期刊
JHEP REPORTS
卷 3, 期 3, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.jhepr.2021.100284
关键词
alcoholic liver disease; cirrhosis; fatty liver disease; genetics; IL32; interleukin-32; MBOAT7; non-alcoholic fatty liver disease; precision medicine; PNPLA3; steatohepatitis; therapy
资金
- MyFirst Grant AIRC [16888]
- Ricerca Finalizzata Ministero della Salute [RF-2016-02364358]
- Ricerca corrente Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- European Union (EU) Programme Horizon 2020 Programme Photonics [101016726]
- Innovative Medicines Initiative 2 joint undertaking of European Union's Horizon 2020 research and innovation programme
- EFPIA [777377]
- Fondazione IRCCS Ca' Granda Liver BIBLE [PR-0391]
- Fondazione IRCCS Ca' Granda core COVID-19 Biobank [RC100017A]
Fatty liver disease can be caused by a combination of factors such as excess alcohol consumption, dysmetabolism, and environmental cues, leading to steatohepatitis and potentially severe liver conditions like liver failure and hepatocellular carcinoma. Recent genetic discoveries have shed light on the causes of steatohepatitis, opening up new possibilities for more targeted risk assessment and potential therapeutic developments. This knowledge could pave the way for precision medicine approaches tailored to individuals at higher risk of liver diseases.
Fatty liver disease can be triggered by a combination of excess alcohol, dysmetabolism and other environmental cues, which can lead to steatohepatitis and can evolve to acute/chronic liver failure and hepatocellular carcinoma, especially in the presence of shared inherited determinants. The recent identification of the genetic causes of steatohepatitis is revealing new avenues for more effective risk stratification. Discovery of the mechanisms underpinning the detrimental effect of causal mutations has led to some breakthroughs in the comprehension of the pathophysiology of steatohepatitis. Thanks to this approach, hepatocellular fat accumulation, altered lipid droplet remodelling and lipotoxicity have now taken centre stage, while the role of adiposity and gut-liver axis alterations have been independently validated. This process could ignite a virtuous research cycle that, starting from human genomics, through omics approaches, molecular genetics and disease models, may lead to the development of new therapeutics targeted to patients at higher risk. Herein, we also review how this knowledge has been applied to: a) the study of the main PNPLA3 I148M risk variant, up to the stage of the first in-human therapeutic trials; b) highlight a role of MBOAT7 downregulation and lysophosphatidyl-inositol in steatohepatitis; c) identify IL-32 as a candidate mediator linking lipotoxicity to inflammation and liver disease. Although this precision medicine drug discovery pipeline is mainly being applied to non-alcoholic steatohepatitis, there is hope that successful products could be repurposed to treat alcohol-related liver disease as well. (C) 2021 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
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