Chen Hanqing
Department of Gastroenterology and Hepatology, Guangzhou Digestive Disease Center, Guangzhou Key Laboratory of Digestive Diseases, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Liver Res. 2022 Sep 19;6(4):203-213. doi: 10.1016/j.livres.2022.09.003. eCollection 2022 Dec.
Non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease worldwide, and is closely associated with the increased risk of the prevalence of obesity and diabetes. NAFLD begins with the presence of >5% excessive lipid accumulation in the liver, and potentially develops into non-alcoholic steatohepatitis, fibrosis, cirrhosis and hepatocellular carcinoma. Therefore, insight into the pathogenesis of NAFLD is of key importance to its effective treatment. Iron is an essential element in the life of all mammalian organisms. However, the free iron deposition is positively associated with histological severity in NAFLD patients due to the production of reactive oxygen species via the Fenton reaction. Recently, several iron metabolism-targeted therapies, such as phlebotomy, iron chelators, nanotherapeutics. and ferroptosis, have shown their potential as a therapeutic option in the treatment of NAFLD and as a clinical strategy to intervene in the progression of NAFLD. Herein, we review the recent overall evidence on iron metabolism and provide the mechanism of hepatic iron overload-induced liver pathologies and the recent advances in iron metabolism-targeted therapeutics in the treatment of NAFLD.
非酒精性脂肪性肝病(NAFLD)已成为全球慢性肝病最常见的病因,并且与肥胖症和糖尿病患病率增加的风险密切相关。NAFLD始于肝脏中存在超过5%的过量脂质蓄积,并有可能发展为非酒精性脂肪性肝炎、纤维化、肝硬化和肝细胞癌。因此,深入了解NAFLD的发病机制对其有效治疗至关重要。铁是所有哺乳动物生命中的必需元素。然而,由于通过芬顿反应产生活性氧,游离铁沉积与NAFLD患者的组织学严重程度呈正相关。最近,几种针对铁代谢的疗法,如放血疗法、铁螯合剂、纳米疗法和铁死亡,已显示出它们作为治疗NAFLD的治疗选择以及作为干预NAFLD进展的临床策略的潜力。在此,我们综述了近期关于铁代谢的总体证据,并阐述了肝脏铁过载诱导肝脏病变的机制以及铁代谢靶向治疗在NAFLD治疗中的最新进展。