Metabolomic features of energy metabolic dysregulation and related targeted therapeutic strategies in acute-on-chronic liver failure
- VernacularTitle:慢加急性肝衰竭能量代谢紊乱的代谢组学特征及相关靶向治疗策略
- Author:
Xinxin CHEN
1
;
Juan LUO
1
;
Fengqin YE
1
;
Zhengyuan MO
1
;
Xiufeng WANG
2
Author Information
- Publication Type:Review
- Keywords: Acute-On-Chronic Liver Failure; Energy Metabolism; Metabolomics
- From: Journal of Clinical Hepatology 2026;42(7):1710-1716
- CountryChina
- Language:Chinese
- Abstract: Acute-on-chronic liver failure is an acute decompensated syndrome that occurs on the basis of chronic liver disease and is characterized by a high short-term mortality rate. Metabolomics reveals the presence of significant energy metabolic reprogramming， manifesting as extensive dysregulation of glucose/lipid/amino acid metabolism， mitochondrial metabolism， and intestinal flora， and it closely interacts with systemic inflammation and immune imbalance， jointly promoting disease progression. The core metabolic phenotypes include suppressed gluconeogenesis， enhanced glycolysis， impaired β-oxidation， inhibited mitochondrial oxidative phosphorylation， ammonia metabolic imbalance， and gut microbiota dysbiosis. This article analyzes the latest studies on metabolomic and molecular mechanisms and systematically reviews the dysregulation characteristics of the five major metabolic networks. In terms of intervention for energy metabolism， this article summarizes the five strategies of glucose metabolism regulation， lipid metabolism intervention， mitochondria-targeted protection， gut microbiota rebalancing， and amino-acid optimization and assesses their application value and prospects for clinical translation， so as to provide a scientific basis for the treatment， alleviation， and even reversal of disease progression.
