Nonalcoholic fatty liver disease (NAFLD) is an emerging global health issue associated with metabolic syndrome, closely linked to obesity, insulin resistance, heightened systemic inflammation, and chronic inflammation. Chronic inflammation is increasingly recognized as a significant factor in the progression of NAFLD and its complications (
1). The precise cause of NAFLD has not been fully elucidated (
1). The progression mechanism is typically explained by the classic "multiple strikes" theory of NAFLD pathogenesis (
1). This theory suggests that lipid accumulation initiates hepatic steatosis, leading to various redox perturbations arising from adipokine secretion, inflammation, lipotoxicity, and disruptions in glucose and lipid metabolism (
1,
2). These factors can ultimately progress to non-alcoholic steatohepatitis (NASH) and cirrhosis (
2,
3). Cytokines play a crucial role as mediators of inflammation, fibrosis, and cirrhosis in NAFLD (
1-
4). Prior research has identified many inflammatory mediators, including members of the interleukin-1 (IL-1) cytokine family, which are key contributors to the progression of NAFLD. The pro-inflammatory cytokine interleukin-1β (IL-1β) is particularly significant in this context, playing a pivotal role at all stages of NAFLD, from liver steatosis to NASH and fibrosis. IL-1β is synthesized as an inactive protein and requires proteolytic cleavage to become biologically active (
5,
6).
Various pathways may trigger the activation of IL-1β in NAFLD. This cytokine is primarily secreted by activated macrophages and monocytes. It promotes liver steatosis, inflammation, and fibrosis by signaling through the IL-1 receptor, which is widely expressed on several liver cell subpopulations. Interleukin--1β induces hepatic steatosis by increasing triglyceride and cholesterol accumulation in primary liver hepatocytes and promoting the formation of lipid droplets (
5-
7). Elevated levels of reactive oxygen species (ROS) in mitochondria disrupt the redox balance, triggering an inflammatory response and activating NF-κB (
8). Once activated, NF-κB translocates to the nucleus, initiating the transcription of genes such as interleukin-1 beta (
8).
Mouse model studies have shown that IL-1β, along with interleukin-6 (IL-6) and TNF, triggers immune responses in the liver, resulting in chronic inflammation. This process impairs the body's defenses by reducing the activity of anti-inflammatory cytokines such as IL-4. Interleukin-4, a multifunctional cytokine primarily produced by activated T cells, mast cells, basophils, and eosinophils, exhibits anti-inflammatory properties by suppressing the production of tumor necrosis factor (TNF)-α and IL-1β (
9). Research has shown that IL-4 levels are elevated in non-alcoholic steatohepatitis, potentially increasing the risk of NAFLD (
10,
11).
Glucocorticoids have been proposed as a potential treatment for NAFLD across all stages (
12). They increase the release of fatty acids from adipose tissue and stimulate their uptake by the liver (
12). It is well-documented that plasma triglycerides and free fatty acid (FFA) levels rise in response to glucocorticoids (
12). On the other hand, glucocorticoids exert an anti-inflammatory effect by suppressing the expression of inflammatory genes under various inflammatory conditions (
12,
13). Glucocorticoids inhibit the production of cytokines, chemokines, adhesion molecules, and other inflammatory proteins, thereby preventing the migration of inflammatory cells to inflamed areas (
12,
13).
Additionally, glucocorticoids suppress the production of inflammatory mediators in macrophages and other cells, making them effective in treating various inflammatory diseases caused by immune system dysregulation (
14). Studies have shown that neutrophils activated with TNF-α in vitro produce significant amounts of IL-1β, but the production of IL-1β is inhibited by dexamethasone, which dampens the immune response (
15).
Metabolic disorders, including NAFLD, are significant factors that disrupt redox homeostasis, inducing metaflammation in liver tissue and systemic blood circulation. Various methods exist to modulate the body's inflammatory state; among the non-invasive approaches, the use of minerals and trace elements (MTEs) is noteworthy. Selenium is an essential mineral that plays a pivotal antioxidant role as part of the structure of antioxidant enzymes, such as selenoproteins (
16). Its antioxidant properties help break down peroxides that can disrupt tissue and DNA homeostasis, causing inflammation and associated health issues (
17). Selenium supplementation may influence inflammatory processes, glucose regulation, and oxidative stress by suppressing the formation of advanced glycation end products (AGEs) and reducing the production of free radicals and lipid hydroperoxides (
18).
In addition, another non-invasive and non-pharmacological approach for improving and regulating inflammation and related disorders is physical exercise. The modulating effects of exercise training on immunological and oxidative stress responses are widely recognized across bodily fluids, organs, and tissues (
19). Studies have shown that high-intensity interval training (HIIT) can increase pro-inflammatory cytokines, which subsequently stimulate the production of anti-inflammatory cytokines such as IL-4 (
20). High-intensity interval training consists of short, intense efforts followed by periods of rest or low-intensity activity (
19,
20) and is recognized as an effective method for enhancing the body's inflammatory and metabolic responses (
19,
20).
Hooshangi et al. (2022) demonstrated that a 4-week application of HIIT combined with nanoselenium supplementation resulted in elevated gene expression levels of interleukin-4 and reduced interferon-γ, indicating anti-inflammatory effects (
21). Hamedchaman et al. reported that HIIT elicited antioxidant responses in rat testis tissue (
19). However, prolonged intensive interval training in various conditions has been shown to negatively impact immune system indices (
19).