Nassir Fatiha
Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO 65212, USA.
Biomolecules. 2022 Jun 13;12(6):824. doi: 10.3390/biom12060824.
Nonalcoholic fatty liver disease (NAFLD), recently renamed metabolic-associated fatty liver disease (MAFLD), is one of the most common causes of liver diseases worldwide. NAFLD is growing in parallel with the obesity epidemic. No pharmacological treatment is available to treat NAFLD, specifically. The reason might be that NAFLD is a multi-factorial disease with an incomplete understanding of the mechanisms involved, an absence of accurate and inexpensive imaging tools, and lack of adequate non-invasive biomarkers. NAFLD consists of the accumulation of excess lipids in the liver, causing lipotoxicity that might progress to metabolic-associated steatohepatitis (NASH), liver fibrosis, and hepatocellular carcinoma. The mechanisms for the pathogenesis of NAFLD, current interventions in the management of the disease, and the role of sirtuins as potential targets for treatment are discussed here. In addition, the current diagnostic tools, and the role of non-coding RNAs as emerging diagnostic biomarkers are summarized. The availability of non-invasive biomarkers, and accurate and inexpensive non-invasive diagnosis tools are crucial in the detection of the early signs in the progression of NAFLD. This will expedite clinical trials and the validation of the emerging therapeutic treatments.
非酒精性脂肪性肝病（NAFLD），最近更名为代谢相关脂肪性肝病（MAFLD），是全球最常见的肝脏疾病病因之一。NAFLD的增长与肥胖流行趋势同步。目前尚无专门治疗NAFLD的药物。原因可能是NAFLD是一种多因素疾病，人们对其涉及的机制了解不全面，缺乏准确且廉价的成像工具，以及缺乏足够的非侵入性生物标志物。NAFLD表现为肝脏中脂质过度蓄积，导致脂毒性，进而可能发展为代谢相关脂肪性肝炎（NASH）、肝纤维化和肝细胞癌。本文讨论了NAFLD发病机制、当前该疾病管理中的干预措施以及沉默调节蛋白作为潜在治疗靶点的作用。此外，还总结了当前的诊断工具以及非编码RNA作为新兴诊断生物标志物的作用。非侵入性生物标志物以及准确且廉价的非侵入性诊断工具对于检测NAFLD进展的早期迹象至关重要。这将加快临床试验以及新兴治疗方法的验证。
