非酒精性脂肪性肝炎目前和新出现的药物治疗的叙述性回顾。

IF 3 4区 医学 Q1 Medicine
Translational gastroenterology and hepatology Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI:10.21037/tgh-20-247
Jinendra Satiya, Heather S Snyder, Shivaram Prasad Singh, Sanjaya K Satapathy
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引用次数: 9

摘要

非酒精性脂肪性肝炎(NASH)是当今慢性肝病最常见的病因,现已成为需要肝移植的终末期肝病的主要病因。它是一种非酒精性脂肪性肝病的进行性形式,不仅可以发展为肝硬化和肝细胞癌(HCC),而且还与心血管风险增加有关。尽管对NASH发病和进展的危险因素和发病途径的了解取得了进展,但尚未开发出有效的NASH治疗方法。虽然包括饮食调整和体育锻炼在内的生活方式改变仍然是治疗的主要方法,但目前还没有满足开发一种药物或药物联合治疗的需求,这种药物或药物联合治疗不仅可以减少肝脏的脂肪浸润,还可以阻止纤维化的发展和进展,并阻止肝硬化和HCC的发展。正在开发的药物治疗针对被认为与非酒精性脂肪性肝病(NAFLD)/NASH发病机制有关的各种成分,包括胰岛素抵抗、脂质代谢氧化应激、脂质过氧化、炎症和细胞死亡途径以及纤维化。在这篇综述中,我们总结了NASH药物治疗的现状,并重点介绍了该领域的最新进展,以优化NASH的管理和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Narrative review of current and emerging pharmacological therapies for nonalcoholic steatohepatitis.

Nonalcoholic steatohepatitis (NASH) is the most common cause of chronic liver disease today, and it has now emerged as the leading etiology of end-stage liver disease requiring liver transplantation. It is a progressive form of non-alcoholic fatty liver disease which can not only progress to cirrhosis of liver and hepatocellular carcinoma (HCC), but is associated with increased cardiovascular risks too. Despite all the advances in the understanding of the risk factors and the pathogenetic pathways involved in the pathogenesis and progression of NASH, an effective therapy for NASH has not been developed yet. Although lifestyle modifications including dietary modifications and physical activity remain the mainstay of therapy, there is an unmet need to develop a drug or a combination of drugs which can not only reduce the fatty infiltration of the liver, but also arrest the development and progression of fibrosis and advancement to cirrhosis of liver and HCC. The pharmacologic therapies which are being developed target the various components believed to be involved in the pathogenesis of nonalcoholic fatty liver disease (NAFLD)/NASH which includes insulin resistance, lipid metabolism oxidative stress, lipid peroxidation, inflammatory and cell death pathways, and fibrosis. In this review, we summarize the current state of knowledge on pharmacotherapy of NASH, and also highlight the recent developments in the field, for optimizing the management and treatment of NASH.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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