Pathogenetic mechanisms of nonalcoholic fatty liver disease and inhibition of the inflammasome as a new therapeutic target

• Published in: Clinics and research in hepatology and gastroenterology Vol. 45; no. 4; p. 101710
• Main Authors: Colak, Yasar, Hasan, Badar, Erkalma, Banu, Tandon, Kanwarpreet, Zervos, Xaralambos, Menzo, Emanuele Lo, Erim, Tolga
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.07.2021
• Subjects: Humans; Inflammasome; Inflammasomes - antagonists & inhibitors; Inflammasomes - metabolism; NLR Family, Pyrin Domain-Containing 3 Protein - antagonists & inhibitors; NLR Family, Pyrin Domain-Containing 3 Protein - metabolism; NLRP3 inflammasome; Non-alcoholic Fatty Liver Disease - drug therapy; Non-alcoholic Fatty Liver Disease - pathology; Nonalcoholic fatty liver disease; NAFLD; PRRs; HFD; Inflammasome; NLRP3 inflammasome; CARD; DAMPs; ASC; NF-κB; IL1-R; CASP1; FAs; NLRP3; PAMPs; Nonalcoholic fatty liver disease; TLR; GSDMD; NOD; IL; LPSs; NASH; NAIPs; AIM2; ZO-1; GLA
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2021.101710

•The nonalcoholic fatty disease is currently the most common liver disease in the United States.•Lifestyle modification remains the primary therapy as no pharmacological therapy has been approved.•NLR family pyrin domain-containing protein 3 (NLRP3) inflammasome plays a critical role in the inflammatory stimuli and its response in the gut–liver axis.•Inhibition of inflammasome could be a potential therapeutic target in the treatment of nonalcoholic steatohepatitis. Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and its incidence is increasing. Nonalcoholic steatohepatitis (NASH), the progressive form of the disease, can lead to end-stage liver disease. The pathogenesis of the disease is not fully understood, and there is currently no specific treatment. Therefore, an effective and reliable treatment modality is needed. In recent years, the inflammasome has been shown to play a vital role in many stages of NAFLD pathogenesis. In particular, the detection, by toll-like receptors, of pathogen-associated molecular patterns induced by the gut–liver axis triggers the formation of the NLRP3 (NLR family pyrin domain-containing protein 3) inflammasome. Stimulation of damage-associated molecular patterns also activates the NLRP3 inflammasome. The activated inflammasome has caspase-1 activity, which leads to the release of interleukin (IL)-1 and IL-18 and formation of pores in the cell wall. This process spreads the inflammatory process to the outside of the cell and induces inflammatory cell death (pyroptosis). Subsequent progression of the inflammatory process leads to fibrosis. Recent evidence suggests that the NLRP3 inflammasome may be a potential target for the treatment of NASH. The discovery of specific NLRP3 inflammasome blockers in recent years and evidence of their positive effects in experimental models support this therapeutic approach. In this article, we discuss recent evidence on the pathogenesis of NAFLD, the role of the inflammasome in the pathogenesis of NAFLD, and the potential effects of inhibition of the inflammasome.