上海交通大学医学院李华婷课题组的研究显示，肠道微生物组的个体间变异介导了抗性淀粉对MASLD的疗效。相关论文发表在2025年11月20日出版的《细胞—代谢》杂志上。

该团队观察到其异质性疗效，其中30%的参与者表现出有限的益处，这在一项多中心试验中得到了重复（ChiCTR2300074588）。多组学分析和粪便微生物群移植确定了基线微生物群是反应的主要贡献者。进一步的种群分层和网络分析结合体外和体内实验表明，普雷沃氏菌通过抑制RS降解菌的低反应，从而影响RS的利用，是低反应的关键catheme。相反，从他们的同群中分离出的伪atenulatum双歧杆菌RRP01恢复了RS降解并改善了普雷沃特菌减毒RS反应。

此外，该研究团队开发了一个整合基线微生物和临床特征的预测模型（曲线下面积[AUC] = 0.74-0.87），从而实现个性化干预的分层。他们的研究表明，肠道微生物群决定了RS疗效的异质性，并为MASLD的新型微生物群定向精确治疗提供了可能性。

据悉，他们的随机、安慰剂对照试验显示，抗性淀粉（RS）是一种益生元，对代谢功能障碍相关的脂肪变性肝病（MASLD）有治疗作用。

附：英文原文

Title: Interindividual variability in gut microbiome mediates the efficacy of resistant starch on MASLD

Author: Xiaoxue Long, Hui Wang, Yuwei Lu, Xiaojing Gao, Yuanyuan Xiao, Mingliang Zhang, Jingyi Guo, Jingyi Yang, Ruiqi Zhang, Qian Li, Guiyun Zhou, Ruibao Yang, Feng Chen, Qingqing Wu, Liming Sun, Chengshuang Chu, Xuexue Zhu, Zhengjun Wu, Quanlu Ren, Chunping You, Zhenmin Liu, Qian Li, Dan Liu, Di Cheng, Piao Kang, Anran Chen, Qian Wu, Qichen Fang, Li Wei, Lei Zhang, Jun Li, Gianni Panagiotou, Weiping Jia, Rong Zeng, Yueqiong Ni, Luonan Chen, Huating Li

Issue&Volume: 2025-11-20

Abstract: Our randomized, placebo-controlled trial showed resistant starch (RS), a type of prebiotic, has therapeutic effects in metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we observed its heterogeneous efficacy, where 30% of participants exhibited limited benefits, which was replicated in a multi-center trial (ChiCTR2300074588). Multi-omics analysis and fecal microbiota transplantation identified baseline microbiota as a dominant contributor of response. Further population stratification and network analysis combined with in vitro and in vivo experiments revealed Prevotella as the key cause of low response by inhibiting RS-degrading bacteria, thereby impairing RS utilization. Conversely, Bifidobacterium pseudocatenulatum RRP01, a strain isolated from our cohort, restored RS degradation and improved Prevotella-attenuated RS response. Furthermore, we developed a predictive model integrating baseline microbial and clinical features (area under the curve [AUC] = 0.74–0.87), enabling stratification for personalized interventions. Our study indicates that gut microbiota determines the heterogeneity in RS efficacy and offers possibilities for novel microbiota-oriented precision therapeutics for MASLD.

DOI: 10.1016/j.cmet.2025.10.017

Source: https://www.cell.com/cell-metabolism/abstract/S1550-4131(25)00477-2