Metformin Inhibits Inflammation by Targeting the NLRP3 Inflammasome: Linking NF-κB/NEK7/AMPK Signaling to Mitochondrial Function.

Metformin, the first-line treatment for type 2 diabetes, has significant anti-inflammatory functions in addition to controlling blood glucose levels. Although metformin has been proven to inhibit NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome, the function of mitochondria in this effect has not been fully studied. This review summarizes studies on metformin that could regulate inflammation progression through the Toll-like Receptor 4/Nuclear Factor Kappa B (TLR4/NF-κB) pathway, NIMA-related kinase 7 (NEK7) pathway, AMPK pathway, and Janus kinase 2-Signal Transducer and Activator of Transcription (JAK2-STAT) pathway, with the involvement of mitochondria. The effects of metformin on the mitochondria block the key steps of NLRP3 inflammation activation, including NEK7 assembly, reactive oxygen species (ROS) activation, reduced thioredoxin-interacting protein (TXNIP) expression, and caspase 1-mediated IL-1β/IL-18 maturation. Importantly, we propose that metformin improves the pathological development of common multi-organ diseases by regulating NLRP3-inflammation pathways. These findings highlight the promising treatment potential of metformin in diseases driven by inflammasomes and make it meaningful to implement clinical trials to evaluate its efficacy in NLRP3 inflammasome-driven pathologies beyond diabetes.