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. 2022 Oct 3;13:999412. doi: 10.3389/fimmu.2022.999412

Figure 2.

Figure 2

Protective effects of helminths and their products in NAFLD. ① Helminth infection and its derived products regulate glucose metabolism, alleviate insulin resistance, and improve insulin sensitivity; they also affect lipid metabolism and reduce lipogenesis through the Erk-Ap1-Fxrα axis; ②secrete anti-inflammatory cytokines by inducing type 2 immunity and M2 macrophage polarization; ③ influence the composition of gut microbiota through the liver-gut axis, increase the level of fecal SCFAs and upregulate the expression of its main receptors, GPRs, thereby coordinating multiple signaling pathways to prevent obesity. Meanwhile, the increase of tight junction proteins leads to the decrease of intestinal permeability and the expansion of the dominant bacteria, causing the increase of intestinal microbial abundance and diversity. NAFLD, nonalcoholic fatty liver disease; T2DM, type 2 diabetes mellitus; TG, triglyceride; IR, insulin resistance; IL, interleukin; LPS, lipopolysaccharide; Erk, extracellular signal-regulated kinase; AP-1, activator protein-1; Fxrα, farnesoid X receptor alpha; Th2, T helper type 2; M2, alternatively activated macrophage; ILC2, type 2 innate lymphoid cell; Ig, immunoglobulin; SCFAs, short chain fatty acids; GRPs, g-protein coupled receptors.