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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2023; 29(32): 4831-4850
Published online Aug 28, 2023. doi: 10.3748/wjg.v29.i32.4831
Non-alcoholic fatty liver disease: Immunological mechanisms and current treatments
Lucy Petagine, Mohammed Gulrez Zariwala, Vinood B Patel
Lucy Petagine, Mohammed Gulrez Zariwala, Vinood B Patel, Centre for Nutraceuticals, School of Life Sciences, University of Westminster, London W1W6UW, United Kingdom
Author contributions: Petagine L performed the literature search, wrote the original draft, designed the figures, and reviewed and edited the final manuscript; Patel VB reviewed and edited the final manuscript; Zariwala MG reviewed and edited the final manuscript; All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vinood B Patel, FRSC, PhD, Professor, Centre for Nutraceuticals, School of Life Sciences, University of Westminster, No. 115 New Cavendish Street, London W1W6UW, United Kingdom. v.b.patel@westminster.ac.uk
Received: May 3, 2023
Peer-review started: May 3, 2023
First decision: June 14, 2023
Revised: July 14, 2023
Accepted: August 7, 2023
Article in press: August 7, 2023
Published online: August 28, 2023
Processing time: 114 Days and 0 Hours
Abstract

Non-alcoholic fatty liver disease (NAFLD) causes significant global disease burden and is a leading cause of mortality. NAFLD induces a myriad of aberrant changes in hepatocytes at both the cellular and molecular level. Although the disease spectrum of NAFLD is widely recognised, the precise triggers for disease progression are still to be fully elucidated. Furthermore, the propagation to cirrhosis is poorly understood. Whilst some progress in terms of treatment options have been explored, an incomplete understanding of the hepatic cellular and molecular alterations limits their clinical utility. We have therefore reviewed some of the key pathways responsible for the pathogenesis of NAFLD such as innate and adaptative immunity, lipotoxicity and fibrogenesis, and highlighted current trials and treatment options for NAFLD patients.

Keywords: Liver; Fat; Inflammation; Mitochondria; Immune system

Core Tip: Non-alcoholic fatty liver disease (NAFLD) is a significant global disease burden and a leading cause of mortality causing aberrant changes in hepatocytes. Although the disease spectrum is widely recognised, precise triggers for disease progression remain poorly understood. Whilst some progress has evolved in terms of treatment, there are still no approved pharmacological therapies for NAFLD treatment due to the incomplete understanding of the hepatic cellular and molecular alterations in disease pathogenesis.