School of Clinical Medical, Hubei University of Chinese Medicine, Wuhan 430000, PR China.
Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430070, PR China.
Clin Res Hepatol Gastroenterol. 2024 Oct;48(8):102458. doi: 10.1016/j.clinre.2024.102458. Epub 2024 Sep 2.
Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease associated with metabolic dysfunction, ranging from hepatic steatosis with or without mild inflammation to nonalcoholic steatohepatitis, which can rapidly progress to liver fibrosis and even liver cancer. In 2023, after several rounds of Delphi surveys, a new consensus recommended renaming NAFLD as metabolic dysfunction-associated steatotic liver disease (MASLD). Ninety-nine percent of NAFLD patients meet the new MASLD criteria related to metabolic cardiovascular risk factors under the "multiple parallel hits" of lipotoxicity, insulin resistance (IR), a proinflammatory diet, and an intestinal microbiota disorder, and previous research on NAFLD remains valid. The NLRP3 inflammasome, a well-known member of the pattern recognition receptor (PRR) family, can be activated by danger signals transmitted by pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), as well as cytokines involved in immune and inflammatory responses. The activation of the NLRP3 inflammasome pathway by MASLD triggers the production of the inflammatory cytokines IL-1β and IL-18. In MASLD, while changes in the composition and metabolites of the intestinal microbiota occur, the disrupted intestinal microbiota can also generate the inflammatory cytokines IL-1β and IL-18 by damaging the intestinal barrier, negatively regulating the liver on the gut-liver axis, and further aggravating MASLD. Therefore, modulating the gut-microbiota-liver axis through the NLRP3 inflammasome may emerge as a novel therapeutic approach for MASLD patients. In this article, we review the evidence regarding the functions of the NLRP3 inflammasome and the intestinal microbiota in MASLD, as well as their interactions in this disease.
非酒精性脂肪性肝病(NAFLD)是一种与代谢功能障碍相关的慢性肝病,其范围从伴有或不伴有轻度炎症的肝脂肪变性到非酒精性脂肪性肝炎,后者可迅速进展为肝纤维化甚至肝癌。2023 年,经过几轮 Delphi 调查,一项新的共识建议将 NAFLD 重新命名为代谢相关脂肪性肝病(MASLD)。99%的 NAFLD 患者符合代谢心血管危险因素的新 MASLD 标准,这与脂毒性、胰岛素抵抗(IR)、促炎饮食和肠道微生物失调的“多重平行打击”有关,以前关于 NAFLD 的研究仍然有效。NLRP3 炎性体是模式识别受体(PRR)家族的知名成员之一,它可以被病原体相关分子模式(PAMPs)和损伤相关分子模式(DAMPs)以及参与免疫和炎症反应的细胞因子传递的危险信号激活。MASLD 中 NLRP3 炎性体通路的激活触发了促炎细胞因子 IL-1β和 IL-18 的产生。在 MASLD 中,虽然肠道微生物群的组成和代谢物发生了变化,但被破坏的肠道微生物群也可以通过破坏肠道屏障产生促炎细胞因子 IL-1β和 IL-18,在肠-肝轴上对肝脏产生负面影响,并进一步加重 MASLD。因此,通过 NLRP3 炎性体调节肠道微生物群-肝轴可能成为 MASLD 患者的一种新的治疗方法。在本文中,我们回顾了 NLRP3 炎性体和肠道微生物群在 MASLD 中的作用及其在该疾病中的相互作用的证据。
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