Department of Physiology and Pathophysiology, Tianjin Medical University, Tianjin 300070, China.
The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, Tianjin 300070, China.
World J Gastroenterol. 2023 Jan 7;29(1):75-95. doi: 10.3748/wjg.v29.i1.75.
Nonalcoholic fatty liver disease (NAFLD), a leading chronic disease worldwide, affects approximately a quarter of the global population. Nonalcoholic steatohepatitis (NASH) is an advanced form of NAFLD and is more likely to progress to liver fibrosis than simple steatosis. NASH is also identified as the most rapidly growing cause of hepatocellular carcinoma. Although in the past decade, several phase II/III clinical trials have shown promising results in the use of novel drugs targeting lipid synthase, farnesoid X receptor signaling, peroxisome proliferator-activated receptor signaling, hepatocellular injury, and inflammatory signaling, proven pharmaceutical agents to treat NASH are still lacking. Thus, continuous exploration of the mechanism underlying the pathogenesis of NAFLD and the identification of novel therapeutic targets remain urgent tasks in the field. In the current review, we summarize studies reported in recent years that not only provide new insights into the mechanisms of NAFLD development but also explore the possibility of treating NAFLD by targeting newly identified signaling pathways. We also discuss evidence focusing on the intrahepatic targets involved in the pathogenesis of NAFLD as well as extrahepatic targets affecting liver metabolism and function.
非酒精性脂肪性肝病(NAFLD)是一种全球主要的慢性疾病,影响着大约全球四分之一的人口。非酒精性脂肪性肝炎(NASH)是一种更为严重的 NAFLD 形式,比单纯性脂肪变性更容易进展为肝纤维化。NASH 也是肝细胞癌增长最快的原因之一。尽管在过去十年中,一些 II/III 期临床试验显示了新型药物靶向脂质合成酶、法尼醇 X 受体信号、过氧化物酶体增殖物激活受体信号、肝细胞损伤和炎症信号在治疗中的有前景的结果,但仍缺乏用于治疗 NASH 的已证实的药物。因此,持续探索 NAFLD 发病机制的机制和鉴定新的治疗靶点仍然是该领域的紧迫任务。在当前的综述中,我们总结了近年来的研究报告,这些研究不仅为 NAFLD 发展的机制提供了新的见解,还探讨了通过靶向新鉴定的信号通路治疗 NAFLD 的可能性。我们还讨论了重点关注参与 NAFLD 发病机制的肝内靶点以及影响肝脏代谢和功能的肝外靶点的证据。
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