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Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) is becoming the leading cause of chronic liver disease-related morbidity and mortality globally. It encompasses a spectrum from metabolic dysfunction-associated steatotic liver (MASL) to metabolic dysfunction-associated steatohepatitis (MASH), potentially advancing to cirrhosis and hepatocellular carcinoma. While the pathogenesis of MASLD is complicated and not yet completely elucidated, hepatic macrophages, including liver resident Kupffer cells (Res-KCs) and recruited circulating monocyte-derived macrophages (MoDMs), play a pivotal role in its initiation and progression. Recent advancements in single-cell RNA sequencing have unveiled significant heterogeneity among macrophages and their diverse contributions to MASLD progression. This review delineates the origin and surface markers of hepatic macrophages, emphasizing their multifaceted roles in the pathogenesis of MASLD in steatosis, inflammation and fibrosis. Furthermore, we delve into the latest advancements in pharmacological treatment strategies for patients with MASLD.
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