Platycodin D attenuates alcohol-associated fatty liver disease by suppressing TLR4–NF-κB and activating PPAR signaling

Alcohol-associated fatty liver disease (AFLD) is driven by ethanol-induced metabolic dysregulation and hepatic inflammation, with gut dysbiosis and endotoxin-triggered innate immune activation implicated in disease progression. Platycodin D (PD), a triterpenoid saponin from Platycodon grandiflorum, has been reported to have antioxidant and immunomodulatory activities, but its efficacy and mechanisms in AFLD remain unclear. We hypothesized that PD alleviates AFLD by suppressing TLR4/NF-κB signaling, activating PPAR pathways, and remodeling gut microbiota and hepatic metabolites.