Nonalcoholic fatty liver disease (NAFLD) is globally prevalent and characterized by abnormal lipid accumulation in the liver, frequently accompanied by insulin resistance (IR), enhanced hepatic inflammation, and apoptosis. Recent studies showed that endoplasmic reticulum stress (ERS) at the subcellular level underlies these featured pathologies in the development of NAFLD. As an effective treatment, exercise significantly reduces hepatic lipid accumulation and thus alleviates NAFLD. Confusingly, these benefits of exercise are associated with increased or decreased ERS in the liver. Further, the interaction between diet, medication, exercise types, and intensity in ERS regulation is more confusing, though most studies have confirmed the benefits of exercise. In this review, we focus on understanding the role of exercise-modulated ERS in NAFLD and ERS-linked molecular pathways. Moderate ERS is an essential signaling for hepatic lipid homeostasis. Higher ERS may lead to increased inflammation and apoptosis in the liver, while lower ERS may lead to the accumulation of misfolded proteins. Therefore, exercise acts like an igniter or extinguisher to keep ERS at an appropriate level by turning it up or down, which depends on diet, medications, exercise intensity, etc. Exercise not only enhances hepatic tolerance to ERS but also prevents the malignant development of steatosis due to excessive ERS.

中文翻译：

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了解运动在非酒精性脂肪肝中的作用：ERS 相关分子途径。


非酒精性脂肪性肝病（NAFLD）在全球范围内普遍存在，其特征是肝脏中脂质异常积累，常常伴有胰岛素抵抗（IR）、肝脏炎症增强和细胞凋亡。最近的研究表明，亚细胞水平的内质网应激（ERS）是 NAFLD 发展过程中这些特征病理的基础。作为一种有效的治疗方法，运动可显着减少肝脏脂质积累，从而缓解 NAFLD。令人困惑的是，运动的这些好处与肝脏 ERS ​​的增加或减少有关。此外，饮食、药物、运动类型和 ERS ​​调节强度之间的相互作用更加令人困惑，尽管大多数研究已经证实了运动的好处。在这篇综述中，我们重点了解运动调节的 ERS ​​在 NAFLD 和 ERS ​​相关分子通路中的作用。中等 ERS ​​是肝脂质稳态的重要信号。较高的 ERS ​​可能导致肝脏炎症和细胞凋亡增加，而较低的 ERS ​​可能导致错误折叠蛋白的积累。因此，运动就像点火器或灭火器一样，通过升高或降低ERS使ERS保持在适当的水平，这取决于饮食、药物、运动强度等。运动不仅可以增强肝脏对ERS的耐受性，还可以预防ERS的恶性发展。 ERS 过多导致脂肪变性。