PNPLA3 as a therapeutic target for fatty liver disease: the evidence to date
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Introduction An interaction between metabolic triggers and inherited predisposition underpins the development and progression of non alcoholic fatty liver disease (NAFLD) and fatty liver disease in general. Among the specific NAFLD risk variants, PNPLA3 rs738409 C>G, encoding for the p.I148M protein variant, accounts for the largest fraction of liver disease heritability and is being intensively scrutinized. It promotes intrahepatic lipid accumulation and is associated with lipotoxicity and the more severe phenotypes, including fibrosis and carcinogenesis. Therefore, PNPLA3 appears as an appealing therapeutic target to counter NAFLD progression.Areas covered The scope of this review is to briefly describe the PNPLA3 gene and protein function before discussing therapeutic approaches for fatty liver aiming at this target. Literature review was carried out searching through PubMed and clinicaltrials.gov website and focusing on the most recent works and reviews.Expert opinion The main therapeutic strategies under development for NAFLD have shown variable efficacy and side-effects likely due to disease heterogeneity and lack of engagement of the main pathogenic drivers of liver disease. To overcome these limitations, new strategies are becoming available for targeting PNPLA3 p.I148M, responsible for a large fraction of disease susceptibility.
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- Authors
- Cherubini, A., Casirati, E., Tomasi, M., & Valenti, L.
- Affiliations
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Milan (IT)
- Corresponding author
- Valenti, Luca
- Venue
- Expert Opinion on Therapeutic Targets
- Publisher
- Informa UK Limited
- Published
- 2021-12-02
- Volume
- 25
- Issue
- 12
- Pages
- 1033-1043
- ISSN
- 1472-8222 (ISSN-L)
- 1744-7631
- OpenAlex
- W4200065618
- Cited by
- 79
- References
- 88
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 24 · 2023: 14 · 2022: 4
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Expert Opinion on Therapeutic Targets (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Funders
- the Italian Ministry of Health
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Keywords
- PNPLA3, non-alcoholic fatty liver disease, therapeutic target, lipotoxicity, liver fibrosis, hepatocellular carcinoma, genetic susceptibility, disease heterogeneity
- MeSH terms
- Genotype, Humans, Lipase, Liver, Membrane Proteins, Genetic Predisposition to Disease, Polymorphism, Single Nucleotide, Non-alcoholic Fatty Liver Disease
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