Therapeutic targets, novel drugs, and delivery systems for diabetes associated NAFLD and liver fibrosis

V Kumar, X Xin, J Ma, C Tan, N Osna… - Advanced drug delivery …, 2021 - Elsevier
Advanced drug delivery reviews, 2021Elsevier
Type 2 diabetes mellitus (T2DM) associated non-alcoholic fatty liver disease (NAFLD) is the
fourth-leading cause of death. Hyperglycemia induces various complications, including
nephropathy, cirrhosis and eventually hepatocellular carcinoma (HCC). There are several
etiological factors leading to liver disease development, which involve insulin resistance and
oxidative stress. Free fatty acid (FFA) accumulation in the liver exerts oxidative and
endoplasmic reticulum (ER) stresses. Hepatocyte injury induces release of inflammatory …
Abstract
Type 2 diabetes mellitus (T2DM) associated non-alcoholic fatty liver disease (NAFLD) is the fourth-leading cause of death. Hyperglycemia induces various complications, including nephropathy, cirrhosis and eventually hepatocellular carcinoma (HCC). There are several etiological factors leading to liver disease development, which involve insulin resistance and oxidative stress. Free fatty acid (FFA) accumulation in the liver exerts oxidative and endoplasmic reticulum (ER) stresses. Hepatocyte injury induces release of inflammatory cytokines from Kupffer cells (KCs), which are responsible for activating hepatic stellate cells (HSCs). In this review, we will discuss various molecular targets for treating chronic liver diseases, including homeostasis of FFA, lipid metabolism, and decrease in hepatocyte apoptosis, role of growth factors, and regulation of epithelial-to-mesenchymal transition (EMT) and HSC activation. This review will also critically assess different strategies to enhance drug delivery to different cell types. Targeting nanocarriers to specific liver cell types have the potential to increase efficacy and suppress off-target effects.
Elsevier
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