Khurana Amit, Hartmann Phillipp
Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, United States.
World J Gastroenterol. 2025 Jul 21;31(27):109105. doi: 10.3748/wjg.v31.i27.109105.
Alcohol-associated liver disease, metabolic dysfunction-associated steatotic liver disease, and metabolic dysfunction-associated steatohepatitis are chronic liver diseases (CLDs) driven by metabolic dysregulation, immune dysfunction, and gut microbiome alterations. Current treatments are inadequate and provide only symptomatic relief in most cases, underscoring the urgent need for forward-looking approaches. The disturbances in gut and liver communication contribute towards disease progression, making microbiome-based therapeutic strategies an area of growing interest. Nanoparticles have emerged as a powerful tool for drug delivery with high targetability, stability, and targeted release. Further, artificial intelligence offers a transformative approach by accelerating nanoparticle design, optimizing microbial therapy formulations, predicting treatment responses, and personalizing interventions based on patient-specific microbiota compositions. Herein, we give an overview of important liver diseases, key nanocarrier types, and the approaches wherein nanocarriers have been integrated to modulate gut microbiota for the therapy of CLDs. We also describe future directions and the challenges, which need to be overcome for wide scale application and tailored use of gut microbiome-focused nano-drug delivery carriers for the therapy of CLDs. Despite current hurdles, the integration of nanotechnology, microbiome therapeutics, and artificial intelligence-driven precision medicine holds immense promise for reshaping the treatment landscape of CLDs.
酒精性肝病、代谢功能障碍相关脂肪性肝病和代谢功能障碍相关脂肪性肝炎是由代谢失调、免疫功能障碍和肠道微生物群改变驱动的慢性肝病(CLD)。目前的治疗方法并不充分,在大多数情况下只能缓解症状,这凸显了采用前瞻性方法的迫切需求。肠道与肝脏之间通讯的紊乱会促进疾病进展,这使得基于微生物群的治疗策略成为一个越来越受关注的领域。纳米颗粒已成为一种强大的药物递送工具,具有高靶向性、稳定性和靶向释放能力。此外,人工智能提供了一种变革性方法,可加速纳米颗粒设计、优化微生物治疗配方、预测治疗反应,并根据患者特定的微生物群组成进行个性化干预。在此,我们概述了重要的肝脏疾病、关键的纳米载体类型,以及将纳米载体整合用于调节肠道微生物群以治疗CLD的方法。我们还描述了未来的方向和挑战,要广泛应用和定制使用以肠道微生物群为重点的纳米药物递送载体来治疗CLD,这些挑战需要被克服。尽管目前存在障碍,但纳米技术、微生物群治疗和人工智能驱动的精准医学的整合,对于重塑CLD的治疗格局具有巨大的前景。