Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2025; 31(3): 98783
Published online Jan 21, 2025. doi: 10.3748/wjg.v31.i3.98783
Elafibranor: A promising therapeutic approach for liver fibrosis and gut barrier dysfunction in alcohol-associated liver disease
Chun-Han Cheng, Wen-Rui Hao, Tzu-Hurng Cheng
Chun-Han Cheng, Department of Medical Education, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
Wen-Rui Hao, Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei City 23561, Taiwan
Wen-Rui Hao, Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11002, Taiwan
Tzu-Hurng Cheng, Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, Taichung 404328, Taiwan
Co-corresponding authors: Wen-Rui Hao and Tzu-Hurng Cheng.
Author contributions: Cheng CH, Hao WR, and Cheng TH have contributed to this article; Cheng CH and Hao WR primarily responsible for writing; Cheng TH overseeing revisions; Hao WR and Cheng TH refined the final manuscript in their respective areas of specialization, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest 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: Tzu-Hurng Cheng, PhD, Professor, Department of Biochemistry, School of Medicine, College of Medicine, China Medical University, No. 91 Xueshi Road, North District, Taichung 404328, Taiwan. thcheng@mail.cmu.edu.tw
Received: July 5, 2024
Revised: November 18, 2024
Accepted: December 2, 2024
Published online: January 21, 2025
Processing time: 167 Days and 20 Hours
Abstract

This article discusses the recent study written by Koizumi et al. Alcohol-associated liver disease (ALD) is a major cause of liver-related morbidity and mortality, which is driven by complex mechanisms, including lipid accumulation, apoptosis, and inflammatory responses exacerbated by gut barrier dysfunction. The study explored the therapeutic potential of elafibranor, a dual peroxisome proliferator-activated receptor alpha/delta agonist. In clinical trials, elafibranor has shown promise for the treatment of other liver conditions; however, its effects on ALD remain unclear. The authors’ findings indicate that elafibranor significantly reduced liver fibrosis and enhanced gut barrier integrity in patients with ALD. These positive effects of elafibranor are mediated through multiple pathways. Elafibranor promotes lipid metabolism, reduces oxidative stress, and inhibits inflammatory responses by restoring gut barrier function. Specifically, it improves hepatocyte function by enhancing autophagic and antioxidant capacity, and it mitigates inflammation by suppressing the lipopolysaccharide/toll-like receptor 4/nuclear factor kappa B signaling pathway. These findings indicate that elafibranor has promising clinical applications. In addition, the study highlights elafibranor’s potential as a therapeutic agent for liver diseases, particularly ALD. This article underscores the importance of understanding the mechanistic pathways underlying ALD and suggests directions for future research aimed at elucidating the benefits and limitations of elafibranor.

Keywords: Elafibranor; Liver fibrosis; Gut barrier function; Alcohol-associated liver disease; Peroxisome proliferator-activated receptor agonists

Core Tip: This article highlights the major findings of the study written by Koizumi et al. The study demonstrated the potential of elafibranor, a peroxisome proliferator-activated receptor agonist, in mitigating liver fibrosis and improving gut barrier integrity in a mouse model of alcohol-associated liver disease. These findings underscore the promising therapeutic potential of elafibranor and its relevance in advancing treatment strategies for liver diseases linked to chronic alcohol consumption.