Target Therapies for NASH/NAFLD: From the Molecular Aspect to the Pharmacological and Surgical Alternatives

Michele Finotti1, Maurizio Romano1, Pasquale Auricchio2

  • 14th Surgery Unit, Regional Hospital Treviso, DISCOG, University of Padua, 31100 Padua, Italy.

Insights

Non-alcoholic fatty liver disease (NAFLD) management requires personalized treatment strategies. This review covers new drug therapies, bariatric surgery, and liver transplant impacts for better NAFLD outcomes.

Area of Science:

  • Hepatology
  • Metabolic Syndrome Research
  • Transplantation Science

Background:

  • Non-alcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver disease.
  • NAFLD often coexists with metabolic syndrome and other comorbidities.
  • Current therapeutic options for NAFLD are diverse and can be complex to manage.

Purpose of the Study:

  • To review recent advancements in pharmacological therapies for NAFLD.
  • To evaluate the role of bariatric surgery in managing NAFLD.
  • To assess the impact of liver transplantation on NAFLD patient outcomes.

Main Methods:

  • Literature review of recent pharmacological target therapies for NAFLD.
  • Analysis of studies on bariatric surgery's efficacy in NAFLD.
  • Review of outcomes data for liver transplantation in NAFLD patients.

Main Results:

  • Emerging pharmacological therapies show promise for targeting NAFLD.
  • Bariatric surgery can significantly improve or resolve NAFLD in eligible patients.
  • Liver transplantation offers a viable option for end-stage NAFLD, improving survival.

Conclusions:

  • Patient stratification based on disease severity is crucial for tailoring NAFLD treatment.
  • A multidisciplinary approach integrating lifestyle, pharmacotherapy, surgery, and transplantation is key.
  • Continued research into targeted therapies and surgical interventions is vital for improving NAFLD management.

Related Concept Videos

Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
85
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
8.0K
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
60
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
46
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
627
Targets for Drug Action: Overview01:26

Targets for Drug Action: Overview

Drugs target macromolecules to modify ongoing cellular processes. Primary drug targets include receptors, ion channels, transporters, and enzymes.
Receptors are either membrane-spanning or intracellular proteins, which upon binding a ligand, get activated and transmit the signal downstream to elicit a response. Drugs bind receptors, either mimicking the action of endogenous ligands or blocking the receptor activity to bring about a modified response. Nearly 35% of approved drugs target the G...
8.3K