脂肪性肝病和癌症:从致病源到治疗点
Zhihong Yang1, Zhenjie Liu2, Wanqing Liu2,3
1Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
eGastroenterology
|October 16, 2025
概括
全球肝脏疾病由于环境变化和过度营养和酒精等生活方式因素而上升. 早期的肝细胞损伤,炎症和纤维化是脂肪性肝病 (SLD) 发展的关键因素,受遗传学和环境的影响.
科学领域:
- 肝病学和环境健康
- 分子和遗传流行病学.
- 肝脏疾病免疫学的免疫学
背景情况:
- 与环境暴露变化相关的代谢功能障碍相关的脂肪性肝病 (MASLD) 和与酒精相关的肝病 (ALD) 的全球患病率增加.
- 营养过度,久坐不动的生活方式和酒精消费是MASLD和ALD的主要驱动因素.
- 肝细胞损伤,炎症和纤维化是脂肪性肝病 (SLD) 发病的早期病理事件.
研究的目的:
- 审查肝脏疾病不断变化的情况.
- 讨论环境和遗传因素在SLD病变发生过程中的相互作用.
- 突出目前和新兴的SLD治疗策略.
主要方法:
- 文献综述综合了关于SLD的当前研究.
- 分析肝病发病率的流行病学趋势.
- 对SLD的遗传关联和环境风险因素的检查.
主要成果:
- 确定了与SLD特征相关的关键遗传变异 (例如PNPLA3,TM6SF2,MBOAT7,HSD17B13).
- 突出了免疫细胞 (中性粒细胞,库普弗细胞,巨细胞) 和肝星细胞在肝损伤和纤维化中的作用.
- 根据SLD病因学,注意到肝硬化和肝癌的病理差异.
结论:
- 预防和治疗策略必须解决SLD的因果和可修改因素.
- 新兴的治疗方法包括甲状腺激素受体β激动剂,GLP-1受体激动剂和FGF21类似物.
- 了解环境和遗传学的复杂相互作用对于管理全球肝病负担至关重要.
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