Evidence map›Paper›PMID 34931080›Full record

ReviewNature metabolism2021

Non-alcoholic fatty liver disease: the interplay between metabolism, microbes and immunity.

Herbert Tilg, Timon E Adolph, Michael Dudek, Percy Knolle

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 300 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
300citing papers in PubMed, 7 pooled it
42.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

300 citing papers in PubMed, 7 syntheses or guidelines pooled it, 431 citations in OpenAlex.

  1. Pooled it
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  5. Efficacy of interventions with live combinedFrontiers in pharmacology · 2025
    Pooled it
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  16. The Polyphenol-EnrichedFoods (Basel, Switzerland) · 2026
    Article
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240 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Herbert TilgDepartment of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria. herbert.tilg@i-med.ac.at.ORCID http://orcid.org/0000-0002-4235-2579
Timon E AdolphDepartment of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.ORCID http://orcid.org/0000-0002-4736-830X
Michael DudekInstitute of Molecular Immunology and Experimental Oncology, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
Percy KnolleInstitute of Molecular Immunology and Experimental Oncology, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
Innsbruck Medical University · ATTechnical University of Munich · DE

Funding

Austrian Science Fund FWF P 29379Austrian Science Fund FWF P 33070
6 · The paper itself

Abstract

Non-alcoholic fatty liver disease (NAFLD) has emerged pandemically across the globe and particularly affects patients with obesity and type 2 diabetes. NAFLD is a complex systemic disease that is characterised by hepatic lipid accumulation, lipotoxicity, insulin resistance, gut dysbiosis and inflammation. In this review, we discuss how metabolic dysregulation, the gut microbiome, innate and adaptive immunity and their interplay contribute to NAFLD pathology. Lipotoxicity has been shown to instigate liver injury, inflammation and insulin resistance. Synchronous metabolic dysfunction, obesity and related nutritional perturbation may alter the gut microbiome, in turn fuelling hepatic and systemic inflammation by direct activation of innate and adaptive immune responses. We review evidence suggesting that, collectively, these unresolved exogenous and endogenous cues drive liver injury, culminating in liver fibrosis and advanced sequelae of this disorder such as liver cirrhosis and hepatocellular carcinoma. Understanding NAFLD as a complex interplay between metabolism, gut microbiota and the immune response will challenge the clinical perception of NAFLD and open new therapeutic avenues.

Indexed as

Disease SusceptibilityEnergy MetabolismImmunityMicrobiotaAdaptive ImmunityAnimalsDiabetes Mellitus, Type 2Endoplasmic Reticulum StressGastrointestinal MicrobiomeHumansImmunity, InnateInsulin ResistanceLipid MetabolismNon-alcoholic Fatty Liver DiseaseObesitySugarsSugars

Identifiers

PMID34931080
OpenAlexW4200440801

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.