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脂肪自噬在非酒精性脂肪性肝病防治中的作用

肖智利 卢晨霞 周丹妮 陈壮壮 肖明中 李晓东

引用本文:
Citation:

脂肪自噬在非酒精性脂肪性肝病防治中的作用

DOI: 10.12449/JCH240725
基金项目: 

国家自然科学基金面上项目 (82274352);

湖北省自然科学基金 (2020CFA023);

湖北省自然科学基金 (2023AFB426);

湖北省自然科学基金 (2023AFD129);

湖北省自然科学基金 (2023AFD178)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:肖智利负责课题设计,收集与分析资料,撰写论文;卢晨霞、周丹妮参与分析资料,修改论文;陈壮壮参与收集资料;肖明中、李晓东负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    肖明中, xmz0001@sohu.com (ORCID: 0000-0002-8432-703X)

Role of lipophagy in the prevention and treatment of nonalcoholic fatty liver disease

Research funding: 

General Project of National Natural Science Foundation of China (82274352);

Natural Science Foundation of Hubei Province (2020CFA023);

Natural Science Foundation of Hubei Province (2023AFB426);

Natural Science Foundation of Hubei Province (2023AFD129);

Natural Science Foundation of Hubei Province (2023AFD178)

More Information
    Corresponding author: XIAO Mingzhong, xmz0001@sohu.com (ORCID: 0000-0002-8432-703X)
  • 摘要: 目前非酒精性脂肪性肝病在国内外流行趋势不断上升,发病率逐年增加,已严重影响人类生命健康。脂肪自噬是分子伴侣介导的自噬,具有促进脂肪分解、维持肝细胞脂质稳态、缓解肝细胞脂肪变性等作用。脂肪自噬主要包括脂滴分解、脂滴自噬和脂肪酸β氧化三个过程,受关键基因、受体、酶调控。目前中药、西药及饮食运动等干预手段在脂肪自噬研究方面取得了重要进展,为非酒精性脂肪性肝病防治策略提供了新的视角。

     

  • 图  1  脂肪自噬过程

    注: ATGL,脂肪甘油三酯脂肪酶。

    Figure  1.  The process of lipophagy

    图  2  NAFLD发展过程及其脂肪自噬的作用

    Figure  2.  The process of NAFLD development and the role of its lipophagy

    表  1  不同靶点对脂肪自噬的影响及在NAFLD中的可能作用机制

    Table  1.   Effect of different targets on lipophagy and possible mechanisms of action in NAFLD

    靶点 类型 靶点 影响 相关作用机制
    基因 TFEB16 增强 通过PGC-1α和PPARα调节参与脂质代谢相关基因
    TFE317 增强 激活PGC-lα介导的脂肪酸β氧化
    IRGM18 增强 敲除IRGM抑制细胞中的自噬通量
    SRSF319 增强 SRSF3的缺失增加STX17的泛素化和降解,阻断自噬体和溶酶体的融合
    LXRα20 减弱 转录激活microRNA let-7a-2和microRNA 34a基因,下调ATG4B和Rab-8B 抑制肝细胞中的自噬
    C9ORF7221 减弱 激活Cdc42/N-WASP轴,抑制脂肪自噬
    受体 ORP822 增强 ORP8与LC3/GABARAP相互作用,充当递送脂滴的受体
    SQSTM1/p6223 增强 (1)作为非排他性脂肪自噬受体;(2)影响溶酶体中脂滴丰度
    CD3624-25 减弱 与AMPK途径及ULK1/Beclin1的磷酸化有关
    P2RX726 增强 激活AMPK/ULK1途径
    mTORC1-Plin327 增强 mTORC1和脂滴包衣蛋白Plin3可作为对接蛋白,促进Plin3磷酸化
    ATGL 增强 促进脂肪分解过程
    STX1128 减弱 (1)调节ATGL的空间分布;(2)削弱ATGL在肝细胞中的作用
    IFGGA229 增强 (1)IFGGA2与ATGL相互作用;(2)增强LC3B与脂滴的结合
    AMPK 增强 促进脂肪自噬过程
    SIRT330 增强 (1)激活AMPK和ULK1;(2)刺激LAMP2A-HSC70-PLN2复合物的形成
    SCD131 减弱 抑制肝细胞中SCD1表达可增强AMPK活性
    过氧化物酶体32 减弱 促进RPTOR的乙酰化,激活mTOR活化抑制脂肪自噬
    下载: 导出CSV

    表  2  不同干预手段基于脂肪自噬作用防治NAFLD的研究

    Table  2.   Different interventions against NAFLD based on the role of lipophagy

    干预 相关靶点或通路 主要结论
    西药
    地高辛与阿培利司33 尚未明确 通过脂肪自噬降低肝脂肪变性,减弱炎症和促纤维化基因的表达,抑制肝纤维化
    二甲双胍34 AMPK; AMPK-SIRT1轴 通过AMPK介导的氧化降低血浆游离脂肪酸,诱导自噬和自噬通量,AMPK-SIRT1轴诱导三四脯氨酸活化,以减少肝细胞坏死性凋亡;同时破坏肝细胞中脑内富含Ras同源物mRNA的稳定性来增加脂肪自噬
    非诺贝特35 CaMKKβ-AMPK-ULK1途径; TFEB;TFE3;mTOR 通过激活钙调磷酸酶和CaMKKβ-AMPK-ULK1途径,促进TFEB、TFE3去磷酸化和核易位,并以mTOR非依赖性方式减少肝脂肪堆积
    生长分化因子1136 尚未明确 上调细胞自噬,消除高脂导致的肝细胞脂质积累,并减少ROS,提升线粒体膜电位,从而改善NAFLD
    培贝夫明37 FGF21 FGF21参与了脂肪生成、糖摄取、β氧化、炎症和纤维化等过程的调节,可显著减少NASH患者的肝脂肪
    p62激动剂38 p62 通过N-degron促进脂肪自噬,治疗小鼠肝脂肪病和肥胖症
    CAY1056631 SCD1 增强的AMPK活性促进脂肪吞噬,显著减少肝脂肪变性和肝脂滴积聚
    中药有效活性成分
    川陈皮素39 TFEB 通过TFEB介导的溶酶体生物发生和脂肪自噬来缓解肝脂肪变性,减少NOD样受体蛋白3炎症小体组装,调节体内外M1/M2巨噬细胞极化,从而减轻NAFLD
    益母草苷40 TFEB 促进TFEB介导的脂肪自噬以缓解NAFLD
    尚未明确 通过脂肪自噬途径诱导肝脂肪清除
    青钱柳提取物41
    连翘脂素42 钙调磷酸酶-TFEB轴 通过调节肝细胞中的钙调磷酸酶-TFEB轴来恢复脂肪自噬,并抑制脂质积累和炎症
    柚皮苷43 TFEB 促进自噬体和溶酶体的融合,恢复受损的自噬通量,并进一步诱导脂肪自噬,减轻肝脂肪变性
    白藜芦醇苷44 mTOR;TFEB 抑制mTOR信号传导并上调TFEB的表达和活性,恢复自噬通量改善NASH
    芒柄花黄素45 AMPK;TFEB 激活AMPK并促进TFEB的后续核易位,从而改善小鼠的肝脂肪变性
    萝卜硫素46-47 AMPK-mTOR-ULK1通路 Nrf2依赖性方式刺激脂肪自噬来增强脂滴降解,同时通过AMPK-mTOR-ULK1通路促进噬脂作用,改善肝细胞中脂滴的过度积累
    人参皂苷化合物K48 AMPK/ULK1途径;ATGL 与糖皮质激素受体结合,通过AMPK/ULK1途径激活脂肪自噬,同时促进糖皮质激素受体与ATGL启动子的结合,增加脂肪酶表达
    和厚朴酚49 SIRT3-AMPK-脂肪自噬轴 激活SIRT3-AMPK-脂肪自噬轴来改善肝细胞的脂毒性
    槲皮素50-51 AMPK 激活AMPK信号传导,促进脂肪自噬以产生线粒体中脂肪酸β氧化的底物;降低Perilipin 2水平,激活AMPK活性促进脂肪自噬,减轻肝脏脂肪的积累
    甜叶菊和甜菊糖苷52 PPARα 通过PPARα介导的脂肪自噬,减轻肝细胞中的肝脂肪变性
    缬草及其环烯醚萜53 mTORC1;Atg5 作为自噬增强剂来分解脂滴,通过抑制mTORC1活性诱导自噬,同时以Atg5依赖性方式减少脂质积累
    饮食
    高碳水化合物55 ROS-AKT-Beclin1途径 肠道脂质积聚后,通过ROS-AKT-Beclin1途径激活肠上皮细胞中的脂肪自噬,减轻葡萄糖诱导的脂质积累
    高磷饮食56 AMPK 激活AMPK通路和上调Beclin1磷酸化水平,促进脂肪自噬来减少肝脂沉积
    禁食57 FGF21 诱导FGF21信号转导,通过组蛋白去甲基化酶激活肝脏脂肪自噬和脂质降解
    饥饿后进食58 尚未明确 激活肠道中的脂肪自噬
    运动
    跑步运动60 FITM2、CIDEA和FSP27基因 降低脂滴生成以及脂滴扩张相关基因FITM2、CIDEA和FSP27的表达,促进LAMP1与脂滴的共定位,抑制异常脂滴膨胀和增强溶酶体噬脂作用,从而调节脂滴的生物发生和自噬以缓解NAFLD
    游泳运动61 AMPK/SIRT1 刺激AMPK/SIRT1激活肝脏的脂肪自噬,从而降低肝脂肪变性和胰岛素抵抗
    下载: 导出CSV
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  • 收稿日期:  2023-11-23
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