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细胞凋亡与非酒精性脂肪性肝病。

Apoptosis and non-alcoholic fatty liver diseases.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan. @yahoo.co.jp.

Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan.

出版信息

World J Gastroenterol. 2018 Jul 7;24(25):2661-2672. doi: 10.3748/wjg.v24.i25.2661.

Abstract

The number of patients with nonalcoholic fatty liver diseases (NAFLD) including nonalcoholic steatohepatitis (NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma (HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.

摘要

非酒精性脂肪性肝病(NAFLD)患者的数量不断增加,包括非酒精性脂肪性肝炎(NASH)。NASH 可导致肝硬化和肝细胞癌(HCC),是世界上最严重的健康问题之一。NASH 进展的机制仍在很大程度上未知。半胱天冬酶、Bcl-2 家族蛋白和 c-Jun N 末端激酶诱导的肝细胞凋亡的激活在 NAFLD/NASH 的激活中起作用。凋亡的肝细胞通过炎性小体和细胞因子的产生刺激免疫细胞和肝星状细胞向肝纤维化进展。葡萄糖和脂质代谢以及微生物群的异常加速了这些过程。活性氧、氧化应激和内质网应激的产生也与此相关。细胞死亡,包括细胞凋亡,在 NAFLD 和 NASH 的进展中似乎非常重要。最近,凋亡抑制剂已被开发为 NASH 的治疗药物,可能预防肝硬化和 HCC。肝细胞凋亡的增加可能将 NASH 与 NAFLD 区分开来,改善凋亡可能在控制 NASH 的发展中发挥作用。本文讨论了凋亡与 NAFLD/NASH 之间的关联。这篇综述可以提供有关知识,这对日常临床实践中诊治 NAFLD/NASH 患者具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee5e/6034146/839f316d054a/WJG-24-2661-g001.jpg

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