非酒精性脂肪性肝炎免疫细胞调控与治疗研究现状  

Research status of immune cell regulation and therapy in non-alcoholic steatohepatitis

作　　者：郭释琦 邢骋 葛云鹏 石浩伟 郑洋洋 宋京海 Guo Shiqi;Xing Cheng;Ge Yunpeng;Shi Haowei;Zheng Yangyang;Song Jinghai(Graduate School of Peking Union Medical College,Beijing 100730,China;General Surgery Department of Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京协和医学院研究生院,北京100730 [2]北京医院,中国医学科学院老年医学研究院,国家老年医学中心普通外科,北京100730

出　　处：《临床普外科电子杂志》2025年第1期25-32,54,共9页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：中央高水平医院临床科研业务费(BJ-2023-083)。

摘　　要：随着全球代谢性疾病患病率逐年上升,代谢相关的非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)已经成为最常见的慢性肝病,NAFLD疾病谱包括初期的肝脏脂肪变性以及进展期的非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)、肝硬化与肝细胞癌(hepatic cell carcinoma,HCC)。在NASH阶段,脂肪毒性和肝细胞炎性损害极大增加了终末期肝病的发生风险。截至目前,全球针对治疗NASH的临床试验已有1400余项,但没有任何特异性药物获批,也没有有效的NASH相关HCC的治疗方案。即便是对于较新兴的免疫检查点抑制剂治疗,NASH相关HCC也表现出明显的免疫治疗耐药。多数研究显示,固有免疫与适应性免疫细胞亚群介导的免疫微环境的改变对NASH起病和进展起到重要作用。本文重点阐述多种免疫细胞在NASH中作用机制以及相关治疗研究现状,旨在为了解NASH免疫微环境以及探索新研究方向提供参考。With the global prevalence of metabolic diseases increasing year by year,metabolism related non-alcoholic fatty liver disease(NAFLD)has become the most common chronic liver disease.NAFLD disease spectrum included initial liver steatosis,advanced non-alcoholic steatohepatitis(NASH),liver cirrhosis and hepatocellular carcinoma(HCC).In NASH stage,lipotoxicity and inflammatory damage of hepatocytes greatly increase the risk of end-stage liver disease.So far,there have been more than 1400 clinical trials for the treatment of Nash worldwide,but no specifi c drugs have been approved with no eff ective treatment for NASH related HCC.Even for emerging immunotherapy,NASH related HCC also showed signifi cant resistance to immunotherapy.The changes of immune microenvironment mediated by innate and adaptive immune cell subsets play an important role in the onset and progression of NASH.Thi s review focuses on the mechanism of a variety of immune cells in NASH and the research status of related immunotherapy,in order to provide reference for understanding the immune microenvironment of NASH and exploring new research directions.

关 键 词：非酒精性脂肪性肝炎 免疫细胞 固有免疫 适应性免疫 治疗 

分 类 号：R575[医药卫生—消化系统]