遗传证据表明,FGF21信号减少了问题性酒精使用和与酒精有关的肝病
Daniel B Rosoff1, Josephin Wagner2, Tyler Perlstein2
1Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA; NIH-Oxford-Cambridge Scholars Program, University of Oxford, UK; Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
Journal of hepatology
|February 26, 2026
概括
遗传证据表明,纤维细胞生长因子21 (FGF21) 的类似物可以通过行为和代谢变化来减少有问题的酒精使用和与酒精有关的肝病 (ARLD). 这些发现支持FGF21的研究结果.
科学领域:
- 遗传学和精准医学 遗传学和精准医学
- 代谢和肝脏疾病
- 酒精使用障碍 治疗方法
背景情况:
- 纤维细胞生长因子21 (FGF21) 的类似物正在开发中,用于与代谢功能障碍相关的脂肪性肝病 (MASLD).
- 关于FGF21对问题性酒精使用 (PAU),酒精使用障碍 (AUD),过度饮酒和与酒精有关的肝病 (ARLD) 的影响仍然未被描述.
- 对于AUD和ARLD存在有限的药物治疗方法,这突出了严重的未满足需求.
研究的目的:
- 研究基因预测的FGF21水平对PAU,AUD,过度饮酒和ARLD的影响.
- 将FGF21与其他MASLD目标 (PNPLA3,TM6SF2,HSD17B13) 对与酒精有关的结果的影响进行比较.
- 探索FGF21在与酒精有关的疾病中的潜在途径和潜在安全概况.
主要方法:
- 利用了来自多个大队伍的全基因组关联研究 (GWAS) 数据 (英国生物银行,FinnGen,百万退伍军人计划,GenomALC).
- 采用多变量门德尔随机化 (MVMR) 和调解分析来评估FGF21的因果作用和途径.
- 进行了对MASLD/ARLD遗传点的比较MR,受体集中MR (KLB,FGFRs) 和全现象MR的安全性评估.
主要成果:
- 较高的基因预测FGF21与明显较低的PAU,减少饮酒频率,更少的暴饮暴食事件和降低ARLD风险有关.
- MVMR和调解分析表明,这些影响是由行为途径 (减少饮酒,改善饮食) 和基础代谢率的增加调解的.
- 与PNPLA3和HSD17B13相比,肝脏FGF21表达显示出对PAU和ARLD的更强的保护作用,其中涉及大脑区域 (海马体,基底腺) 和1,022个特征的有利安全概况.
结论:
- 人类遗传证据强烈支持FGF21类似物作为减轻危险饮酒和ARLD的潜在治疗策略.
- FGF21表现出双重作用机制,影响行为和代谢途径,使其与其他MASLD标区别开来.
- 结果支持在AUD和ARLD的临床试验中重新使用FGF21类型,有可能对遗传分层患者进行选择.
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