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解读17-β-羟基类固醇脱氢酶13:关于其在肝脂肪变性及相关疾病中作用的多方面视角

Decoding 17-Beta-hydroxysteroid Dehydrogenase 13: A Multifaceted Perspective on Its Role in Hepatic Steatosis and Associated Disorders.

作者信息

Demirtas Coskun Ozer, Yilmaz Yusuf

机构信息

Department of Gastroenterology, School of Medicine, Marmara University, İstanbul, Türkiye.

Institute of Gastroenterology, Marmara University, İstanbul, Türkiye.

出版信息

J Clin Transl Hepatol. 2024 Oct 28;12(10):857-864. doi: 10.14218/JCTH.2024.00257. Epub 2024 Sep 19.

Abstract

Chronic liver disease (CLD) represents a significant global health burden, with hepatic steatosis-associated disorders-such as metabolic dysfunction-associated steatohepatitis (MASH), alcoholic liver disease, and hepatitis C virus infection-being major contributors. Recent genome-wide association studies have identified the rs72613567:TA variant in the 17-beta-hydroxysteroid dehydrogenase 13 () gene as a protective factor against the development and progression of these conditions. In this review, we summarized the current evidence surrounding the rs72613567 variant, aiming to elucidate its impact on CLD risk and outcomes, and to explore the potential mechanisms behind its hepatoprotective effects. The rs72613567:TA variant induces a splice donor site mutation, resulting in a truncated, non-functional HSD17B13 protein. Numerous studies have demonstrated that this loss-of-function mutation confers protection against the development of cirrhosis and hepatocellular carcinoma (HCC) in patients with MASH, alcoholic liver disease, and hepatitis C virus infection. Moreover, the rs72613567:TA variant has been associated with reduced liver enzyme levels and improved survival in HCC patients. Integrating this variant into genetic risk scores has shown promise in predicting the progression of fatty liver disease to cirrhosis and HCC. Furthermore, inhibiting expression through RNA interference and small molecule inhibitors has emerged as a potential therapeutic strategy for MASH. However, the precise molecular mechanisms underlying the hepatoprotective effects of the rs72613567 variant remain to be fully elucidated. Future research should focus on clarifying the structure-function relationship of and its role in liver pathophysiology to facilitate the development of targeted therapies for CLD associated with hepatic steatosis.

摘要

慢性肝病(CLD)是一项重大的全球健康负担,肝脂肪变性相关疾病,如代谢功能障碍相关脂肪性肝炎(MASH)、酒精性肝病和丙型肝炎病毒感染,是主要促成因素。最近的全基因组关联研究已确定17-β-羟基类固醇脱氢酶13()基因中的rs72613567:TA变异是预防这些疾病发生和进展的保护因素。在本综述中,我们总结了围绕rs72613567变异的现有证据,旨在阐明其对CLD风险和结局的影响,并探索其肝脏保护作用背后的潜在机制。rs72613567:TA变异会引发剪接供体位点突变,导致截短的、无功能的HSD17B13蛋白。大量研究表明,这种功能丧失突变可预防MASH、酒精性肝病和丙型肝炎病毒感染患者发生肝硬化和肝细胞癌(HCC)。此外,rs72613567:TA变异与HCC患者肝酶水平降低和生存率提高有关。将该变异纳入遗传风险评分在预测脂肪性肝病进展为肝硬化和HCC方面已显示出前景。此外,通过RNA干扰和小分子抑制剂抑制表达已成为MASH的一种潜在治疗策略。然而rs72613567变异肝脏保护作用的确切分子机制仍有待充分阐明。未来的研究应集中于阐明的结构-功能关系及其在肝脏病理生理学中的作用,以促进针对与肝脂肪变性相关的CLD的靶向治疗的开发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d8/11491501/a49a46c8246c/JCTH-12-857-g001.jpg

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