# FK506-binding protein-5 in high-fat diet-induced metabolic dysfunction-associated steatotic liver disease

## TL;DR

This study shows that the protein FKBP5 plays a key role in protecting against fatty liver disease caused by a high-fat diet by maintaining gut health and immune balance.

## Contribution

The study is the first to directly link FKBP5 to high-fat diet-induced fatty liver disease and gut microbiota homeostasis.

## Key findings

- FKBP5-deficient mice showed reduced hepatic steatosis and inflammation despite a high-fat diet.
- FKKO mice had higher butyric acid levels and a gut microbiota resistant to diet-induced obesity.
- FKBP5 supports gut-liver immunity and gut barrier integrity in metabolic dysfunction-associated steatotic liver disease.

## Abstract

A high-fat diet (HFD) alters the gut microbiota (GM), impairs metabolic efficiency, and increases gut permeability and inflammation. Obesity and insulin resistance are associated with GM dysbiosis. The GM is strongly associated with metabolic disorders and fatty liver disease. The co-chaperone protein FK506-binding protein-5 (FKBP5) regulates several vital cellular processes. Although FKBP5 has been implicated in stress-related disorders, it has not been directly linked to HFD-induced metabolic fatty liver disease. This study aimed to elucidate how FK506 binding protein 5 impairment affects the GM in HFD-induced metabolic dysfunction–associated fatty liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD). Wild-type and FKBP5-knockout (FKKO) mice were fed a normal chow diet or a high-fat diet for 16 weeks. Mouse GM was examined using 16 S rRNA metagenomic analysis. The number of gut-liver immune cells was measured using flow cytometry. HFD-induced hepatic steatosis and inflammation were prevented in FKBP5-deficient mice. FKKO animals showed higher butyric acid levels and GM resistance to diet-induced obesity alterations according to 16 S ribosomal rRNA gene analysis and displayed an HFD-specific gut-liver immunological response that maintained gut barrier failure and mucosal immunity, which are important for GM homeostasis. FKBP5 helps the GM address inadequate immunological responses, including lower gut and liver CD11b+Ly6C+ monocytes and neutrophils, and protects against obesity by improving the GM response to HFD-induced MASLD. FKBP5 protects against HFD-induced MASLD through metabolic coordination between the gut barrier and intrahepatic immunity.

The online version contains supplementary material available at 10.1038/s41598-026-38549-w.