Abstract
Fatty liver disease and steatohepatitis commonly occur in individuals with both metabolic syndrome and excessive alcohol intake. Therefore, the term “metabolic dysfunction–associated steatotic liver disease (MASLD)” has been proposed in 2023 to better reflect these risk factors and the continuum of disease progression. Various factors communicate between parenchymal cells (hepatocytes) and non–parenchymal cells, contributing to the progression from simple lipid accumulation to steatohepatitis, and from mild fibrosis to cirrhosis. Adipose tissue is also associated with MASLD, given the presence of metabolic risk factors like insulin resistance. Extracellular vesicles (EVs), which are membrane–bound endogenous nanoparticles released into the extracellular space by a majority of cell types, are internalized into target cells, facilitating the transfer of bioinformation reflecting the state of the donor cell to the recipient in liver diseases. Moreover, EV composition, such as cellular microRNAs and proteins, can serve as a biomarker to identify the degree and type of liver disease. However, inhibiting specific EV composition as a therapeutic approach may be challenging in real–world scenarios. Current global evidence suggests that EVs derived from mesenchymal stem cells play a crucial role in regulating the immune response, prompting clinical trials for liver disease treatment.
