在肝纤维化治疗当前和未来的前景
Lucia Cerrito1,2, Linda Galasso1, Jacopo Iaccarino1
1Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy.
Pharmaceuticals (Basel, Switzerland)
|September 27, 2025
概括
新兴的肝纤维化治疗方法,包括胆汁酸和微生物群导向疗法,有望扭转肝损伤. 需要进一步的研究来为患者建立安全有效的抗纤维菌策略.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 药理学和治疗学 药理学和治疗学
- 微生物组研究 微生物组研究
背景情况:
- 肝纤维化是一个重大的全球健康负担,从慢性肝损伤发展为肝硬化和肝癌.
- 肝星细胞 (HSC) 的激活和转化生长因子-β (TGF-β) 信号驱动纤维化.
- 目前的治疗方法往往会阻止病变的进展,但很少逆转已经确定的肝纤维化.
研究的目的:
- 审查目前和新兴的肝纤维化治疗策略.
- 为临床实践提供信息,并指导未来对抗纤维菌治疗的研究.
- 探索药理学,微生物群导向和创新的治疗方式.
主要方法:
- 进行了临床前和临床证据的叙述综合.
- 专注于药理学药物,基于微生物群的干预措施和新的治疗方法.
- 该审查考虑了抗纤维素活性的证据.
主要成果:
- 胆酸和Farnesoid X受体 (FXR) 激动剂表现出抗纤维素作用,但具有局限性.
- 脂肪酸合成酶抑制剂在代谢功能障碍相关的脂肪肝炎 (MASH) 中表现有前途.
- 微生物群导向干预正在出现,需要更大的临床试验;非侵入性生物标志物和适应性试验设计至关重要.
结论:
- 包括免疫疗法,基因编辑和多向药物的新疗法为纤维化逆转提供了潜力.
- 持续的翻译性研究对于开发安全,有效和可获得的肝纤维化治疗是必不可少的.
- 解决肠肝轴和利用先进的试验设计是未来的关键方向.
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