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Zhao et al. Microbiome Res Rep. 2025;4:28 https://dx.doi.org/10.20517/mrr.2025.12 Page 5 of 13

Table 2. Changes in BSH expression or activity across different stages of MASLD
BSH activity Microbiome
BSH Ethnicity/animal
change a Subjects model Intervention Group evaluation sequencing References
method
method
Metabolic dysfunction-associated steatotic liver disease (MASLD)
↓ Adults American / mild MASLD (72) vs. BSH gene Metagenomics [9,59,60]
Control (308) abundance
↓ Children Asian / MASLD (32) vs. HC Microbial relative Metagenomics [25]
(36) abundance,
KEGG analysis
↑ Adults American / MASLD (57) vs. HC Microbial relative 16s rRNA [11]
(18) abundance
↓ Mice C57BL/6J / HFD (6) vs. Chow (9) Microbial relative 16s rRNA [22]
abundance
↓ Mice C57BL/6J Drug HFD + IsA (6) vs. In vitro assay 16s rRNA [28]
Chow vs. HFD (6)
↓ Mice C57BL/6J Drug HFD (8) vs. CN (8) Microbial relative 16s rRNA [29]
abundance
↓ Mice C57BL/6J Drug ZKY (6) vs. HFD (6) BSH gene copy 16s rRNA [26]
vs. Con (6 number
↑ Rats Wistar BSH inhibitor AAA-10 (8) vs. In vitro assay / [31]
Vehicle (8)
↑ Mice C57BL/6J BSH inhibitor CAPE (5) vs. Vehicle In vitro assay 16s rRNA [17]
(5)
↑ Mice C57BL/6J Drug PCPE (8) vs. HFD (8) In vitro assay 16s rRNA [30]
Metabolic-Associated Steatohepatitis (MASH)
↓ Mice C57BL/6J Probiotics ALDH2-/--MCD (5) In vitro assay 16s rRNA [32]
vs. WT-MCD (5)
↓ Mice C57BL/6J Drug OCA (8) vs. Vehicle In vitro assay 16s rRNA [34]
(8)
↑ Mice C57BL/6J / HFHC (8) vs. HF (8) Microbial relative 16s rRNA [33]
vs. Con (8) abundance
Advanced liver diseases (Fibrosis and cirrhosis)
↓ Adults Asian / Hepatic fibrosis (17) Microbial relative 16s rRNA [18]
vs. HC (10) abundance,
bile acid profile
analysis
↓ Adults American / Advanced MASLD BSH gene Metagenomics [9,59,60]
(Fibrosis,14) vs. abundance
Control (308)
↓ Adults Asian / Liver cirrhosis (114) vs. BSH gene Metagenomics [9,38]
Control (123) abundance
↓ Mice C57BL/6J Probiotics TAA (6) vs. Control Bile acids profile 16s rRNA [18]
(6) analysis
↓ Mice C57BL/6J / Tlr4-/- (8) vs. WT Microbial relative 16s rRNA [36]
(10) abundance
↓ Mice C57BL/6J Drug DDC + KH (5) vs. Microbial relative 16s rRNA [35]
DDC+H2O (5) abundance
↓ Mice C57BL/6J Drug DDC (5) vs. Control In vitro assay 16s rRNA [19]
(5)
↓ Mice C57BL/6J Probiotics BDL + LGG (7) vs. BDL In vitro assay / [37]
(7)
a
↑, gut BSH activity was higher in the disease state or before intervention; ↓, gut BSH activity was lower in the disease state or before intervention.
The numbers in the “Group” column indicate the total number of participants or animals per group. BSH: Bile salt hydrolase; KEGG: kyoto
encyclopedia of genes and genomes; IsA: ilexsaponin A1; LGG: Lactobacillus rhamnosus GG; HC: health control; HFD: high-fat diet; CN: control;
CAPE: caffeic acid phenethyl ester; PCPE: Penthorum chinense Pursh. extract; ALDH2-/--MCD & WT-MCD: ALDH2 knockout mice and wild-type
littermate mice were fed a methionine-and choline-deficient diet; OCA: obeticholic acid; HFHC: high-fat and high-cholesterol diet; HF: high fat
diet; TAA: thioacetamide; DDC: 3,5-diethoxycarbonyl-1,4-dihydrocollidine; KH: Kuhuang treatment; BDL: bile duct ligation; AAA-10:
small-molecule inhibitor of gut bacterial BSHs.