Understanding the Role of Exercise in Nonalcoholic Fatty Liver Disease: ERS-Linked Molecular Pathways

Figure 2

ERS-linked molecular pathways by which exercise alleviates NAFLD. Exercise maintains ERS at a certain level essential for hepatic lipid homeostasis. First, acute exercise including aerobic and resistance exercise induces ROS production and Ca²⁺ disorders, which evoke the UPR and the resulting ERS. This is conducive to elevate hepatic tolerance against higher ERS and the clearance of misfolded proteins. Second, regular exercise suppresses the activation of UPR and excessive ERS, thereby reducing lipid accumulation, inflammation, insulin resistance, and hepatocyte lipoapoptosis through IRE-1α- and PERK-mediated pathways.