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Clin Endocrinol (Oxf) (2011) 74(1):11824

Chronic liver injury is characterized by the progression of liver fibrosis, characterized by the deposition of type I collagen within the liver parenchyma, leading to advanced fibrosis and ultimately resulting in the manifestation of liver cirrhosis 27 .The gut-liver axis represents a reciprocal interaction between the intestinal microbiota and the liver, impacting metabolic processes and signaling pathways via various factors including dietary intake, genetic predisposition, and environmental influences 28 .The disruption of the gut-liver axis and impairment of intestinal barrier function can result in dysbiosis of the gut microbiota, heightened bacterial translocation, and the activation of inflammatory factors, ultimately leading to the development of severe complications 29,30,31 .The gut microbiota and barrier function play a direct role in the development of compensated cirrhosis and are correlated with the severity and complications of decompensated cirrhosis 28

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Despite these numerous advantages, inhaled drug delivery encounters considerable barriers that limit its overall effectiveness 13,114 (Fig

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