Innovative Therapeutic Approaches in Non-Alcoholic Fatty Liver Disease: When Knowing Your Patient Is Key.
Marta Alonso-PeñaMaria Del BarrioAna Peleteiro-VigilCarolina Jimenez-GonzalezAlvaro Santos-LasoMaria Teresa Arias-LostePaula IruzubietaJavier CrespoPublished in: International journal of molecular sciences (2023)
Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of disorders ranging from simple steatosis to non-alcoholic steatohepatitis (NASH). Hepatic steatosis may result from the dysfunction of multiple pathways and thus multiple molecular triggers involved in the disease have been described. The development of NASH entails the activation of inflammatory and fibrotic processes. Furthermore, NAFLD is also strongly associated with several extra-hepatic comorbidities, i.e., metabolic syndrome, type 2 diabetes mellitus, obesity, hypertension, cardiovascular disease and chronic kidney disease. Due to the heterogeneity of NAFLD presentations and the multifactorial etiology of the disease, clinical trials for NAFLD treatment are testing a wide range of interventions and drugs, with little success. Here, we propose a narrative review of the different phenotypic characteristics of NAFLD patients, whose disease may be triggered by different agents and driven along different pathophysiological pathways. Thus, correct phenotyping of NAFLD patients and personalized treatment is an innovative therapeutic approach that may lead to better therapeutic outcomes.
Keyphrases
- end stage renal disease
- chronic kidney disease
- metabolic syndrome
- cardiovascular disease
- peritoneal dialysis
- clinical trial
- newly diagnosed
- insulin resistance
- ejection fraction
- type diabetes
- blood pressure
- prognostic factors
- randomized controlled trial
- physical activity
- weight loss
- patient reported outcomes
- coronary artery disease
- high throughput
- uric acid
- case report
- liver fibrosis
- single molecule
- phase ii
- double blind