Evolving therapies for non-alcoholic steatohepatitis

Area of Science:

• Hepatology
• Gastroenterology
• Pharmacology

Background:

• Non-alcoholic fatty liver disease (NAFLD) is a global health concern with limited approved therapies.
• Pathophysiological understanding has advanced, identifying insulin resistance, inflammation, and microbiota as key factors.
• A significant portion of NAFLD cases progress to non-alcoholic steatohepatitis (NASH), necessitating effective treatments.

Purpose of the Study:

• To review and highlight the most promising current treatment strategies for NASH and NAFLD.
• To discuss emerging therapeutic targets based on recent pathophysiological insights.

Main Methods:

• Literature review of current research on NAFLD and NASH treatments.
• Analysis of pathophysiological pathways and their relevance to therapeutic development.

Main Results:

• Existing treatments like pioglitazone and vitamin E show some efficacy but are insufficient for long-term management.
• Emerging therapeutic candidates target metabolic inflammation, glucose, and lipid metabolism.

Conclusions:

• NAFLD treatment is in early stages, requiring long-term strategies beyond lifestyle changes.
• Novel agents targeting farnesoid X receptor, peroxisome proliferator-activated receptor, and AdipoR show potential for NAFLD/NASH treatment.