Plant-Derived Interventions for MASLD/MASH: From Extracts and Bioactive Compounds to Exosome-Like Nanoparticles

Summary

This narrative review synthesises evidence for plant-derived interventions in metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH), comparing traditional extracts, purified bioactive compounds, and emerging plant-derived exosome-like nanoparticles (PELNs). Whilst source-plant evidence supports effects across multiple pathogenic pathways including lipogenesis, oxidative stress, and fibrogenesis, direct PELN evidence remains limited to 12 preclinical studies from 11 plant sources, with substantial gaps in vesicle characterisation, functional cargo identity, and oral bioavailability. The authors conclude that advancing this field requires standardised PELN preparation, causal validation of cargo effects, quantitative biodistribution studies, and clinical evaluation of purified formulations.

Regional applicability

The review is mechanism- and evidence-focused rather than geographically bounded. Findings on plant-derived compounds and their potential in MASLD/MASH treatment are broadly applicable to United Kingdom clinical practice and research, particularly given rising MASLD prevalence in UK populations; however, regulatory pathways for PELN products would need to align with MHRA and EMA approval frameworks.

Key measures

Mechanisms of action across lipid handling, insulin sensitivity, mitochondrial function, immune signalling, gut-liver communication, and fibrogenesis; preclinical and clinical evidence for plant extracts, isolated compounds, and PELNs

Outcomes reported

The review compares plant extracts, bioactive compounds, and plant-derived exosome-like nanoparticles (PELNs) for treating MASLD/MASH, evaluating evidence for effects on lipogenesis, oxidative stress, gut microbiota, and hepatic fibrosis. It identifies evidence gaps in PELN characterisation, biodistribution, and clinical translation.

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