细胞外囊泡在非酒精性脂肪性肝病发病机制及诊断治疗中的潜在价值

The potential value of extra-cellular vesicles in the pathogenesis,diagnosis and treatment of non-alcoholic fatty liver disease

非酒精性脂肪性肝病(NAFLD)是全世界慢性肝病的最常见原因,且发病率呈上升趋势,但导致NAFLD从单纯性脂肪变性发展为非酒精性脂肪性肝炎、肝硬化及肝细胞癌的原因仍不明确。除肝活检外,尚无精确而无创的方法用于NAFLD的诊断或分期。近年来,细胞外囊泡(EVs)已成为诊断NAFLD的潜在候选生物标志物。EVs是来自不同细胞的囊泡,其中包含蛋白质、核酸及其他成分,上述成分与邻近或远处的靶细胞相互作用产生影响或交换物质。不同种类的细胞及同种细胞不同状态所产生的EVs靶向不同的细胞对NAFLD产生致病或治疗作用。本文对EVs与NAFLD发病机理中不同肝细胞类型之间的相互作用及各细胞作为NAFLD非侵入性生物标志物诊断和潜在的治疗作用予以综述。

Non-alcoholic fatty liver disease(NAFLD)is the most common cause of chronic liver disease worldwide,and the incidence is on the rise,however,the cause of progression of NAFLD from simple steatosis to nonalcoholic steatohepatitis,cirrhosis,and hepatocellular carcinoma remains unclear.Besides liver biopsy,there is no precise and non-invasive method for the diagnosis or staging of NAFLD.In recent years,extra-cellular vesicles(EVs)have emerged as potential candidate biomarkers for the diagnosis of NAFLD.EVs are vesicles from different cells that contain proteins,nucleic acids,and other components that interact with nearby or distant target cells to influence or exchange substances.EVs produced by different types of cells and different states of the same cell target different cells to have pathogenic or therapeutic effects on NAFLD.This review reviews the interactions between different hepatocyte types in the pathogenesis of EVs and NAFLD,as well as the non-invasive biomarker diagnostic and potential therapeutic effects of each cell for NAFLD.