Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, 8380453, Chile.
Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, 8380453, Chile.
Mol Nutr Food Res. 2024 Apr;68(7):e2400062. doi: 10.1002/mnfr.202400062. Epub 2024 Mar 20.
Obesity is a global health issue characterized by the excessive fat accumulation, leading to an increased risk of chronic noncommunicable diseases (NCDs), including metabolic dysfunction-associated fatty liver disease (MAFLD), which can progress from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Currently, there are no approved pharmacological protocols for prevention/treatment of MAFLD, and due the complexity lying beneath these mechanisms, monotherapies are unlikely to be efficacious. This review article analyzes the possibility that NCDs can be prevented or attenuated by the combination of bioactive substances, as they could promote higher response rates, maximum reaction results, additive or synergistic effects due to compounds having similar or different mechanisms of action and/or refraining possible side effects, related to the use of lower doses and exposures times than monotherapies. Accordingly, prevention of mouse MAFLD is observed with the combination of the omega-3 docosahexaenoic acid with the antioxidant hydroxytyrosol, whereas attenuation of mild cognitive impairment is attained by folic acid plus cobalamin in elderly patients. The existence of several drawbacks underlying published monotherapies or combined trials, opens space for adequate and stricter experimental and clinical tryouts to achieve meaningful outcomes with human applicability.
肥胖是一种全球性的健康问题,其特征是脂肪过度积累,导致慢性非传染性疾病(NCDs)的风险增加,包括代谢功能障碍相关脂肪性肝病(MAFLD),其可从单纯脂肪变性进展为脂肪性肝炎、纤维化、肝硬化和肝细胞癌。目前,尚无批准用于预防/治疗 MAFLD 的药理学方案,由于这些机制背后的复杂性,单药治疗不太可能有效。本文综述分析了将生物活性物质联合使用以预防或减轻 NCD 的可能性,因为它们可以因化合物具有相似或不同的作用机制和/或避免与使用单药治疗相关的可能的副作用而产生更高的反应率、最大反应结果、相加或协同作用。因此,通过将 ω-3 二十二碳六烯酸与抗氧化剂羟基酪醇联合使用,可以预防小鼠 MAFLD;而通过在老年患者中使用叶酸加钴胺素,可以减轻轻度认知障碍。由于发表的单药治疗或联合试验存在一些缺陷,因此需要进行充分和更严格的实验和临床尝试,以实现对人类有意义的结果。