From:  The role of the resveratrol-sirtuin axis in the treatment of metabolic dysfunction-associated diseases

 The role of the RSV-SIRT axis in the treatment of MASLD.

RSV-targeted
SIRTS
Mechanisms of actionRegulation of substrates and pathwaysRoles in diseasesResearch objectsReferences
Not applicable↑Thrombospondin-2 as a predictive biomarkerThrombospondin-2 levels correlate with HCC risk after HCV cure.Predicts HCC occurrence post-DAA treatment.HCV-infected patients treated with DAAs[72]
SIRT1↑SIRT1
↓Lipogenesis
↓Inflammation
RSV activates SIRT1, which decreases lipogenesis and inflammation.Alleviates hepatic steatosis in obese mice.High-fat diet-fed mice[73]
SIRT1↑SIRT1
↓TGF-β/Smad signaling
SIRT1 activation inhibits TGF-β/Smad pathway.Ameliorates liver fibrosis.Rhesus monkeys with liver fibrosis; aged rats with liver fibrosis[71]
SIRT1↑SIRT1
↓p53-related senescence
↓NLRP3 inflammation
Deacetylation of HnRNP U by SIRT1 inhibits cellular senescence and suppresses NLRP3 inflammasome activation in liver fibrosis.Contributes to the amelioration of liver fibrosis.Aged rats with liver fibrosis[81]
SIRT1-independent↑OBRb expression, ↑Leptin sensitivityRSV increases long-form OBRb content, enhancing leptin-induced STAT3 phosphorylation and reducing triglyceride accumulation.Improves hepatic steatosis by restoring leptin signaling.Palmitate-induced steatotic HepG2 cells[77]
SIRT1↑SIRT1 activity
↓STAT3 phosphorylation
↓HSC proliferation
Pterostilbene (RSV analog) inhibits excessive proliferation of activated HSCs through crosstalk between SIRT1 and STAT3 pathways.Alleviates liver fibrosis by reducing HSC activation.Activated HSCs[79]
SIRT1↑SIRT1, regulation of SREBPs
↓Lipid synthesis
SIRT1 regulates SREBPs to control lipid metabolism.Contributes to the improvement of NAFLD and metabolic syndrome.Palmitate-induced steatotic HepG2 cells[77]
SIRT1↑SIRT1, deacetylation of PGC-1α
↑Mitochondrial fatty acid oxidation
SIRT1-mediated deacetylation of PGC-1α improves mitochondrial fatty acid oxidation.Alleviates hepatic steatosis in type 2 diabetes.Animal model of type 2 diabetes mellitus with hepatic steatosis[75]

DAAs: direct-acting antivirals; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; HnRNP U: heterogeneous nuclear ribonucleoprotein U; HSCs: hepatic stellate cells; MASLD: metabolic dysfunction-associated steatotic liver disease; NAFLD: non-alcoholic fatty liver disease; NLRP3: NOD-like receptor family, pyrin domain-containing 3; OBRb: leptin receptor isoform b; p53: tumor protein p53; PGC-1α: peroxisome proliferator-activated receptor gamma coactivator 1-alpha; RSV: resveratrol; SIRT: sirtuin; SREBPs: sterol regulatory element-binding proteins; STAT3: signal transducer and activator of transcription 3; TGF-β: transforming growth factor-β.