Yu Zhao, Luting Wang, Shengrui Zhu, Rui Feng, Wei Zhang
Non-alcoholic fatty liver disease (NAFLD) affects approximately 25% of the global adult population and represents a major public health burden, characterized by disease progression from steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and potentially hepatocellular carcinoma. Despite this high prevalence and serious clinical outcomes, no pharmacologic therapies are currently approved, and standard lifestyle interventions often prove ineffective. Therefore, there is a major unmet clinical need for innovative treatments. To overcome these limitations, nanomedicine has emerged as a promising approach, with multifunctional nanoplatforms (MFNs) demonstrating distinctive advantages in tackling the complex pathology of NAFLD. For instance, MFNs enable targeted liver delivery, synergistic therapeutic effects (eg, reducing hepatic lipogenesis and fibrosis), and theranostic integration, thereby minimizing rapid clearance and adverse effects associated with conventional low-molecular-weight compounds. Consequently, this review comprehensively synthesizes the latest advances in MFNs for NAFLD management, critically analyzing their design strategies (eg, nanoencapsulation of bioactive compounds for enhanced bioavailability) and mechanistic roles in ameliorating inflammation, fibrosis, and steatosis. Furthermore, it explores challenges such as optimizing organ-specific targeting and personalized applications, while outlining future research directions to accelerate clinical translation and address coexisting conditions like chronic hepatitis B infection. By bridging current knowledge gaps, this work aims to inform the development of effective nanotherapeutic strategies for NAFLD.