非酒精性脂肪性肝炎（NASH）已成为全球慢性肝病的主要原因，由于肥胖流行病的加剧，其患病率正在迅速增加。目前尚无美国食品药品监督管理局（FDA）批准的用于治疗NASH的药物，因此迫切需要开发新的治疗方法，以阻止或逆转肝纤维化、肝硬化和肝细胞癌的发展。迄今为止，单一药物治疗NASH的临床试验显示出令人失望的疗效。目前正在探索针对NASH疾病发病机制底层不同靶标的联合治疗策略。正在开发新型RNA疗法，以攻击以前“无法用药”而闻名的靶标，离实用治疗方法越来越近。辨别循环生物标志物以作为有价值的非侵入性诊断工具，以指导临床实践对于纤维化至关重要。尽管在转化和临床研究方面取得了一些进展，然而有效治疗方法缺乏的一个主要原因是我们对于从脂肪肝到NASH进展及其最致命后果-纤维化的病理生理学尚未完全理解。多组学平台将有助于推动NASH和肝病精准医学的有效发展。© 2022 作者，由德古意特（De Gruyter）出版，柏林/波士顿。

Nonalcoholic steatohepatitis (NASH) has emerged as the leading cause of chronic liver disease worldwide and is rapidly increasing in prevalence due to the obesity epidemic. There are currently no Food and Drug Administration (FDA) approved drugs to treat NASH, and therefore a critical need exists for novel therapies that can halt or reverse the progression to hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Clinical trials to date using single drugs to treat NASH have shown disappointing efficacy. Combination therapies to attack different targets underlying disease pathogenesis of NASH are being explored as a strategy currently. Novel RNA therapies are also being developed to target previously "undruggable" targets and are close to the maturity necessary to be viable therapeutic approaches for the treatment of NASH and fibrosis. Identifying circulating biomarkers of fibrosis could serve as a valuable, non-invasive diagnostic tool to guide clinical practice. Despite progress in translational and clinical research, one of the major reasons for the absence of effective therapeutics is our incomplete understanding of the pathophysiology that underlies the progression from steatosis to NASH and its most deadly consequence-fibrosis. Multi-omics platforms will help to drive effective precision medicine development in NASH and hepatology.© 2022 the author(s), published by De Gruyter, Berlin/Boston.