Pacana Tommy, Sanyal Arun J
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine Richmond, VA 23298 USA.
F1000Prime Rep. 2015 Mar 3;7:28. doi: 10.12703/P7-28. eCollection 2015.
Non-alcoholic steatohepatitis (NASH) can lead to advanced fibrosis, hepatocellular carcinoma, and end-stage liver disease requiring liver transplantation. A myriad of pathways and genetic influence contribute to NASH pathogenesis and liver disease progression. Diagnosing patients with NASH and advanced fibrosis is critical prior to treatment and prognostication. There has been ongoing interest in developing non-invasive biomarkers and tools for identifying NASH and advanced fibrosis. To date, there has been no approved therapy for NASH. Recently, the FLINT (Farnesoid X Receptor [FXR] Ligand Obeticholic Acid in NASH Treatment) trial provided promising results of the efficacy of obeticholic acid, a farnesoid X receptor agonist, in improving histological features of NASH and fibrosis. Long-term studies are needed to assess the safety of obeticholic acid and its effects on liver- and cardiovascular-related outcomes.
非酒精性脂肪性肝炎（NASH）可导致严重纤维化、肝细胞癌以及需要肝移植的终末期肝病。众多途径和遗传影响因素参与了NASH的发病机制及肝病进展过程。在治疗和预后评估之前，诊断NASH及严重纤维化患者至关重要。人们一直致力于开发用于识别NASH和严重纤维化的非侵入性生物标志物及工具。迄今为止，尚无获批用于NASH的治疗方法。最近，FLINT（法尼醇X受体[FXR]配体奥贝胆酸治疗NASH）试验提供了奥贝胆酸（一种法尼醇X受体激动剂）在改善NASH组织学特征和纤维化方面疗效的有前景的结果。需要进行长期研究以评估奥贝胆酸的安全性及其对肝脏和心血管相关结局的影响。
