Chinese Medicine for Non-Alcoholic Fatty Liver Disease: Targeting Key Signaling Pathways

Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatocellular injury, inflammation and fibrosis, which result from the accumulation of hepatic lipids. As one of the most prevalent chronic liver diseases globally, its pathogenesis remains complex. With the improvement in living standards, the incidence of NAFLD is expected to rise, drawing increasing attention to its development, prevention, and treatment from researchers worldwide. Currently, the therapeutic progress achieved by Western medicine in treating NAFLD remains limited, and its clinical efficacy is unsatisfactory. In contrast, Chinese medicine has a long history in the treatment of NAFLD, and possesses such advantages as fewer side effects, and multi-component, multi-target, and multi-pathway therapeutic actions. In recent years, several studies have demonstrated that Chinese medicine can modulate the progression of NAFLD by regulating relevant signaling pathways both in vivo and in vitro. However, comprehensive reviews on this topic remain scarce. Therefore, in this paper, a literature search was conducted using PubMed and Web of Science to summarize key signaling pathways implicated in Chinese medicine-mediated interventions in NAFLD, including AMPK, mTOR, PI3K/Akt, Toll-like receptor, NF-[Formula: see text]B, and MAPK pathways. Furthermore, the specific anti-NAFLD mechanisms of these pathways were elaborated. The objective of this paper is to provide an overview of the effective therapeutic pathways and mechanisms associated with Chinese medicine in the treatment of NAFLD, and to thereby offer a theoretical foundation and innovative perspectives for future research and clinical applications.