Publication Name	World Journal of Gastroenterology
Manuscript ID	119467
Country	Italy

Category	Gastroenterology & Hepatology
Manuscript Type	Review
Article Title	Liver-spleen axis: Deciphering a crucial crosstalk in non‐alcoholic fatty liver disease progression and therapeutic implications
Manuscript Source	Invited Manuscript
All Author List	Giovanni Tarantino and Vincenzo Citro
Funding Agency and Grant Number
Corresponding Author	Giovanni Tarantino, Department of Clinical Medicine and Surgery, Federico II University Medical School, Department of Clinical and Experimental Medicine, Hepatology in Internal Medicine Section, Federico II University Medical School of Naples, Naples, Italy. tarantin@unina.it, Naples 80131, Italy. tarantin@unina.it
Key Words	Immune cells; Diagnostic imaging; Spleen longitudinal diameter at ultrasound; Portal circulation; Chronic inflammation; Comorbidities; Central nervous system involvement; Therapeutic approach
Core Tip	Traditional models of non‐alcoholic fatty liver disease focus on the “liver-adipose-gut axis”, but emerging evidence establishes the “liver-spleen axis” as a critical immunometabolic rheostat. The spleen is not a passive bystander; it acts as an active “priming station” where metabolic stress triggers immune reprogramming. Splenic monocytes and pro-inflammatory cytokines (interleukin-6, tumor necrosis factor alpha) are deployed via the portal circulation to the liver, accelerating steatohepatitis and fibrosis. Clinically, spleen longitudinal diameter measured by ultrasound and splenic metabolic activity assessed via positron emission tomography/computed tomography serve as high-reliability, non-invasive biomarkers of disease severity. Targeting this axis—through pharmacological agents like statins or neuroimmune modulation—offers a novel frontier for precision diagnostics and interventions to halt the progression of metabolic and systemic inflammatory decay.
Citation	Tarantino G, Citro V. Liver-spleen axis: Deciphering a crucial crosstalk in non‐alcoholic fatty liver disease progression and therapeutic implications. World J Gastroenterol 2026; In press

Received	2026-01-29 01:59
Peer-Review Started	2026-01-29 02:03
First Decision by Editorial Office Director	2026-02-14 07:51
Return for Revision	2026-02-14 07:51
Revised	2026-03-05 01:59
Publication Fee Transferred
Second Decision by Editor	2026-04-20 02:54
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-20 06:41
Articles in Press	2026-04-20 06:41
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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