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NAFLD 中的炎症和纤维化机制——对新治疗策略的启示

英文原题:Inflammatory and fibrotic mechanisms in NAFLD-Implications for new treatment strategies.

PubMed 2021/09/26(内容时间) J Intern Med Q1 · IF 7.6(JCR 2025)

研究概要

非酒精性脂肪性肝病包括单纯性脂肪变性(非酒精性脂肪肝)或更晚期的炎症和纤维化阶段(非酒精性脂肪性肝炎[NASH])。

中文摘要

非酒精性脂肪性肝病包括单纯性脂肪变性(非酒精性脂肪肝)或更晚期的炎症和纤维化阶段(非酒精性脂肪性肝炎[NASH])。NASH影响着全球日益增多的成人和儿童人群,导致肝纤维化和肝细胞癌发病率不断上升。NASH是一种多因素疾病,是全身性代谢紊乱的一部分。在此,我们概述了NASH发病机制的代谢基础以及炎症和纤维化的既定驱动因素。由于目前尚无获批疗法,阐明潜在的纤维化和炎症机制将推动新型治疗策略的开发。我们讨论了新兴的实验方法以及源自动物模型的潜在新型研究策略,包括炎症小体、表观遗传重编程、Hippo信号通路、Notch信号通路、工程化T细胞清除纤维化HSC以及HSC特异性靶向治疗。本文还讨论了近期已完成和正在进行的临床试验及抗纤维化药物,表明人们日益期待在未来几年内一种或多种疗法将在NASH中产生临床获益。

展开英文摘要原文

Non-alcoholic fatty liver disease is comprised of either simple steatosis (non-alcoholic fatty liver) or a more advanced inflammatory and fibrogenic stage (non-alcoholic steatohepatitis [NASH]). NASH affects a growing proportion of the global adult and pediatric population, leading to rising rates of liver fibrosis and hepatocellular carcinoma. NASH is a multifactorial disease that is part of a systemic metabolic disorder. Here, we provide an overview of the metabolic underpinnings of NASH pathogenesis and established drivers of inflammation and fibrosis. Clarification of underlying fibrogenic and inflammatory mechanisms will advance the development of novel treatment strategies as there are no approved therapies at present. We discuss emerging experimental approaches and potential novel investigational strategies derived from animal models including the inflammasome, epigenetic reprogramming, Hippo signaling, Notch signaling, engineered T cells to remove fibrogenic HSCs, and HSC-specific targeting therapies. Recently completed and ongoing clinical trials and antifibrotics are discussed, illuminating the growing expectation that one or more therapies will yield clinical benefit in NASH in the coming years.

论文信息

作者
Lee YA、Friedman SL
第一作者单位
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.United States
通讯作者单位
Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.United States
文献类型
综述
期刊
Journal of internal medicine2022 Jan
原文标识
PubMed 34564899 · DOI 10.1111/joim.13380