Potential Role of Dexamphetamine in the Treatment of Non-alcoholic Fatty Liver Disease: Hopes and Pitfalls.

TouchREVIEWS in endocrinology Pub Date : 2021-04-01 Epub Date: 2021-04-28 DOI:10.17925/EE.2021.17.1.33
C S Gautam, Jatin Sharma, Mandeep Singla, Ilmjot Kaur Tiwana, Harmanjit Singh
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引用次数: 1

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of most frequent causes of chronic liver disease. Global prevalence of NAFLD and nonalcoholic steatohepatitis (NASH) with advanced fibrosis is increasing day by day. Patients with NAFLD are more susceptible to encounter cardiovascular morbidity and mortality. Apart from lifestyle changes and dietary modifications, no effective pharmacotherapy is available to prevent the progression of NAFLD to NASH and advanced stages of hepatic fibrosis and cirrhosis. Dexamphetamine is the d-isomer of amphetamine, which acts by inhibiting monoamine reuptake and direct stimulation of dopamine and noradrenaline release. Presently, dexamphetamine is indicated for the treatment of attention deficit hyperactivity disorder and narcolepsy, but since its use was found to be associated with weight loss, it is also now used as an off-label drug for the treatment of obesity. Direct or indirect evidence is present in the form case reports, case series and from effects of related drugs to support the potential role of dexamphetamine in NAFLD. There is an urgent need to initiate preclinical and clinical studies involving robust methodology and adequate sample sizes to explore the potential of dexamphetamine in patients with NAFLD. In this review, we will discuss the therapeutic potential of dexamphetamine for the treatment of NAFLD.

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右旋苯丙胺在治疗非酒精性脂肪肝中的潜在作用:希望与缺陷
非酒精性脂肪性肝病(NAFLD)是慢性肝病最常见的病因之一。NAFLD和非酒精性脂肪性肝炎(NASH)伴晚期纤维化的全球患病率日益增加。NAFLD患者更容易发生心血管疾病和死亡。除了生活方式的改变和饮食的改变,没有有效的药物治疗可用于预防NAFLD进展为NASH和晚期肝纤维化和肝硬化。右旋安非他明是安非他明的d型异构体,通过抑制单胺再摄取和直接刺激多巴胺和去甲肾上腺素的释放而起作用。目前,右安非他明被用于治疗注意力缺陷多动障碍和嗜睡症,但由于它的使用被发现与体重减轻有关,它现在也被用作治疗肥胖的标签外药物。直接或间接的证据以病例报告、病例系列和相关药物效应的形式存在,支持右安非他明在NAFLD中的潜在作用。迫切需要开展临床前和临床研究,包括可靠的方法和足够的样本量,以探索右安非他明在NAFLD患者中的潜力。在这篇综述中,我们将讨论右安非他明治疗NAFLD的治疗潜力。
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