Perspectives on Precision Medicine Approaches to NAFLD Diagnosis and Management
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In this article, the authors focus on how sex and reproductive status, genetics, intestinal microbiota diversity, endocrine and metabolic status, as well as physical activity may interact in determining NAFLD/MAFLD heterogeneity.Abstract:
Precision medicine defines the attempt to identify the most effective approaches for specific subsets of patients based on their genetic background, clinical features, and environmental factors. Nonalcoholic fatty liver disease (NAFLD) encompasses the alcohol-like spectrum of liver disorders (steatosis, steatohepatitis with/without fibrosis, and cirrhosis and hepatocellular carcinoma) in the nonalcoholic patient. Recently, disease renaming to MAFLD [metabolic (dysfunction)-associated fatty liver disease] and positive criteria for diagnosis have been proposed. This review article is specifically devoted to envisaging some clues that may be useful to implementing a precision medicine-oriented approach in research and clinical practice. To this end, we focus on how sex and reproductive status, genetics, intestinal microbiota diversity, endocrine and metabolic status, as well as physical activity may interact in determining NAFLD/MAFLD heterogeneity. All these factors should be considered in the individual patient with the aim of implementing an individualized therapeutic plan. The impact of considering NAFLD heterogeneity on the development of targeted therapies for NAFLD subgroups is also extensively discussed.read more
Citations
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Insights into the molecular targets and emerging pharmacotherapeutic interventions for nonalcoholic fatty liver disease.
TL;DR: In this paper, a review summarizes the current understanding of the pathogenic mechanisms of NAFLD and provides an insight into the pharmacological targets and emerging therapeutics with specific interventional mechanisms.
Journal ArticleDOI
Insights into the molecular targets and emerging pharmacotherapeutic interventions for nonalcoholic fatty liver disease
TL;DR: In this article , a review summarizes the current understanding of the pathogenic mechanisms of NAFLD and provides an insight into the pharmacological targets and emerging therapeutics with specific interventional mechanisms.
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Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity.
Marco Arrese,Juan Pablo Arab,Francisco Barrera,Benedikt Kaufmann,Luca Valenti,Ariel E. Feldstein +5 more
TL;DR: In this paper, a review of existing data on the differential contribution of known factors to the pathogenesis and clinical expression of NAFLD, thus determining the different clinical subphenotypes observed in practice.
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Non-Alcoholic Steatohepatitis Drug Development Pipeline: An Update.
TL;DR: In this review, several of the therapeutic agents that have been studied in phase 2 and 3 randomized trials are summarized and the rationale behind the use of combination therapy and the lessons learned from unsuccessful or negative clinical trials are discussed.
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Nonalcoholic Fatty Liver Disease and Endocrine Axes—A Scoping Review
Madalena Von-Hafe,Marta Borges-Canha,Catarina Vale,Ana Rita Leite,João Sérgio Neves,Davide Carvalho,Adelino F. Leite-Moreira +6 more
TL;DR: It appears likely that there is a link between several endocrine disorders and NAFLD other than the typically known type 2 diabetes mellitus and metabolic syndrome (MS).
References
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TL;DR: This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care.
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NAFLD: A multisystem disease
TL;DR: A narrative review focuses on the rapidly expanding body of clinical evidence that supports the concept of NAFLD as a multisystem disease and the factors linkingNAFLD with other extra-hepatic chronic diseases, such as T2DM, CVD, cardiac diseases and CKD.