Innovative Therapeutic Approaches in Non-Alcoholic Fatty Liver Disease: When Knowing Your Patient Is Key

• Published in: International journal of molecular sciences Vol. 24; no. 13; p. 10718
• Main Authors: Alonso-Peña, Marta, Del Barrio, Maria, Peleteiro-Vigil, Ana, Jimenez-Gonzalez, Carolina, Santos-Laso, Alvaro, Arias-Loste, Maria Teresa, Iruzubieta, Paula, Crespo, Javier
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27-06-2023; MDPI
• Subjects: Cardiovascular disease; Cardiovascular diseases; Chronic kidney failure; Clinical trials; Comorbidity; Development and progression; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Fatty liver; Genotype & phenotype; Health aspects; Health services; Heterogeneity; Histology; Humans; Hypertension; Inflammation; Insulin resistance; Kidney diseases; Liver; Liver cancer; Liver cirrhosis; Liver diseases; Medical innovations; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - complications; Metabolism; Mortality; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - therapy; Pathophysiology; patient phenotyping; Patients; personalized medicine; Phenotyping; Regulatory approval; Review; Signal transduction; steatohepatitis; Steatosis; Type 2 diabetes; steatohepatitis; fatty liver; patient phenotyping; personalized medicine
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms241310718

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of disorders ranging from simple steatosis to non-alcoholic steatohepatitis (NASH). Hepatic steatosis may result from the dysfunction of multiple pathways and thus multiple molecular triggers involved in the disease have been described. The development of NASH entails the activation of inflammatory and fibrotic processes. Furthermore, NAFLD is also strongly associated with several extra-hepatic comorbidities, i.e., metabolic syndrome, type 2 diabetes mellitus, obesity, hypertension, cardiovascular disease and chronic kidney disease. Due to the heterogeneity of NAFLD presentations and the multifactorial etiology of the disease, clinical trials for NAFLD treatment are testing a wide range of interventions and drugs, with little success. Here, we propose a narrative review of the different phenotypic characteristics of NAFLD patients, whose disease may be triggered by different agents and driven along different pathophysiological pathways. Thus, correct phenotyping of NAFLD patients and personalized treatment is an innovative therapeutic approach that may lead to better therapeutic outcomes.