Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity

Author:

Arrese Marco12,Arab Juan P.12,Barrera Francisco12,Kaufmann Benedikt3,Valenti Luca4,Feldstein Ariel E.3

Affiliation:

1. Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

2. Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile

3. Department of Pediatric Gastroenterology, Rady Children's Hospital, University of California San Diego, California

4. Department of Pathophysiology and Transplantation, Universita degli Studi di Milano, Translational Medicine, Department of Transfusion, Medicine and Hematology, Fondazione IRCCS Ca' Granda, Pad Marangoni, Milan, Italy

Abstract

AbstractThe acronym nonalcoholic fatty-liver disease (NAFLD) groups a heterogeneous patient population. Although in many patients the primary driver is metabolic dysfunction, a complex and dynamic interaction of different factors (i.e., sex, presence of one or more genetic variants, coexistence of different comorbidities, diverse microbiota composition, and various degrees of alcohol consumption among others) takes place to determine disease subphenotypes with distinct natural history and prognosis and, eventually, different response to therapy. This review aims to address this topic through the analysis 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. To improve our understanding of NAFLD heterogeneity and the dominant drivers of disease in patient subgroups would predictably impact on the development of more precision-targeted therapies for NAFLD.

Funder

Fondo Nacional De Ciencia y Tecnología de Chile

Comisión Nacional de Investigación, Ciencia y Tecnología

European Union's Horizon 2020 Research and Innovation Program

NIH

MyFirst Grant AIRC

Ricerca Finalizzata Ministero della Salute

Publisher

Georg Thieme Verlag KG

Subject

Hepatology

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