imbalance even before clinical damage is apparent.
3. BEV biomarkers
   - Extracellular vesicle analysis reveals immune activation in autoimmune hepatitis.
4. Personalizable lifestyle interventions
   - Multi-omics can predict who will benefit from HIIT, nutrition or probiotic modulation in MASLD.

Why My InnerSelfie is unique

• Multi-omics integration: DNA, microbiome, bile acids and metabolites in a single clinical profile.
• Crosstalk focus: we visualize how gut and liver influence each other in inflammation and fibrosis.
• Preventive precision: risks of MASLD progression or autoimmune activation are revealed early.
• Additional tool for the physician: decisions always remain in the hands of the hepatologist/gastroenterologist; we offer an additional layer of evidence.
• Tomorrow's care: innovative, preventive and always customized. Innovation of today becomes the standard of tomorrow - safe and scientifically based.

Key insights

• Gut-liver crosstalk is crucial in MASLD, autoimmune hepatitis and liver toxicity.
• Multi-omics reveals oxidative stress, epigenetic changes and bile acid signals that remain invisible in routine research.
• My InnerSelfie offers physicians new biomarkers for early detection and personalized follow-up.

Scientific references

• Zhou M, Lv J, Chen X, et al. Gut-liver axis and oxidative stress in MASLD. Ann Hepatol. 2025.
• Pirola CJ, Salatino A, Gianotti TF, et al. Liver microbiome-epigenome crosstalk in MASLD. Lancet. 2024.
• Goyal H, Fatima K, Kaur J. Gut-liver microbiome crosstalk in liver cancer. Cancer Cell Int. 2025.
• Yan W, Zhang K, Guo J, et al. Bile acid-mediated gut-liver axis signaling. Front Immunol. 2025.
• Zhou Y, Sun Y, Yin P, et al. Bacterial extracellular vesicles in gut-liver crosstalk. Front Cell Infect Microbiol. 2025.
• Deng D, Xu L, Liu Y, et al. HIIT vs MICT in MASLD: gut-liver-mitochondrial crosstalk. Lipids Health Dis. 2025.