极长链脂肪酸在代谢相关脂肪性肝病发病机制中的作用
DOI: 10.12449/JCH260830
The role of very-long-chain fatty acids in the pathogenesis of metabolic dysfunction-associated fatty liver disease
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摘要: 代谢相关脂肪性肝病作为一种最常见的慢性肝脏疾病,已成为全球性的重大健康问题。其核心病理事件是肝脏内脂质的过度累积,继而引发脂毒性,通过介导内质网应激、氧化应激、细胞器功能障碍和铁死亡等,最终导致细胞凋亡、坏死及炎症级联反应,推动单纯性肝脂肪变性向脂肪性肝炎和纤维化进展。在此过程中,极长链脂肪酸(VLCFA)作为细胞膜和脂质代谢中的重要组成部分,其在脂毒性机制中的作用逐渐受到关注。本文综述VLCFA在脂质代谢过程及脂毒性机制中的作用,重点阐述VLCFA通过关键蛋白参与代谢调控、破坏细胞膜诱发氧化应激,及其代谢产物与衍生物驱动炎症反应,最终促进代谢相关脂肪性肝病进展的分子机制。Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease, and it has become a major global health issue. Excessive lipid accumulation in the liver is the core pathological event of MAFLD, which triggers lipotoxicity and leads to cell apoptosis, necrosis, and inflammatory cascades by mediating endoplasmic reticulum stress, oxidative stress, organelle dysfunction, and ferroptosis, thereby promoting the progression of simple hepatic steatosis to steatohepatitis and fibrosis. In this process, very-long-chain fatty acids (VLCFAs), as essential components of cell membranes and lipid metabolism, have attracted increasing attention for their role in lipotoxicity mechanisms. This article reviews the role of VLCFAs in lipid metabolism processes and lipotoxicity mechanisms, focusing on how VLCFAs participate in metabolic regulation through key proteins and disrupt cell membranes to induce oxidative stress, and how their metabolites and derivatives drive inflammatory responses, ultimately promoting the progression of MAFLD.
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注: VLCFA,极长链脂肪酸;ELOVL1,极长链脂肪酸延长酶1;SCD1,硬脂酰辅酶A去饱和酶1;UPR,未折叠蛋白应答;PERK,蛋白质激酶RNA样内质网激酶;IRE1α,肌醇需求酶1α;ATF6,激活转录因子6;ETC,电子传递链;ROS,活性氧;mPTP,线粒体通透性转换孔;Caspase,胱天蛋白酶;NLRP3,核苷酸结合寡聚结构域样受体家族热蛋白结构域相关蛋白3;IL-1β,白细胞介素1β;IL-18,白细胞介素18;MASH,代谢相关脂肪性肝炎;MAFLD,代谢相关脂肪性肝病。
图 1 VLCFA通过细胞器互作网络驱动MAFLD进展的机制
Figure 1. Schematic diagram of the mechanism by which VLCFA drive MAFLD progression through organelle interaction networks
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[1] Riazi K, Azhari H, Charette J H, et al. The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2022, 7( 9): 851- 861. DOI: 10.1016/S2468-1253(22)00165-0. [2] Rinella M E, Lazarus J V, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature[J]. J Hepatol, 2023, 79( 6): 1542- 1556. DOI: 10.1016/j.jhep.2023.06.003. [3] Powell E E, Wong V W, Rinella M. Non-alcoholic fatty liver disease[J]. Lancet, 2021, 397( 10290): 2212- 2224. DOI: 10.1016/S0140-6736(20)32511-3. [4] Iturbe-Rey S, Maccali C, Arrese M, et al. Lipotoxicity-driven metabolic dysfunction-associated steatotic liver disease(MASLD)[J]. Atherosclerosis, 2025, 400: 119053. DOI: 10.1016/j.atherosclerosis.2024.119053. [5] Lu Q Y, Zong W C, Zhang M, et al. The overlooked transformation mechanisms of VLCFAs: Peroxisomal β-oxidation[J]. Agriculture, 2022, 12( 7): 947. DOI: 10.3390/agriculture12070947. [6] Lu D L, He A Y, Tan M, et al. Liver ACOX1 regulates levels of circulating lipids that promote metabolic health through adipose remodeling[J]. Nat Commun, 2024, 15( 1): 4214. DOI: 10.1038/s41467-024-48471-2. [7] Badmus O O, Hillhouse S A, Anderson C D, et al. Molecular mechanisms of metabolic associated fatty liver disease(MAFLD): Functional analysis of lipid metabolism pathways[J]. Clin Sci(Lond), 2022, 136( 18): 1347- 1366. DOI: 10.1042/CS20220572. [8] Geng Y N, Faber K N, de Meijer V E, et al. How does hepatic lipid accumulation lead to lipotoxicity in non-alcoholic fatty liver disease?[J]. Hepatol Int, 2021, 15( 1): 21- 35. DOI: 10.1007/s12072-020-10121-2. [9] Perez V M, Gabell J, Behrens M, et al. Deletion of fatty acid transport protein 2(FATP2) in the mouse liver changes the metabolic landscape by increasing the expression of PPARα-regulated genes[J]. J Biol Chem, 2020, 295( 17): 5737- 5750. DOI: 10.1074/jbc.RA120.012730. [10] Melton E M, Cerny R L, Watkins P A, et al. Human fatty acid transport protein 2a/very long chain acyl-CoA synthetase 1(FATP2a/Acsvl1) has a preference in mediating the channeling of exogenous n-3 fatty acids into phosphatidylinositol[J]. J Biol Chem, 2011, 286( 35): 30670- 30679. DOI: 10.1074/jbc.M111.226316. [11] Zou Z Y, DiRusso C C, Ctrnacta V, et al. Fatty acid transport in Saccharomyces cerevisiae[J]. J Biol Chem, 2002, 277( 34): 31062- 31071. DOI: 10.1074/jbc.m205034200. [12] Zhang X, Luo L J, Wu Y W, et al. The role of CD36 in immune function: Bridging innate and adaptive responses[J]. Front Immunol, 2026, 17: 1728509. DOI: 10.3389/fimmu.2026.1728509. [13] Hao J W, Wang J, Guo H L, et al. CD36 facilitates fatty acid uptake by dynamic palmitoylation-regulated endocytosis[J]. Nat Commun, 2020, 11( 1): 4765. DOI: 10.1038/s41467-020-18565-8. [14] Drover V A, Nguyen D V, Bastie C C, et al. CD36 mediates both cellular uptake of very long chain fatty acids and their intestinal absorption in mice[J]. J Biol Chem, 2008, 283( 19): 13108- 13115. DOI: 10.1074/jbc.M708086200. [15] Moon Y A, Hammer R E, Horton J D. Deletion of ELOVL5 leads to fatty liver through activation of SREBP-1c in mice[J]. J Lipid Res, 2009, 50( 3): 412- 423. DOI: 10.1194/jlr.M800383-JLR200. [16] Ferrero E, Vaz F M, Cheillan D, et al. The ELOVL proteins: Very and ultra long-chain fatty acids at the crossroads between metabolic and neurodegenerative disorders[J]. Mol Genet Metab, 2025, 144( 3): 109050. DOI: 10.1016/j.ymgme.2025.109050. [17] Morita M, Imanaka T. Peroxisomal ABC transporters: Structure, function and role in disease[J]. Biochim Biophys Acta, 2012, 1822( 9): 1387- 1396. DOI: 10.1016/j.bbadis.2012.02.009. [18] Wiesinger C, Kunze M, Regelsberger G, et al. Impaired very long-chain acyl-CoA β-oxidation in human X-linked adrenoleukodystrophy fibroblasts is a direct consequence of ABCD1 transporter dysfunction[J]. J Biol Chem, 2013, 288( 26): 19269- 19279. DOI: 10.1074/jbc.M112.445445. [19] Yagita Y, Shinohara K, Abe Y, et al. Deficiency of a retinal dystrophy protein, acyl-CoA binding domain-containing 5(ACBD5), impairs peroxisomal β-oxidation of very-long-chain fatty acids[J]. J Biol Chem, 2017, 292( 2): 691- 705. DOI: 10.1074/jbc.M116.760090. [20] Ferdinandusse S, Falkenberg K D, Koster J, et al. ACBD5 deficiency causes a defect in peroxisomal very long-chain fatty acid metabolism[J]. J Med Genet, 2017, 54( 5): 330- 337. DOI: 10.1136/jmedgenet-2016-104132. [21] Deng X L, Luo Y Q, Gao Y, et al. Long-chain acyl-CoA synthetases: Biological functions, diseases and therapeutic targets[J]. Mol Biomed, 2025, 6( 1): 117. DOI: 10.1186/s43556-025-00366-4. [22] Wu L Z, Wang J Q, Wang Y W, et al. CLCC1 governs ER bilayer equilibration to maintain lipid homeostasis[J]. Nature, 2026, 652( 8109): 471- 480. DOI: 10.1038/s41586-026-10161-y. [23] Stilkerich A, Schicht G, Seidemann L, et al. Cell homeostasis or cell death-the balancing act between autophagy and apoptosis caused by steatosis-induced endoplasmic reticulum(ER) stress[J]. Cells, 2025, 14( 6): 449. DOI: 10.3390/cells14060449. [24] Elsaid S, Wu X D, Hu J K, et al. Beyond fructolysis: Ketohexokinase orchestrates ER proteostasis in nutrient-stressed hepatocytes[J]. Am J Physiol Gastrointest Liver Physiol, 2025, 329( 6): G708- G719. DOI: 10.1152/ajpgi.00235.2025. [25] Ali H, Yamanishi M, Hasi R Y, et al. Different effects of Lorenzo's oil components against very long-chain fatty acid-induced endoplasmic reticulum stress in peroxisome-deficient CHO cells[J]. Biochim Biophys Acta Mol Cell Biol Lipids, 2025, 1870( 7): 159670. DOI: 10.1016/j.bbalip.2025.159670. [26] Micoogullari Y, Basu S S, Ang J, et al. Dysregulation of very-long-chain fatty acid metabolism causes membrane saturation and induction of the unfolded protein response[J]. Mol Biol Cell, 2020, 31( 1): 7- 17. DOI: 10.1091/mbc.E19-07-0392. [27] van de Beek M C, Ofman R, Dijkstra I, et al. Lipid-induced endoplasmic reticulum stress in X-linked adrenoleukodystrophy[J]. Biochim Biophys Acta Mol Basis Dis, 2017, 1863( 9): 2255- 2265. DOI: 10.1016/j.bbadis.2017.06.003. [28] Summers S A, Chaurasia B, Holland W L. Metabolic messengers: Ceramides[J]. Nat Metab, 2019, 1( 11): 1051- 1058. DOI: 10.1038/s42255-019-0134-8. [29] Kim Y R, Lee E J, Shin K O, et al. Hepatic triglyceride accumulation via endoplasmic reticulum stress-induced SREBP-1 activation is regulated by ceramide synthases[J]. Exp Mol Med, 2019, 51( 11): 1- 16. DOI: 10.1038/s12276-019-0340-1. [30] Contreras C, González-García I, Martínez-Sánchez N, et al. Central ceramide-induced hypothalamic lipotoxicity and ER stress regulate energy balance[J]. Cell Rep, 2014, 9( 1): 366- 377. DOI: 10.1016/j.celrep.2014.08.057. [31] McNally B D, Ashley D F, Hänschke L, et al. Long-chain ceramides are cell non-autonomous signals linking lipotoxicity to endoplasmic reticulum stress in skeletal muscle[J]. Nat Commun, 2022, 13( 1): 1748. DOI: 10.1038/s41467-022-29363-9. [32] Tanaka H, Okazaki T, Aoyama S, et al. Peroxisomes control mitochondrial dynamics and the mitochondrion-dependent apoptosis pathway[J]. J Cell Sci, 2019, 132( 11): jcs224766. DOI: 10.1242/jcs.224766. [33] Marten L M, Lüttgens M S, Berečić B, et al. Mitochondrial dysfunction and impaired oxidative stress defense as potential trigger of cerebral X-linked adrenoleukodystrophy[J]. Free Radic Biol Med, 2026, 242: 654- 666. DOI: 10.1016/j.freeradbiomed.2025.10.289. [34] Zhou J, Terluk M R, Orchard P J, et al. N-acetylcysteine reverses the mitochondrial dysfunction induced by very long-chain fatty acids in murine oligodendrocyte model of adrenoleukodystrophy[J]. Biomedicines, 2021, 9( 12): 1826. DOI: 10.3390/biomedicines9121826. [35] Nury T, Doria M, Lizard G, et al. Docosahexaenoic acid attenuates mitochondrial alterations and oxidative stress leading to cell death induced by very long-chain fatty acids in a mouse oligodendrocyte model[J]. Int J Mol Sci, 2020, 21( 2): 641. DOI: 10.3390/ijms21020641. [36] Han Z N, Yan Z B, Ma Z H, et al. Targeting ABCD1-ACOX1-MET/IGF1R axis suppresses multiple myeloma[J]. Leukemia, 2025, 39( 3): 720- 733. DOI: 10.1038/s41375-025-02522-9. [37] Reyna-Bolaños I, Solís-García E P, Vargas-Vargas M A, et al. Polydatin prevents electron transport chain dysfunction and ROS overproduction paralleled by an improvement in lipid peroxidation and cardiolipin levels in iron-overloaded rat liver mitochondria[J]. Int J Mol Sci, 2024, 25( 20): 11104. DOI: 10.3390/ijms252011104. [38] Panov A V, Dikalov S I. Cardiolipin, perhydroxyl radicals, and lipid peroxidation in mitochondrial dysfunctions and aging[J]. Oxid Med Cell Longev, 2020, 2020: 1323028. DOI: 10.1155/2020/1323028. [39] Parisi L R, Sowlati-Hashjin S, Berhane I A, et al. Membrane disruption by very long chain fatty acids during necroptosis[J]. ACS Chem Biol, 2019, 14( 10): 2286- 2294. DOI: 10.1021/acschembio.9b00616. [40] Dong L W, Xiao J, Liu S, et al. Lysosomal cholesterol accumulation is commonly found in most peroxisomal disorders and reversed by 2-hydroxypropyl-β-cyclodextrin[J]. Sci China Life Sci, 2023, 66( 8): 1786- 1799. DOI: 10.1007/s11427-022-2260-4. [41] Ma C, Wang S, Dong B, et al. Metabolic reprogramming of immune cells in MASH[J]. Hepatology, 2025. DOI: 10.1097/HEP.0000000000001371.[ Epub ahead of print] [42] Raas Q, Tawbeh A, Tahri-Joutey M, et al. Peroxisomal defects in microglial cells induce a disease-associated microglial signature[J]. Front Mol Neurosci, 2023, 16: 1170313. DOI: 10.3389/fnmol.2023.1170313. [43] He A Y, Chen X W, Tan M, et al. Acetyl-CoA derived from hepatic peroxisomal β-oxidation inhibits autophagy and promotes steatosis via mTORC1 activation[J]. Mol Cell, 2020, 79( 1): 30- 42. DOI: 10.1016/j.molcel.2020.05.007. [44] Ross D, Siegel D. The diverse functionality of NQO1 and its roles in redox control[J]. Redox Biol, 2021, 41: 101950. DOI: 10.1016/j.redox.2021.101950. [45] Petrillo S, D’Amico J, Nicita F, et al. Antioxidant response in human X-linked adrenoleukodystrophy fibroblasts[J]. Antioxidants(Basel), 2022, 11( 11): 2125. DOI: 10.3390/antiox11112125. [46] Kanoh H, Nitta T, Go S, et al. Homeostatic and pathogenic roles of GM3 ganglioside molecular species in TLR4 signaling in obesity[J]. EMBO J, 2020, 39( 12): e101732. DOI: 10.15252/embj.2019101732. [47] Yanagisawa N, Shimada K, Miyazaki T, et al. Enhanced production of nitric oxide, reactive oxygen species, and pro-inflammatory cytokines in very long chain saturated fatty acid-accumulated macrophages[J]. Lipids Health Dis, 2008, 7: 48. DOI: 10.1186/1476-511X-7-48. -

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