The Roles of Gut Microbiota Extracellular Vesicles in Modulating the Gut-Liver Axis During the Hepatic Diseases

The interaction between intestinal microbiota and hosts plays a crucial role in the occurrence and progression of various diseases. Among these, the gut-liver axis, which serves as a bidirectional communication pathway between the intestine and liver, has garnered significant attention in liver disease research in recent years. Microbiota-derived extracellular vesicles (MDEVs) act as a vital medium for information transmission between microorganisms and host cells, and they play a significant role in the regulation of liver diseases via the gut-liver axis. This article reviews the biological functions of MDEVs within the gut-liver axis and elucidates their mechanisms of action in the development of liver diseases. Unlike previous reviews that focused primarily on bacterial extracellular vesicles (BEVs), this review integrates recent evidence from fungal- and archaea-derived EVs and specifically examines the potential roles of MDEVs in cirrhotic complications, including portal hypertension and hepatic encephalopathy. However, MDEV research remains constrained by the lack of MDEV-specific isolation methods and a scarcity of clinical evidence beyond preclinical models. It emphasizes the potential of MDEVs as novel biomarkers for diagnosing liver diseases and highlights the latest research advancements in targeted therapeutic strategies based on MDEVs. Furthermore, this article anticipates future research directions and application prospects in this domain.