免疫代谢与非酒精性脂肪性肝炎(2017年第九届全国疑难及重症肝病大会专家报告).pdfVIP

免疫代谢 非酒精性脂肪性肝病 Immunometabolism NAFLD 马 雄 上海市消化疾病研究所 上海交通大学医学院附属仁济医院 Immunometabolism Immunometabolism segregate along two paths: The effects of immune cells on organs that regulate whole-body metabolism, such as adipose tissue and liver. The role of metabolic pathways within immune cells and how this regulates immune response outcome. Pearce EL, Pearce EJ. Immunity. 2013;38:633-43. A guide to immunometabolism for immunologists ONeill LA, et al. Nat Rev Immunol. 2016;16:553-65. Systemic to Cellular Immunometabolic Crosstalk Norata GD, et al. Immunity. 2015;43:421-34. NASH and associated morbidity Risk factors for  progression Hepatic Decompensation •Age HCC Risk •Obesity •DM CVD Risk Progression Abbreviations: CVD, cardiovascular disease; DM, diabetes mellitus; HCC, hepatocellular carcinoma. “二次打击”学说 单纯性脂肪肝 良性 病程 胰岛素 炎症免疫 抵抗 调控异常 纤维化 肝硬化 脂肪性肝炎 6 The metabolic and hormonal interplay between liver and adipose tissues Scheja L, et al. J Hepatol. 2016;64:1176-86. Evolution of inflammation in NAFLD: the multiple parallel hits hypothesis