Metabolic dysfunction-associated steatotic liver disease: mechanisms, oxidative stress, and the therapeutic potential of garcinol and astaxanthin

Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most prevalent chronic liver disease worldwide, affecting nearly one in three adults. Strongly associated with obesity, insulin resistance, and dyslipidemia, MASLD increases the risk of hepatic fibrosis, liver dysfunction, and systemic metabolic complications. Despite its growing prevalence, effective pharmacological therapies remain limited. Natural bioactive compounds with antioxidant, anti-inflammatory, and lipid metabolism-modulating properties are widely studied and gaining popularity for their potential hepatoprotective effects.

This review provides an overview of the pathophysiology of MASLD, highlighting its metabolic and oxidative stress-related mechanisms, and explores the potential benefits of garcinol (GAR) and astaxanthin (AX), two natural bioactive compounds that may support liver. Based on the literature review of in vivo studies, it can be concluded that the administration of GAR and AX to animals with induced liver steatosis exerted hepatoprotective effects. The hepatoprotective impact was evident in their inhibitory action on oxidative stress, inflammation, and fibrosis in the liver, as well as in supporting lipid metabolism. In some studies, GAR and AX were also administered in combination with other hepatoprotective compounds, such as vitamin E and curcuminoids.

Although evidence supports their individual benefits, the therapeutic potential of combining GAR and AX in MASLD remains unexplored. Consequently, based on the available studies, it is not possible to evaluate their combined effects. Further research is needed to determine their mechanisms of interaction, optimal dosages, and clinical relevance. We believe that their combination may offer additional benefits and provide new perspectives on natural bioactive compounds-based interventions for liver protection.