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Precision medicine in nonalcoholic fatty liver disease: New therapeutic insights from genetics and systems biology

Clinical and Molecular Hepatology 2020년 26권 4호 p.461 ~ 475
Sookoian Silvia, Pirola Carlos J.,
소속 상세정보
 ( Sookoian Silvia ) - University of Buenos Aires School of Medicine Institute of Medical Research A Lanari
 ( Pirola Carlos J. ) - University of Buenos Aires School of Medicine Institute of Medical Research A Lanari

Abstract


Despite more than two decades of extensive research focusing on nonalcoholic fatty liver disease (NAFLD), no approved therapy for steatohepatitis?the severe histological form of the disease?presently exists. More importantly, new drugs and small molecules with diverse molecular targets on the pathways of hepatocyte injury, inflammation, and fibrosis cannot achieve the primary efficacy endpoints. Precision medicine can potentially overcome this issue, as it is founded on extensive knowledge of the druggable genome/proteome. Hence, this review summarizes significant trends and developments in precision medicine with a particular focus on new potential therapeutic discoveries modeled via systems biology approaches. In addition, we computed and simulated the potential utility of the NAFLD polygenic risk score, which could be conceptually very advantageous not only for early disease detection but also for implementing actionable measures. Incomplete knowledge of the druggable NAFLD genome severely impedes the drug discovery process and limits the likelihood of identifying robust and safe drug candidates. Thus, we close this article with some insights into emerging disciplines, such as chemical genetics, that may accelerate accurate identification of the druggable NAFLD genome/proteome.

키워드

Nonalcoholic fatty liver disease; Genetics; Steatohepatitis; Precision medicine; Complex traits

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