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Hepatic exposome as an emerging contributor to metabolic dysfunction-associated steatotic liver disease
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Fatty liver disease is usually blamed on diet and weight, but this review of existing research points to another suspect: everyday chemical exposures like microplastics, "forever chemicals" (PFAS), pesticides, and air pollution, which may quietly damage the liver by disrupting hormones, cell energy production, and gut bacteria. This matters because it could help explain why some lean, seemingly healthy people still develop liver disease, and it suggests that reducing chemical exposure, not just improving diet, might be an important, actionable way to protect liver health.
Metabolic dysfunction-associated steatotic liver disease is among the most prevalent chronic liver diseases worldwide. Its increasing incidence is typically linked to over-nutrition and metabolic syndrome. However, this account remains insufficiently detailed, particularly regarding diseases in lean individuals and the generational acceleration of metabolic illnesses. The exposome encompasses the entirety of the environmental exposure throughout an individual’s life and provides a complementary framework. The liver is a pivotal organ given that it is the primary location for the biotransformation of xenobiotics. This study synthesized data suggesting that environmental chemical exposure may be a plausible and controllable factor in steatotic liver disease while distinguishing associations from causation. We reviewed the main exposure classes, including per- and polyfluoroalkyl substances, micro- and nanoplastics, endocrine-disrupting plasticizers, persistent organic pollutants, hazardous metals, and air pollution. We assessed the strength of human evidence and delineated the potential mechanisms shared by these agents, including nuclear receptor disruption, mitochondrial and oxidative injury, inflammasome activation, stellate cell fibrogenesis, gut microbiota-bile acid disruption, and developmental reprogramming, along with their documented associations with steatosis, steatohepatitis, fibrosis, and hepatocellular carcinoma. The recognition of environmental exposure redefines metabolic dysfunction-associated steatotic liver disease as chemical environment-driven. These findings have implications in risk assessment, treatment, and prevention.
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The nexus of environmental endocrine-disrupting chemical exposure and metabolic dysfunction-associated steatotic liver disease: An emerging public health challenge
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This review examines evidence that chronic low-dose exposure to endocrine-disrupting chemicals, including micro- and nanoplastics, may be an underappreciated factor driving the global rise of metabolic liver disease. Researchers found that these pollutants can promote liver fat accumulation, inflammation, and scarring by disrupting hormone signaling, gut health, and mitochondrial function. The study suggests that environmental chemical exposures should be considered alongside diet and lifestyle when assessing liver disease risk.
Overview of the hazardous impacts of metabolism-disrupting chemicals on the progression of fatty liver diseases.
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This review examined how metabolism-disrupting chemicals (MDCs)—including bisphenol A and phthalates from plastics—promote the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD). MDC exposure was found to impair liver lipid homeostasis and contribute to the global rise in fatty liver disease.
Microplastics, nanoplastics and liver disease: an emerging health concern?
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Researchers reviewed emerging evidence that microplastics and nanoplastics accumulate in human liver tissue at increasing concentrations over the past decade, trigger oxidative stress, fibrogenesis, and inflammation in cell and animal models, and may carry microbial pathogens and endocrine-disrupting chemicals, introducing the concept of plastic-induced liver injury as a new focus for environmental hepatology.
Letter to the Editor: Microplastics as promoters of metabolic dysfunction-associated steatotic liver disease: Mechanistic insights and implications
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Tiny plastic particles found in our bodies—including the liver—may worsen fatty liver disease by disrupting how liver cells manage fat, handle stress, and clean out damaged parts, according to this commentary on existing lab and animal research. Since fatty liver disease is already the most common chronic liver condition worldwide and can lead to liver cancer, these findings raise concerns about how everyday plastic exposure might be affecting our health, though more human studies are needed to confirm the connection.
Microplastics in metabolic dysfunction-associated steatotic liver disease: An emerging threat to liver health
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This review examined emerging evidence linking microplastic exposure to the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD). The authors found that microplastics detected in liver tissue can exacerbate hepatic inflammation, lipid accumulation, and oxidative stress through multiple mechanisms, adding a novel environmental risk factor to MASLD pathogenesis.
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When a large batch of papers lands in the Atlas, we read through it and send a short write-up of what stood out.