Hepatology and Molecular Medicine Lab, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamil Nadu, India.
Department of Biomedical Science, Science Campus, Alagappa University, Karaikudi, Tamil Nadu, India.
Cell Biochem Funct. 2024 Sep;42(7):e4112. doi: 10.1002/cbf.4112.
Numerous studies highlight the potential of natural antioxidants, such as those found in foods and plants, to prevent or treat nonalcoholic fatty liver disease (NAFLD). Inflammation is a key factor in the progression from high-fat diet-induced NAFLD to nonalcoholic steatohepatitis (NASH). Injured liver cells and immune cells release inflammatory cytokines, activating hepatic stellate cells. These cells acquire a profibrogenic phenotype, leading to extracellular matrix accumulation and fibrosis. Persistent fibrosis can progress to cirrhosis. Fatty infiltration, oxidative stress, and inflammation exacerbate fatty liver diseases. Thus, many plant-derived antioxidants, like silymarin, silibinin, curcumin, resveratrol, berberine, and quercetin, have been extensively studied in experimental models and clinical patients with NAFLD. Experimentally, these compounds have shown beneficial effects in reducing lipid accumulation, oxidative stress, and inflammatory markers by modulating the ERK, NF-κB, AMPKα, and PPARγ pathways. They also help decrease metabolic endotoxemia, intestinal permeability, and gut inflammation. Clinically, silymarin and silibinin have been found to reduce transaminase levels, while resveratrol and curcumin help alleviate inflammation in NAFLD patients. However, these phytocompounds exhibit poor water solubility, leading to low oral bioavailability and hindering their biological efficacy. Additionally, inconclusive clinical results highlight the need for further trials with larger populations, longer durations, and standardized protocols.
许多研究强调了天然抗氧化剂的潜力，如食物和植物中的抗氧化剂，可预防或治疗非酒精性脂肪性肝病（NAFLD）。炎症是非酒精性脂肪性肝炎（NASH）从高脂肪饮食诱导的非酒精性脂肪肝进展的关键因素。受损的肝细胞和免疫细胞释放炎症细胞因子，激活肝星状细胞。这些细胞获得成纤维表型，导致细胞外基质积累和纤维化。持续的纤维化可进展为肝硬化。脂肪浸润、氧化应激和炎症会加重脂肪肝疾病。因此，许多植物来源的抗氧化剂，如水飞蓟素、水飞蓟宾、姜黄素、白藜芦醇、小檗碱和槲皮素，已在非酒精性脂肪性肝病的实验模型和临床患者中进行了广泛研究。在实验中，这些化合物通过调节 ERK、NF-κB、AMPKα 和 PPARγ 途径，显示出减少脂质积累、氧化应激和炎症标志物的有益作用。它们还有助于减少代谢性内毒素血症、肠道通透性和肠道炎症。临床上，水飞蓟素和水飞蓟宾已被发现可降低转氨酶水平，而白藜芦醇和姜黄素有助于缓解非酒精性脂肪性肝病患者的炎症。然而，这些植物化合物的水溶性较差，导致口服生物利用度低，阻碍了它们的生物学疗效。此外，不一致的临床结果强调需要进行更大人群、更长时间和标准化方案的进一步试验。
