Mechanisms of NAFLD development and therapeutic strategies.

Mechanisms of NAFLD development and therapeutic strategies.
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DOI:
10.1038/s41591-018-0104-9
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发表时间:
2018-07
期刊:
影响因子:
82.9
通讯作者:
Sanyal AJ
Sanyal AJ
中科院分区:
医学1区
文献类型:
--
作者:
Friedman SL;Neuschwander-Tetri BA;Rinella M;Sanyal AJ

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非酒精性脂肪性肝病(NAFLD)的患病率一直在上升,与全球糖尿病和代谢综合征的增加并行。NAFLD是从非酒精性脂肪肝(NAFL)到非酒精性脂肪性肝炎(NASH)的一系列肝脏异常,具有可变的病程,但可导致肝硬化和肝癌。在这里,我们回顾了NAFLD的致病和临床特征,其主要的合并症,临床进展和并发症的风险,以及NAFLD的体外和动物模型,使治疗靶点的改进能够加速药物开发。我们还讨论了临床试验设计的演变原则,以评估药物疗效和药物开发的新兴目标,涉及单一药物或联合治疗,旨在阻止或逆转疾病进展。
There has been a rise in the prevalence of nonalcoholic fatty liver disease (NAFLD), paralleling a worldwide increase in diabetes and metabolic syndrome. NAFLD, a continuum of liver abnormalities from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), has a variable course but can lead to cirrhosis and liver cancer. Here we review the pathogenic and clinical features of NAFLD, its major comorbidities, clinical progression and risk of complications and in vitro and animal models of NAFLD enabling refinement of therapeutic targets that can accelerate drug development. We also discuss evolving principles of clinical trial design to evaluate drug efficacy and the emerging targets for drug development that involve either single agents or combination therapies intended to arrest or reverse disease progression.
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发表时间: 2017-10
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