Gurjar Swasthika, Bhat A Ramanarayana, Upadhya Raghavendra, Shenoy Revathi P
Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, 576104, Manipal, India.
Manipal Centre for Biotherapeutics Research, Manipal, Manipal Academy of Higher Education, Karnataka, 576104, Manipal, India.
Lipids Health Dis. 2025 Jan 7;24(1):5. doi: 10.1186/s12944-024-02396-3.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is an asymptomatic, multifaceted condition often associated with various risk factors, including fatigue, obesity, insulin resistance, metabolic syndrome, and sleep apnea. The increasing burden of MASLD underscores the critical need for early diagnosis and effective therapies. Owing to the lack of efficient therapies for MASLD, early diagnosis is crucial. Consequently, noninvasive biomarkers and imaging techniques are essential for analyzing disease risk and play a pivotal role in the global diagnostic process. The use of extracellular vesicles has emerged as promising for early diagnosis and therapy of various liver ailments. Herein, a comprehensive summary of the current diagnostic modalities for MASLD is presented, highlighting their advantages and limitations while exploring the potential of extracellular vesicles (EVs) as innovative diagnostic and therapeutic tools for MASLD. With this aim, this review emphasizes an in-depth understanding of the origin of EVs and the pathophysiological alterations of these ectosomes and exosomes in various liver diseases. This review also explores the therapeutic potential of EVs as key components in the future management of liver disease. The dual role of EVs as biomarkers and their therapeutic utility in MASLD essentially highlights their clinical integration to improve MASLD diagnosis and treatment. While EV-based therapies are still in their early stages of development and require substantial research to increase their therapeutic value before they can be used clinically, the diagnostic application of EVs has been extensively explored. Moving forward, developing diagnostic devices leveraging EVs will be crucial in advancing MASLD diagnosis. Thus, the literature summarized provides suitable grounds for clinicians and researchers to explore EVs for devising diagnostic and treatment strategies for MASLD.
代谢功能障碍相关脂肪性肝病（MASLD）是一种无症状的多方面病症，常与多种风险因素相关，包括疲劳、肥胖、胰岛素抵抗、代谢综合征和睡眠呼吸暂停。MASLD日益加重的负担凸显了早期诊断和有效治疗的迫切需求。由于缺乏针对MASLD的有效治疗方法，早期诊断至关重要。因此，非侵入性生物标志物和成像技术对于分析疾病风险至关重要，并在全球诊断过程中发挥关键作用。细胞外囊泡的应用已成为各种肝脏疾病早期诊断和治疗的有前景方法。本文全面总结了目前MASLD的诊断方式，强调了它们的优点和局限性，同时探讨了细胞外囊泡（EVs）作为MASLD创新诊断和治疗工具的潜力。为此，本综述强调深入了解EVs的起源以及这些外泌体和微泡在各种肝脏疾病中的病理生理改变。本综述还探讨了EVs作为肝脏疾病未来管理关键组成部分的治疗潜力。EVs作为生物标志物的双重作用及其在MASLD中的治疗效用本质上突出了它们在改善MASLD诊断和治疗方面的临床整合。虽然基于EVs的治疗仍处于早期开发阶段，在临床应用前需要大量研究以提高其治疗价值，但EVs的诊断应用已得到广泛探索。展望未来，开发利用EVs的诊断设备对于推进MASLD诊断至关重要。因此，总结的文献为临床医生和研究人员探索EVs以制定MASLD的诊断和治疗策略提供了合适的依据。
