Ji Jie, Wu Liwei, Wei Jue, Wu Jianye, Guo Chuanyong
Department of Gastroenterology, Putuo People's Hospital, Tongji University, Shanghai, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
J Clin Transl Hepatol. 2023 Feb 28;11(1):174-187. doi: 10.14218/JCTH.2022.00136. Epub 2022 Jul 14.
Metabolic-associated fatty liver disease (MAFLD) is a new disease definition, and is proposed to replace the previous name, nonalcoholic fatty liver disease (NAFLD). Globally, MAFLD/NAFLD is the most common liver disease, with an incidence rate ranging from 6% to 35% in adult populations. The pathogenesis of MAFLD/NAFLD is closely related to insulin resistance (IR), and the genetic susceptibility to acquired metabolic stress-associated liver injury. Similarly, the gut microbiota in MAFLD/NAFLD is being revaluated by scientists, as the gut and liver influence each other via the gut-liver axis. Ferroptosis is a novel form of programmed cell death caused by iron-dependent lipid peroxidation. Emerging evidence suggests that ferroptosis has a key role in the pathological progression of MAFLD/NAFLD, and inhibition of ferroptosis may become a novel therapeutic strategy for the treatment of NAFLD. This review focuses on the main mechanisms behind the promotion of MAFLD/NAFLD occurrence and development by the intestinal microbiota and ferroptosis. It outlines new strategies to target the intestinal microbiota and ferroptosis to facilitate future MAFLD/NAFLD therapies.
代谢相关脂肪性肝病（MAFLD）是一种新的疾病定义，旨在取代先前的名称——非酒精性脂肪性肝病（NAFLD）。在全球范围内，MAFLD/NAFLD是最常见的肝脏疾病，在成年人群中的发病率为6%至35%。MAFLD/NAFLD的发病机制与胰岛素抵抗（IR）以及对获得性代谢应激相关肝损伤的遗传易感性密切相关。同样，MAFLD/NAFLD中的肠道微生物群正受到科学家们的重新评估，因为肠道和肝脏通过肠-肝轴相互影响。铁死亡是一种由铁依赖性脂质过氧化引起的新型程序性细胞死亡形式。新出现的证据表明，铁死亡在MAFLD/NAFLD的病理进展中起关键作用，抑制铁死亡可能成为治疗NAFLD的一种新的治疗策略。这篇综述重点关注肠道微生物群和铁死亡促进MAFLD/NAFLD发生发展的主要机制。它概述了针对肠道微生物群和铁死亡的新策略，以促进未来MAFLD/NAFLD的治疗。
